North Bronx Healthcare Organizations, Facilities Win HANYS’ Pinnacle Award

BOLTON LANDING, N.Y. — The Healthcare Association of New York State awarded its 2011 Pinnacle Award for Quality and Patient Safety to three institutions in recognition of accomplishments improving the quality and safety of healthcare for patients:  North Bronx Healthcare Network, Bassett Medical Center and Mercy Hospital of Buffalo/Catholic Health System.

HANYS established the Pinnacle Award for Quality and Patient Safety in 2001 to celebrate significant achievements by its members in the areas of quality improvement and patient safety. The program recognizes successful quality improvement and patient safety initiatives and encourages broad dissemination of best practices.

“North Bronx Healthcare Network, Bassett Medical Center, and Mercy Hospital of Buffalo demonstrate the commitment of New York’s healthcare providers to making continuous improvements in the quality and safety of patient care,” said HANYS President Daniel Sisto.

In the System category, HANYS’ prestigious 2011 Pinnacle Award for Quality and Patient Safety was presented to the North Bronx Healthcare Network for its Reducing Adverse Outcomes on Labor and Delivery program. Recognizing that shoulder dystocia, Erb’s Palsy, and other perinatal events are devastating to newborns and their families, North Bronx Healthcare Network launched a successful campaign to reduce occurrences of these adverse events. The initiative focused on the analysis of obstetrics department risk management data and implementation of facility-specific oxytocin bundles, management protocols and TeamSTEPPS® training.

Through these efforts, North Bronx Healthcare Network:

• Reduced deliveries complicated by shoulder dystocia from 4% in 2008 to 1.4% in 2010;

• Reduced the number of severe Erb’s Palsy cases from 0.4% in 2008 to 0.08% in 2010;

• Decreased adverse patient occurrences (APOs) from 80 per month in January 2009, to 35 per month in July 2010 (examples of APOs are hemorrhages, hematomas, third and fourth degree lacerations, and Erb’s Palsy); and

• Achieved cesarean section rates of 24% to 26%, well below the national average (32%).

Bassett Medical Center was awarded this year’s Pinnacle Award in the Large Hospital category for its program, Reducing Readmissions by Leveraging a Comprehensive Care Transitions Approach.

Seeking to reduce patient readmissions and improve quality across the continuum of care, Bassett Medical Center used an evidence-based approach that included high-risk screening tools, readmission risk reduction strategies, hiring a patient services coordinator for post-hospital contacts and interventions, arranging primary care appointments within five days prior to discharge, an “800” number for patients to call any time before their first primary care visit, and automated communications with primary care providers upon admission and discharge.

As a result of these changes:

• The 30-day readmission rate for high-risk patient diagnoses fell 70% from 13.4% in 2009 to 3.1% in 2010 (year-to-date, the rate in 2011 is 0%);

• The overall readmission rate was reduced by 25%, from 17.4% to 12.9%; and

• Hospital Consumer Assessment of Health Care Providers and Systems ratings related to discharge planning are within the 98th percentile nationally.

In the Small Hospital or Division/Specialty category, the winner of HANYS’ 2011 Pinnacle Award for Quality and Patient Safety is Mercy Hospital of Buffalo/Catholic Health System in recognition of the success of its Improving Hospital Access and Efficiency of Care for Our Community program.

Recognizing that emergency department overcrowding and patient flow bottlenecks are a barrier to access and chief cause of long wait times, Mercy Hospital of Buffalo evaluated key indicators in patient flow and developed a plan to make transformational changes in its fundamental care delivery systems.  The organization implemented two major strategies: a comprehensive admission reception expert (CARE) unit and a patient access center (PAC).  The CARE relies on “pulling” systems to prepare patients for admission, discharge, or transfer to alternative care providers.  PAC is a “24/7” service that coordinates all bed activity, such as transfers and direct admissions, to avoid the ED.

As a result of these changes:

• Transfers from tertiary care increased 177%, from 239 in 2009 to 663 in 2010;

• Direct admissions increased from a negligible number to 376 in 2010;

• ED crowding and bed holds were reduced, as demonstrated by decreasing diversion hours by 92%;

• Emergency patient visits increased 12.3%; and

• Physician and patient satisfaction scores improved.

The Healthcare Association of New York State is the only statewide hospital and continuing care association in New York, representing more than 550 non-profit and public hospitals, nursing homes, home care agencies, and other health care organizations.  No organization can speak more comprehensively on behalf of the state’s entire health care delivery system.