Katherine Shaw Bethea Hospital has been awarded the Quality Excellence Achievement Award by the Illinois Hospital Association for process improvements put in place in the Emergency Department.
KSB received the award from among 67 applicants in the rural hospital category. It was one of three finalists for the honor.
“We knew we had made a huge improvement in the process,” Barb Stockton, Director of Quality and Medical Staff Services, said later, “but we weren’t sure if we met the IHA’s criteria. This is such a personal thing for me and makes me so happy to see that we are doing such a great job.
“To be recognized by the IHA, which sets the standards by which all hospitals are judged in the state, is wonderful.”
KSB’s entry in the quality competition dealt with the process of improving response times for cardiac patients who present themselves at the Emergency Department (ED) with symptoms of chest pain.
The goal was to increase the number of patients receiving a blood draw for a Troponin (lab test) within 60 minutes of arriving at the ED or having an EKG test performed within 10 minutes.
“We weren’t meeting our metrics for core CMS (Centers of Medicare and Medicaid) measurements and outcomes,” Director of the Emergency Department Sue Prosch said. “We took our baseline measurements and started to look at how we could improve.”
Sue, Barb and Chief Nursing Officer Linda Clemen established an interdisciplinary process improvement team to identify a path to improving the ED’s numbers.
Employees from the Emergency, Laboratory, Cardiology, Respiratory Therapy and Registration Departments as well as members of KSB’s administration served on the process improvement team.
The group employed such Lean Manufacturing methodology as value-stream mapping, root cause analysis and small test of change to identify hurdles and implement process changes.
The key, everyone agreed, was using the knowledge and input of frontline employees to effect change because they work with patients every day.
“We were successful because the issues were identified at the front-line level,” Sue said. “Directors are not out there working and don’t know first-hand what the issues or roadblocks are.
“The front-line people are the ones who identify the problems and they should be the ones to explore ways to overcome them.”
In the six months prior to the start of the process improvement initiative, KSB’s numbers were 28% of patients receiving door-to Troponin within 60 minutes and 58% receiving door-to-EKG within 10 minutes.
But by the time the process improvement team had met, identified non-value-added steps and implemented change, the numbers had improved dramatically. For the 6-month period from Jan. 1 to May 31, 2012, 90% of patients received Troponin within 60 minutes and an EKG within 10 minutes.
That is a 221% improvement in the Troponin measurement and a 55% improvement in the EKG metric.
“These numbers and this award validate to the staff that we did the right things in making process improvements and we continue to do the right things,” Sue Prosch said.
Debmitra Das of Quality and Medical Staff Services, who was responsible for working with the data and generating the results-based reports, agreed.
“Everyone on the team realized that this initiative really improved our response times tremendously,” she said. “It was important for them to see the fruits of all their work.”
Now that Lean methodology has yielded positive results, it is being used to drive process improvement in other departments.
A link has been added to the OC under Employee Links/Reference/Quality Tool Box to assist anyone who would like to use Lean to streamline a process.
“If front-line staff see a frustrating issue in their department, the director has these tools to work with to solve the problem,” Linda added. “This ED initiative gives us a roadmap to take us from good to great.
“I think this award reinforces that process improvement tools really work.”
Members of the interdisciplinary team included Hillary Thomas, Carly Lindenmeyer, Lori Bumpus and Karli Fitzsimmons of ED; John Reilly, Jeannette Keegan and Wendy Anderson of Respiratory Therapy; Clinton Pearson, Jamie Moore and Trinette Decker of Registration; Emily Dempsey and Nicole Wyatt of the Cath Lab; Glenda Rickelman and Kathy Smith of the Lab; Doug Sears of Emergency Medical Services; Mary Ann Stone and Debmitra Das of QMSS; Chief Financial Officer Deb Didier; Linda Clemen, Sue Prosch, Barb Stockton, and physicians Rama Shankar, M.D.; Saad Blaney, M.D.; Susan Gould, M.D.; and Earel Belford, M.D.
KSB representatives will accept the award at an IHA reception in September. The hospital also is planning a recognition luncheon for members of the process improvement team.