Quality means safety

BMC gets high marks for quality care

“People can make mistakes, so you have to have systems to help people not make those mistakes, duplicate systems where you have two or three balancing checks,” said Dr. Mark Spektor, chief executive officer for Bayonne Medical Center, explaining why his hospital was honored with an “A” Hospital Safety Score by The Leapfrog Group, an independent national nonprofit run by employers and other large purchasers of health benefits. “So we have systems in place that will not allow that to happen or one to prevent medication error.”
Spektor said it is really a matter of having a culture of concern for safety.
The A score was awarded in the latest update to the Hospital Safety Score. The A, B, C, D or F scores assigned to U.S. hospitals based on the number of preventable medical errors, injuries, accidents, and infections. The Hospital Safety Score was compiled under the guidance of the nation’s leading experts on patient safety and is designed to give the public information they can use to protect themselves and their families.
“Hospitals like this that earn an A have demonstrated their commitment to their patients and their community,” said Leah Binder, president and CEO of The Leapfrog Group. “I congratulate Bayonne Medical Center for its safety excellence, and look forward to the day when all hospitals will match this standard.”
This is a measure of how well a hospital protected patients from mistakes, infections and injuries over the last year with only 30 percent of the nation’s hospitals received a grade A from this group.
The score is compiled based on a survey supplied by the hospital as well as public records of activities at the hospital and covers everything from falls to bed sores, all of which are considered preventable.
This is the second time BMC was reviewed by this group. In June, the group evaluated data from 2010 and received a score of C. The group reviewed activities a relatively short time after the hospital had been sold to new owners. The first time, nobody knew they were doing it,” Spektor said. “And we did not participate in it. It is not a requirement from the state. This year we decided we were going to answer the survey. The report is comprised of data from public and reportable sources as well as a survey filled out by the hospital staff.”

BMC has come a long way

“What is clear about this institution is where we came from. Four or five years ago, we were in bankruptcy and there was very little focus on quality,” Dr. Spektor said. “Tell you the truth, they didn’t know what core measures were in this hospital. It was just trying to survive. Since the purchase and investment of capital by the new owners, there has been also an investment in quality both in human resources and material. We never had a director of quality – this is a very important position here. As a for-profit hospital, we must meet a much stricter standard than anyone else. We really focus on making sure that patients are safe and we provide high quality care because that is what is going differentiate us and make us succeed in this world where value-based purchasing is going to be the rule. People pay for quality and that’s what they will get.”
Calculated under the guidance of The Leapfrog Group’s nine-member Blue Ribbon Expert Panel, the Hospital Safety Score uses 26 measures of publicly available hospital safety data to produce a single score representing a hospital’s overall capacity to keep patients safe from infections, injuries, and medical and medication errors.

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“Quality is a journey that never stops.” – Dr. Mark Spektor
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Pat Whipkey, CNO, said the hospital put together a great team of professionals for the survey portion of the study. The team did a lot of the prep work to get the information needed to show the details about hospital safety and quality.
“We knew the value here and knew this is a quality hospital,” she said. “This is a validation. The survey was very complex. We had a lot of people involved, and we broke it up into specialty areas.”
But the survey matters far less than the teamwork that the hospital has in place to provide safe patient care, Dr. Spektor said.
“We have a very open discussion,” he said. “There is no separation between the executive and the line staff. People feel comfortable communicating ideas about how to make our patients’ experience safer and they are encouraged to speak up. And a lot of these ideas have also filter up through managers to us about quality.”
“This survey highlighted what we were already doing,” said Velisse Perez, Director of Quality
“We were pleased that it confirmed what we knew we are,” Spektor said.

Hospital upgraded equipment, procedures

One of the key elements in patient safety was the hospital’s shift to electronic medical records.
“There is a certain amount of safety in having drug doses programmed into the computer system,” Spektor said. “A doctor is less likely to make a mistake when this data. We have 100 percent physician data entry here.”
Whipkey said communication among the staff is also key, with people free to communicate up and down from the line to management easily.
“We can also survey the staff to see what is working and not working and the staff will come to the table,” she said. “And as Dr. Spektor said, there is no delineation between management and staff. We’re all in this together. Quality is everybody’s responsibility, from housekeeping, physicians and nurses. Everyone has a stake in this.”
“It is driven a lot by nursing, it is driven a lot by everyday people who take care of patients,” said Whipkey, adding that the staff actually knows what the problems are, and they often know how to make improvements, and they are encouraged to tell management.
“This creates a happier working staff, and a happier staff creates happy patients,” she said.
Spektor said through a Culture of Safety survey, the hospital tries to determine what the high risk areas are, and work closely with accreditation and other agencies to create systems.
“It is important to bring our staff to the table so that we can know this is an issue we need to look at,” Perez said. “There is staff representation from every department, front line staff to give their input.”
The grade isn’t a milestone so much as a standard that the hospital holds itself, he said.
“We expect to meet this standard every year from now on,” he said. “It’s not a destination, it’s a journey. Quality is a journey that never stops. This is a different hospital than it was five years ago,” Dr. Spektor said.

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