Becoming Baldrige
Poudre Valley Health System reflects on what it took to achieve nationally-recognized levels of quality, and how ambition alone wasn't enough.
(12/9/2009)

Some providers may see the quality achievements of Poudre Valley Health System as out of reach for their own hospitals—especially given the organization's 2008 selection for the Malcolm Baldrige National Quality award. However, Kay Miller, vice president and chief nursing officer of Medical Center of the Rockies, Poudre Valley's newest facility, remembers a time when the organization struggled with identifying its true mission, a situation only made worse with the upheaval of having five CEOs within a four-year time span.

"With every CEO that came to our organization, we were faced with a whole new set of visions and 'to-do' checklists," she explains. "It seemed that we were never able to complete anything we tried. We needed an improvement model we could stick with, and that's when we decided to adopt the Baldrige criteria as our model for assessing how to improve patient care delivery."

Hospital leaders knew they were onto something, but after submitting three applications for review by the Baldrige team of examiners and receiving feedback for many opportunities for improvement, they realized that their dogged pursuit of accolades wasn't impressing anyone. "The examiners reviewing our application gave us very low scores, even on our third try, which was very humbling," Miller says. "It was a real wake-up call for us, because we found that all along, we had been focusing too much on the award itself, and not what the award was really about—serving our patients. We had to take a hard look in the mirror, and approach the challenge of quality improvement like workhorses, not racehorses; it's a long, hard journey, and it took awhile for us to get on the right path."

Establishing Vision, Mission, Values
With a new organization-wide leadership model, or Global Path to Success, Poudre Valley set its focus on three core principles—Vision, Mission, and Values—to incorporate into all health care initiatives.

"Being able to identify what was important to us, and connecting all of our day-to-day activities back to these strategic objectives was far more important than trying to be perfect," Miller says. "We undertook an organization-wide initiative to make sure every member of our organization, from the physicians to the operations staff, knew exactly how they were contributing to the big picture. Our employees develop their own goals which are written and displayed on special badge cards."

It was also critical for Poudre Valley to define its own identity as a care provider. "We knew that we wanted to deliver 'world-class' health care, but for a long time we were not clear on exactly what that meant," Miller explains.

"Once we established that we wanted to benchmark against the top 10% of hospitals with respect to patient outcomes, we were able to move forward. We focus on our core competencies, or what we were good at, in order to improve. Knowing ourselves and our own strengths and weaknesses helped us to engage our staff and build upon what we had already achieved."

Focusing on Patients, not Data
For any major process change, getting hospital staff to sign on can make the difference between success and failure. Leaders at Poudre Valley knew that Bedside Medication Verification would be necessary to meet their Baldrige goals, and they had to figure out how to sell it to their staff. What they found was that simply bringing the focus back to patients was often enough to convince nurses to use I.T.

"Whenever you adopt new technologies, you're bound to run into one person who says they're too busy to use the new system," says Miller. "What we told them was the truth: that if they didn't use BMV, they could potentially harm the person they're supposed to be taking care of. That has made all the difference—when you focus on the patient, instead of the data, that's what gets nurses motivated."

MEDITECH's Bedside Verification solution turned out to be exactly what was needed, according to Miller. "Early in 2007, our organization reported a 50 percent scanning rate. So, the fact that our scan rates are at 92% today, really means a lot to us," she says. "Even more importantly, we've caught 48 near misses that may have resulted in a critical medication error—which we attribute directly to our success with BV."

Moving Forward
Now that Poudre Valley is a Baldrige award recipient, one might think that the staff would be ready to rest on their laurels for a bit. No chance, says Miller.

"We're still working on ways to improve the efficiency of our system and remove waste, as well as integrate more evidence-based content into our care plans," she says.

"We've learned a lot through our Baldrige experience. Now, it's not the promise of awards that keep us going, but the knowledge that patients are alive today because of what we've done. For us, that's the biggest motivator there is."

MEDITECH
Medical Information Technology, Inc.
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Westwood, MA 02090
781-821-3000
www.meditech.com