Overview

In the realm of cardiovascular care, ensuring adherence to quality metrics is paramount for achieving better patient outcomes. But having a lot of data is not enough. Every healthcare professional who plays a role on an integrated patient care team needs to be aware of the data available to them, understand what it means, and act on that understanding. And that’s a challenge that exists across the health system.

The Challenges

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Dignity Health
From left to right- Alisha McKown, charge nurse, Amanda Merkley, charge nurse, Kerry Webb, CV quality data analyst, Jordan Truax, CVICU educator, Melissa Lazere, charge nurse, Anne Walker, CVICU manager, Mina Choi, CVICU RN, Melanie Fields, CVICU RN 

CommonSpirit Health, based in Chicago, Illinois, routinely uses quality metrics to improve patient outcomes. Yet one of the key challenges they faced in the cardiovascular surgery unit was a lack of awareness among nursing staff and respiratory therapists (RT) of the specific metrics measured and how adherence to them correlated with better patient outcomes. The department also grappled with the diverse practices of different surgeons, leading to difficulties in standardizing orders and processes. 

Actions Taken Using the STS National Database

The health system's first step to tackle these obstacles was to educate nursing and RT staff on the significance of the quality measures being monitored. Emphasis was on the tangible benefits of data monitoring beyond mere numbers. By highlighting how data-driven decisions directly impact patient welfare, CommonSpirit Health garnered greater engagement from the nursing and RT staff, as well as all other stakeholders, and fostered a more collaborative environment conducive to continuous improvement. 

The cardiovascular departments also minimized variability in surgeon practices by consolidating their efforts under one surgeon group. They initiated a CV Process Improvement Committee to foster discussions on education and unit processes. They implemented a tracking log where RNs would input patient information, noting extubation timing and any delays. This log ensured accountability and was a reference point for process improvement discussions.

The hospital used the STS National Database to benchmark performance and leverage real-time data for real-time assessment and proactive adjustments. Monthly reports compared the hospital's performance with STS benchmarks, and regular discussions ensured the team remained engaged throughout the quality improvement process. 
Transparent communication and active involvement in data utilization processes across the integrated patient care team were key to the health system’s success. Sharing pertinent data with all team members fosters buy-in and facilitates collective efforts toward improving patient care outcomes.

Results

CommonSpirit Health’s efforts yielded measurable results, as evidenced by the quarterly STS Published Outcomes Reports. These reports provided baseline performance data and showcased improvements in our <6-hour extubation rates post-implementation of changes. Monthly queries through a third-party vendor supplemented the analysis, offering insights into the health system’s progress and facilitating adjustments.

Common Spirit’s journey toward enhancing quality metrics in cardiovascular care underscores the transformative power of data-driven decision-making. Through education, collaboration, and a strategic approach to utilizing the STS National Database, they paved the way for sustained improvements in patient care quality.