Quality

Twin Cities Hospitals Among Best in Nation on Safety, Quality

Quality care is the result of good processes, transparency in reporting and valid measurement of outcomes. It’s also is a product of the expertise of caregivers, smart staffing, investments in technology and a commitment to innovation.

All these factors come together in Twin Cities hospitals to make them among the highest quality, safest hospitals in the country. In fact, on 13 indicators of patient safety, the “HealthGrades Patient Safety in American Hospitals Study” ranks hospitals in Minneapolis-St. Paul as the best in the nation among metro areas of at least 1 million. The highly-regarded Agency for Healthcare Research and Quality recently ranked Minnesota’s health system as the best in the nation, with care in hospitals as one of the major contributors to the high score.

Improving quality and patient safety is both more important and more challenging than ever. A new era is well underway in health care. Hospitals are being asked to care for populations and to improve quality and patient satisfaction. Meanwhile, individuals, government programs, insurers and employers are demanding that hospitals and all health providers reduce the overall cost of care.

Twin Cities hospitals are approaching the challenge with innovation. They are in the forefront of creating new models of care delivery. Increasingly, hospitals will be rewarded for keeping patients healthy – keeping them out of the hospital and, if hospital care is needed, assuring that they have the best possible outcome. Twin Cities hospitals are breaking new ground in creating new, integrated networks of care providers that work collaboratively to assure the best outcomes for patients. In these new models, the integrated networks – often called Accountable Care Organizations – are responsible for the quality and cost of care for the patients they serve, including populations like Medicare beneficiaries. By one estimate, these organizations could save Medicare up to $940 million in the first four years of implementation.

The transition to the new health marketplace will require flexibility and resources to innovate and to meet the challenges of a changing health care marketplace. What won’t change, though, is the focus of hospitals on delivering safe, quality patient care and ensuring nurses and hospital leaders have the ability and flexibility to continue to deliver exceptional care into the future.

How are Twin Cities hospitals meeting the challenge of maintaining the highest possible quality while reducing the overall cost of care? Some examples offer insight:

• Care Teams. Hospitals are promoting more collaborative approaches to caregiving. Registered nurses, physicians, nursing assistants, emergency medical technicians, social workers and case managers are working together in inter-professional teams to assess the needs of patients and deliver the best care. Flexible staffing will be an essential component of high-quality hospitals.

• Improving Processes. Twin Cities hospitals also are engaging nurses, tapping their expertise in new ways. One example is the discharge process. To the outsider, discharging a patient may seem like a simple process. It’s a surprisingly complicated procedure that requires a carefully orchestrated series of steps. Issues including medication, post-hospital therapy and follow-up with physicians must be coordinated to ensure patients are safe and that their chances of needing re-hospitalization are reduced.  

In the Twin Cities, nurses have been integrally involved in creating solutions that streamline discharges.  They understand the obstacles that create frustrating delays for patients and families. Through their work with others – including pharmacists, physicians, and health unit coordinators – nurses have created much-improved processes.  The results? The “Triple Aim” – quality care, reduced costs and patient satisfaction – all are met through this improved discharge process. Patients are going home earlier and more of them report they understand their post-hospital care goals and medications.

• A Focus on Safety. Safety is a priority in Twin Cities hospitals, and the focus pays off. One program is reducing the number of falls by patients. By listening to nurses and other caregivers, Minneapolis-St. Paul area hospitals have been among the nation’s leaders in reducing falls. A program at one Twin Cities hospital reduced falls by 20.7 percent in the past year, continuing a trend that has seen a 57 percent reduction in falls per 1000 patient days since 2008.

• Information. HealthScores is an easy-to-use report developed by Minnesota Community Measurement. This collaborative effort of hospitals, health plans, employers, consumers and other health care stakeholders builds on the commitment to transparency and sharing of information.  Through measurement and reporting, hospitals and other health providers are able to continuously improve their processes, patient satisfaction and health outcomes and health consumers are able to get the information about hospitals, clinics, physicians and other providers to make choices that are right for them and their families.

As noted above, Minneapolis and St. Paul have the safest hospitals in the nation among metro areas with at least 1 million residents. This has been accomplished without a rigid approach to staffing. Instead the high quality care that has earned a national reputation for the Twin Cities has been supported by common values, including the following:

Engagement/Empowerment. Nurses are actively engaged in the care giving process. The culture empowers nurses, and nurses share the responsibility to define their work and their contributions to caregiving.  

Teamwork. The ability to work as a team is essential.  Each member of the care delivery team has the knowledge and support to make constructive, solutions-oriented contributions to decisions on what is best for the patient. 

Critical Thinking. Every team member’s problem-solving and solutions-oriented skills are a critical factor in delivering quality care. This is one reason why Twin Cities hospitals rank among the nation’s leaders in compensating nurses. The need to attract the best and brightest professionals is essential to quality care. 

Communication. Inherent in all of these factors is the requirement that team members must communicate with one another and their patients, and they must be confident that their voices will be heard.

These values will continue to be the foundation of Twin Cities hospitals’ commitment to meet the challenges of enhancing quality and reducing the overall cost of care in a changing health marketplace.