The fourth quarter poses a challenging balancing act for all organizations: Leaders must simultaneously execute on current priorities while setting strategic focus areas for the year ahead.
As 2018 draws to a close, HBI’s Cost & Quality Academy has been polling the membership community in order to identify pressing priorities for the year ahead. After surveying chief executives, nursing leaders, and quality leaders on the state of healthcare quality, the results are in—revealing a continued focus on sepsis, falls, and clinician engagement.
Growing Attention to Sepsis
Given the high costs and mortality rates associated with sepsis, it comes as little surprise that this syndrome remains top of mind for most healthcare organizations.
But what’s worth noting is that sepsis reduction efforts are rising even further to the forefront. When considering the reduction of hospital-acquired infections or related conditions in 2019, leaders rated the priority of reducing sepsis as a 9.6 on a scale of 1–10, with 10 indicating a significant priority. That’s a notable uptick from two years ago when leaders rated sepsis reduction an average of 8.7 heading into 2017.
By comparison, other prominent conditions haven’t seen nearly as much movement; for instance, reducing surgical site infections was also rated an 8.7 heading into 2017, but crept up only slightly to 8.9 in our latest survey.
As efforts to prevent sepsis and improve sepsis care continue, organizations are narrowing in on new key levers to target—from expediting sepsis labs, to capturing vital signs in real time, to standardizing the involvement of other service lines (e.g., Speech Language Pathology) after patients have been stabilized.
Environmental Safety Takes Precedence
It comes as no shock that respondents rated “reducing patient harm and HACs” their most important quality improvement priority for 2019. However, there was a revealing theme in the harm-reduction initiatives that organizations are pursuing. The three highest patient safety priorities? Patient falls; patient aggression or violence; and environmental safety and ligature risk.
All three can be addressed by modifying the physical care environment, sparking organizations to conduct unit safety assessments and make changes based on the results. In doing so, we’ve seen organizations paying special attention to ensuring the safety of behavioral health patients. For instance, to reduce patient agitation, organizations are looking to develop specialized units that quickly divert behavioral health patients out of the ED and into a calmer setting. In terms of ligature risks, organizations are focusing attention on patient bathrooms, such as by ensuring they’re using Velcro Styrofoam bathroom doors, breakaway shower curtains, or other specialized equipment.
Opportunities Remain to Engage Clinicians in Quality Improvement
Finally, as hospitals and health systems look to improve care quality and the experience of care, the undeniable reality is that quality leaders will need to engage clinicians and patients in the effort. When looking at overall organizational priorities for the year ahead, “engaging clinicians and staff in care quality” as well as “boosting patient satisfaction and experience scores” were among the top three.
While both were given an average priority score of 9.5 for 2019, engaging clinicians and staff has made a bigger jump to gain priority status, up from an average score of 8.3 as leaders prepared for 2017. A number of hospitals and health systems have already made strides, with the vast majority saying they include physicians in quality leadership, appoint physician champions for quality projects, and provide clinicians individualized quality data. However, around 35–50% of organizations still have the opportunity to build quality incentives into physician compensation and educate physicians on process improvement methodologies such as Lean Six Sigma, respectively.
Overall, these three trends are just a fraction of what’s on the radar for 2019. For more information on trending topics currently on leaders’ minds—and others that should be—stay tuned for the Cost & Quality Academy’s upcoming report.
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