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Johns Hopkins Hospital Uses High Reliability Approach on Accountability Measures

Added on December 3, 2013 in General News, Press Releases, JCR Success Stories
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(Oak Brook, Ill.) Today, Joint Commission Resources announced the release of the December 2013 issue of the “The Joint Commission Journal on Quality and Patient Safety,” featuring an article on how the Johns Hopkins Hospital significantly improved performance on Joint Commission accountability measures. The hospital was recognized by the Top Performer on Key Quality Measures® program for using evidence-based care processes that are delivered in the right way and at the right time. In “Demonstrating High Reliability on Accountability Measures at The Johns Hopkins Hospital,” Peter J. Pronovost, M.D., Ph.D. and his co-authors explain how the organization developed and used a four-part conceptual model to systematically improve patient care processes.

Johns Hopkins leaders launched the initiative in December 2011 by clarifying and communicating goals, declaring that the target was 96 percent compliance with eight Joint Commission accountability measures and one Delmarva Foundation core measure. Clinicians and quality improvement staff formed one team for each targeted process measure, and the organization’s Armstrong Institute for Patient Safety and Quality staff supported the work of the teams. 

Next, the organization conducted a gap analysis to prioritize improvement efforts and begin building capacity using Lean Sigma, education and clinical communities. To achieve the 96 percent goal, the Johns Hopkins board committed to transparently reporting results and developing a robust accountability plan that included monthly reports on compliance with the measures and appropriate follow-up. The final part of the model emphasized sustaining compliance with the 96 percent goal. The 96 percent performance goal was achieved for 95 percent of the measures in 2012 as opposed to 82 percent in 2011 before implementation of the conceptual model.

The authors suggest that this improvement work is novel and important for several reasons. Foremost, it demonstrated that large academic medical centers can significantly improve performance on accountability measures. To date, few academic medical centers have made The Joint Commission’s Top Performer on Key Quality Measures list. The authors also note that each aspect of the model, worked together with the other strategic elements, helped support system wide implementation and acceptance.

“The Joint Commission Journal on Quality and Patient Safety,” published monthly by Joint Commission Resources, is a peer-reviewed journal, available by subscription, which serves as a forum for practical approaches to improving quality and safety in health care.

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In a study of 20 community-based primary care providers, rates of prescribing errors with electronic health record (EHR) use were relatively low and were sustained over time. Extensive support for providers before, during, and after implementation may mitigate potential safety threats from implementation of an EHR system and result in sustained safety benefits over the long term.


Research Methods

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A 17-article series of patient safety research case studies illustrates how various research methods and study designs can be used to answer different types of research questions across five stages of the research cycle: (1) measuring harm, (2) understanding causes, (3) identifying solutions, (4) evaluating impact and (5) translating evidence into safer care.


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A novel Medical Emergency Team (MET) running sheet, developed to document events and therapies administered during MET calls, may facilitate handoff from ward nurses to the arriving MET.

 

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