Hospital staff participates in Robert Wood Johnson Foundation initiative to develop innovative strategies that demonstrate measurable improvements for cardiac patients
Niagara Falls Memorial Medical Center announced Tuesday that it has significantly reduced hospital readmissions for heart failure patients as a result of its participation in Aligning Forces for Quality, a national effort to further improve the quality of health care provided in America's hospitals.
The program is an initiative of the Robert Wood Johnson Foundation, the nation's largest health care philanthropy, and is staffed by experts at The George Washington University. The P2 Collaborative of Western New York was selected by RWJF to lead the local Aligning Forces for Quality effort.
Since October 2010, Memorial has participated with 100 other forward-thinking hospitals in 16 communities across the country in identifying innovative ways to improve the quality of patient care and ensure that it is equitably delivered to patients of differing races and ethnicities.
Nationally, 90 percent of hospital teams participating in Aligning Forces for Quality, including the team at Niagara Falls Memorial, improved the quality of care for their patients in measurable ways.
When the study began in October 2010, 24.5 percent of all heart failure patients discharged from Memorial Medical Center were readmitted to the hospital within 30 days. When the study concluded in March of this year, that figure had declined to just 10.4 percent.
"Thanks to some creative thinking and hard work by our quality improvement personnel, staff development team and nursing personnel, our performance was better than average, and better than other medium-sized hospitals that participated in this exercise," said Memorial Vice President and Chief Operating Officer Sheila K. Kee. "What's really exciting about this is the positive impact their efforts have made on the health of our heart failure patients."
Memorial instituted a number of lasting changes to further improve the quality of care provided to its cardiac patients, with the specific goal of reducing the rates with which cardiac patients are readmitted to the hospital after being discharged. The most significant initiative involved revamping the discharge process to give patients the tools they need to stay well.
"One thing that really helped was changing the way we communicate with patients," said Vice President and Chief Nursing Officer Joanne Krolewski. "We developed education tools designed specifically for heart failure patients and instituted a 'teach-back' process that requires patients to show us they understand their discharge instructions."
In addition, nurse clinical coordinators in collaboration with Memorial's coordinator of case management began calling patients at home within 72 hours of their discharge to discuss their follow-up care and ensure compliance with their discharge plan. The hospital also strengthened its process for providing discharge summaries to patients' primary care physicians and assists patients in scheduling follow-up appointments.
"Readmitting patients who were recently discharged from the hospital can often be prevented by better management of the transition to an outpatient setting," said Shelley B. Hirshberg, executive director of the P2 Collaborative of Western New York. "Niagara Falls Memorial's efforts to better educate heart failure patients prior to discharge and enhance the coordination of their care with community physicians not only help to keep patients out of the hospital but improve their quality of life."
As part of Aligning Forces for Quality, Memorial also instituted efficiencies in its emergency department and assessed and improved the way it communicates with patients who speak or understand a language other than English.
Throughout the program, staff members piloted and tested quality improvement strategies while collecting data that have been examined by patient race, ethnicity and language to determine if disparities exist.
"Although people of color comprise 20 percent of the city's population, they make up 40 percent of our heart failure patients. That really underscores the whole disparity issue," Kee said. "Being able to analyze who these patients are was an important part of this study."
A key component of Aligning Forces for Quality was a series of conference calls held with other participating hospitals to discuss best practices.
"The success we have seen and the support our staff has given to, and received from, hospitals across the country is a testament to the power of collaboration in our health care system. We're proud to be part of that," said Memorial President and CEO Joseph A. Ruffolo.
About Aligning Forces for Quality
Aligning Forces for Quality is the Robert Wood Johnson Foundation's signature initiative to lift the overall quality of health care in 16 targeted communities while reducing racial and ethnic disparities and provide models for real reform. The P2 Collaborative was selected by RWJF to lead the local Aligning Forces for Quality effort. In all, 16 regions of the country have been designated as part of Aligning Forces. In each region, a range of efforts to help doctors, nurses and hospitals improve quality - as well as engage consumers to be better patients - is being tested.
Funded by RWJF, Aligning Forces for Quality is coordinated by The Center for Health Care Quality at The George Washington University Medical Center School of Public Health and Health Services in Washington, D.C.
About the P2 Collaborative of Western York
The P2 Collaborative is a not-for-profit organization dedicated to educating and motivating people in Western New York to make lifestyle changes to prevent illness, and if ill, to help them become well again. The P2 Collaborative was hand-picked by the Robert Wood Johnson Foundation to participate in Aligning Forces for Quality, the foundation's signature initiative to lift the overall quality of health care in targeted communities, reduce racial and ethnic disparities, and provide models that will help propel national reform. For more information, visit www.p2wny.org.
For more information on Memorial, visitwww.nfmmc.org.