The hospital medicine team at Sutter Solano Medical Center leveraged leadership, engagement and collaboration to enhance quality, performance and the patient experience.
Hospital Information
Facility: Sutter Solano Medical Center, Vallejo, California
TeamHealth Services: Hospital Medicine
TeamHealth Impact
- Improved HCAHPS top box physician communication score to 83.6% consistently above CMS threshold
- Reduced time from ED door to inpatient admission by more than 2 hours 424 min to 302 min
- Lowered 30-day readmission rate from 10.2% to 8.5%
- Improved glycemic control from 63% of patients to 66% trailing six month average of 71%
- Lowered CAUTI and C. diff rates to 1 per year
- Strengthened partnership between clinicians and hospital leadership, supporting increased engagement, communication and transparency around performance improvement among all stakeholders
“We value the expertise and leadership TeamHealth brings to our longstanding partnership. They take ownership of any challenge and work with us to institute smart, strategic solutions that deliver sustained positive results.” – Abhishek Dosi, Chief Executive Officer, Sutter Solano Medical Center
Challenge
Sutter Solano Medical Center is a 106-bed facility located in Vallejo, California, with approximately 4,400 annual patient discharges. The hospital has trusted TeamHealth to provide its hospital medicine services for over 18 years. When a new CEO was hired in 2017, he brought increased focus on improving patient quality and satisfaction, targeting specific quality measures such as the 30-day readmission rate, HCAHPS scores and glycemic control.
Solution
TeamHealth’s facility medical director (FMD), with support from experienced regional leaders, worked to develop a strong partnership with the hospital’s CEO and administration to ensure alignment on the vision and goals of the hospital medicine program. TeamHealth leadership identified opportunities to create a culture of engagement by developing shared vision and goals for the HM program and providing clinical teams with opportunities to share feedback, raise concerns and contribute their ideas for improvement.
In addition to improved alignment and clinician engagement, TeamHealth leaders focused on improving processes and systems and improving interdisciplinary teamwork to achieve shared goals. One major area of focus was clinical measures. On glycemic control, for example, the FMD began meeting daily with the hospital’s dietitian and pharmacist to discuss patients exhibiting high blood sugar. Together, they investigated and made targeted interventions around the patient’s diet and insulin dosage to better manage glucose. The team also worked with hospital staff to design processes to target improvements in catheter-associated urinary tract infections (CAUTIs) and C. difficile infections.
To enhance patient experience scores, TeamHealth brought in its Hospitalist Services Performance Improvement (HSPI) team to provide formal training on patient experience and to establish and hardwire tandem rounding. In the latter, doctors and nurses round on patients together, ensuring coordination and collaboration on the patient’s status and care plan while giving the patient an opportunity to ask questions with both clinicians in the room. During the rounding process, the physician-nurse team note the patient’s care plan on a white board in the room so the patient can reference it at any time.
The team also created processes to improve patient throughput and readmission rates. Today, at time of discharge, the physician and nurse thoroughly review the discharge plan with the patient, make sure any follow up appointments are scheduled and the patient’s retail pharmacy of choice has received the prescriptions before the patient leaves. Two days after discharge, the nursing staff calls the patient to answer questions, ensure they received their prescription, are taking their medications and address any other issues that could lead to readmission.
Results
The hospital medicine team has shown marked improvement in quality, throughput and patient experience metrics. Additionally, the relationship and collaboration with nurses and other hospital staff has improved dramatically and collaboration with hospital leaders has been strengthened. Hospitalist engagement has also improved. TeamHealth clinicians are taking a more active role on hospital committees and in leadership roles that impact the care of all patients in the hospital. Several TeamHealth clinicians continue to participate in the hospital’s Medical Executive Committee and a TeamHealth physician was recently named the hospital’s director of palliative care. TeamHealth’s clinicians are now champions for the hospital’s values and initiatives across the medical and hospital staffs.
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