Sutter Auburn Faith Hospital: Quality Maven
Hospitals
Written by Deborah Geering   
Saturday, 01 December 2007
Wherever he goes, Mitch Hanna talks about quality of care. He makes it a talking point at regional meetings. He discusses it at hospital board meetings. He brings it up at staff gatherings and committee sessions.

“The reason we’re here is to provide quality care, so if you don’t do that, these other focuses don’t matter,” said the chief administrative officer of Sutter Auburn Faith Hospital in Auburn, Calif.

He even brings it up at his quarterly town-hall meetings for the hospital, which amount to Hanna’s visiting each department’s three shift meetings and giving the same Powerpoint presentation 60 times.

“We always talk about quality, even at the environmental services and food service staff meetings,” he said. “I think it’s important to get the message out to everybody—they need to be involved in what we’re doing, too.”

What they’re doing, specifically, is zeroing in on excellence in performance measures for heart attack, congestive heart failure, surgical infection prevention, and pneumonia. And they’re doing it well: Sutter Auburn Faith is one of 100 member hospitals nationwide to receive a 2007 Leadership Award for clinical excellence from the national health alliance VHA, Inc.

The measurements are chosen by government agencies to determine whether patients receive the recommended treatments for best results. Sutter Auburn Faith achieved 100% compliance with all rate-based indicators for the award.

Hanna sees his primary role in the push for perfect care to be the top communicator. “We think it’s important that everybody knows that this is a focus,” he said. “With many of the core measures, there are time restrictions. It’s important that everyone has an understanding that when that patient walks through the door, we need to get them tagged, we need to get them into the ED.”

Beyond simply being the right thing to do for patient care, he said, meeting the performance standards is critical to the future success of the hospital. “This is now a priority for CMS. Hospitals are being monitored, and we want to make sure we have 100% compliance—or as close to that as possible.”

Hanna might be especially aware of the consequences when standards of care are not met: his background is in healthcare law, including serving as general counsel for hospitals. “I know the risks associated with poor quality, not to mention the disservice to the community,” he said.

Early on, he engaged the staff leadership in discussions about the new core measures. Senior management got on board, establishing processes such as rounding visits from the director of quality management to each admitted patient who falls into one the four focus-care areas. The hospital also established some methods for peer accountability, in which data about the measures is pushed back to the physicians so they know who was involved in each case and how they performed.

He credits the physicians’ early adoption of the processes with the hospital’s success. Although everyone agreed in principle with the treatment standards, some interventions were a little difficult for everyone to accept, Hanna said. Some physicians balked at the need to trim hair before beginning an emergency surgery; some challenged the choice of antibiotics that are to be administered. But Hanna helped the staff see the big picture: “I’d say, ‘This is how we’re being measured; this is what the public will be seeing about our performance; and this is why it’s important for you to apply them.’”

The hospital also worked with other Sutter Health facilities in the Sacramento Sierra region to establish standardized processes for quality care. Better, Safer care teams made up of respected physicians and staff members from all of the facilities meet to find better ways of doing things. “We’ll talk about AMI, let’s say, and the challenges you’re experiencing at your facility. And we would develop some standardized protocols that we instituted throughout the region.”

For instance, the teams developed an influenza vaccine information sheet and a smoking cessation sheet to hand out to patients at the five Sutter Health hospitals in the region. The hospitals also worked together to develop a step-by-step work flow plan specific to each hospital to meet the core measures for treating pneumonia patients.

Aside from improving processes, Hanna noticed that the regional approach also improved execution of those processes. “I think you get better buy-in from the medical staff when they know that other physicians at other facilities are doing this, too—that it’s not just something that administration is jamming down their throats,” he said.

All the care in the world, however, won’t matter if a hospital is unable to keep its doors open. And with about 60% of its patients on Medicare, Sutter Auburn Faith is especially challenged financially.

“Because of the financial challenges presented by a large population of Medicare patients, we are trying to focus our efforts on cost reductions and on growth of certain outpatient services to ensure that we’ve got a margin to maintain our mission,” Hanna said.

Whether it’s a push to meet the core measures or an expansion of outpatient services, however, the mission is the same. “We’re trying to provide the highest quality essential health services to the community,” Hanna said. “And based on this VHA recognition, I can honestly say we’re sustaining it.

“For a little 97-bed hospital in the foothills of the Sierra Nevada Mountains to receive this award, we’re very proud.”

Deborah Geering, This e-mail address is being protected from spam bots, you need JavaScript enabled to view it , is a freelance writer based in Atlanta.
 
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