Driving Innovation | Forging Partnership | Providing a Continuum of Care | Reducing Readmissions | Strengthening Communications | Improving Physician Satisfaction | Quality Measurement & Reporting | Recognition for Quality
High quality care is the basis of Texas Health Resources work and reputation. Without it, we cannot deliver our mission. Today, patients expect to know whether or not a provider delivers exceptional care prior to receiving services.
Since our inception, we have sought to deliver care that is evidence-based and scientifically-sound. After all, it is our medical expertise, innovation of care and history of success that earns patient trust and builds our referral network.
We advance clinical quality of care through the Texas Health Research & Education Institute (THRE), an independent, nonprofit organization within our system. Since its establishment, THRE has conducted more than 200 clinical and preclinical research studies.
Each year, THRE enables thousands of physicians and their clinical teams to receive training that support patient safety and quality initiatives. In 2011, THRE received accreditation by the Association for the Accreditation of Human Research Protection Programs.
Texas Health engages industry, academic and community leaders to gather their insight on ways we can improve quality, reduce costs and manage population health. In 2011-2012, we partnered with:
- Methodist Health Care System and University of Texas Southwestern Medical Center to develop population health strategies.
- The Partnership for Patients: Better Care, Lower Costs, a public-private partnership intended to help improve quality, safety, and reduce unplanned readmissions.
- North Texas Specialty Physicians to create Plus ACO7.
- The Joint Commission Center for Transforming Healthcare to create best practices and toolkits for health care’s most critical quality and safety issues.
- Laura W. Bush Institute for Women’s Health to empower women to takecontrol of their health, and to enable local physicians to receive training in gender-specific medicine.
7 ACOs are a key provision of the Affordable Care Act, aimed at slowing rising health care costs while delivering high-quality care under Medicare.
Providing a Continuum of Care
The need to manage patient care outside the walls of Texas Health Resources creates new opportunities for collaboration with physicians, clinics and primary care providers. Texas Health has been transforming our model of health services to one that is based on a physician-directed, care-team approach, which is designed to keep people healthy and out of hospitals except when they are acutely sick or injured.
Part of this effort includes implementing a case management system to help transition patients from acute care to rehabilitation and recovery care. For example, we send advance practice nurses into the homes of patients at high risk for readmission to provide follow-up care.
Other ways we expanded our continuum of care include:
- Partnered with Healthways to help communities understand and address risky behaviors.
- Collaborated with Presbyterian Communities and Services to provide continuing care retirement and hospice services.
- Acquired MedicalEdge Healthcare Group to enhance our ability to serve patients throughout the lifetime of their changing medical needs and requirements.
- Partnered with Methodist Health System and LHC Group to enhance home health services and facilitate better coordination of care delivery across North Texas.
- Launched Transitions House Calls, a safety net for patients with chronic health care issues who need assessment in the home setting.
- Created post-acute and chronic care clinics to help manage the transition from acute care to home.
As we take greater responsibility for community health, it’s a priority to help patients navigate the next health care steps once they have been discharged from the hospital. Hospital readmissions increase when patients do not understand how to manage their condition and fail to receive timely physician follow-up.
While not all of readmissions are preventable, the CMS estimates at least 75 percent may be. That’s why in October 2012, Medicare began penalizing hospitals for higher-than-expected readmission rates for patients with heart attacks, heart failure and pneumonia. Financial penalties represent a key reputational and financial risk for all hospitals. While Texas Health has had readmission rates below the national mean, we are working to further improve.
One way we did this was through a partnership with AT&T and software maker Intuitive Health. With the goal of reducing readmission rates for patients with congestive heart failure, we equipped them with computer tablets, pulse oximeters, weight scales and blood pressure cuffs following discharge. Patients measured their vital signs at home and transmitted the data to our electronic health record system.
By monitoring patients remotely, we were able to identify early signs of health decline and prevent emergency care readmissions. This pilot project reduced readmission rates 40 percent from 14 percent to 10 percent.
In today’s fast-paced world, people can simply forget to communicate or muddle the messages they send. For health care organizations, communication lapses can put patients’ health at risk. That’s why it is critical for our clinicians to effectively communicate with each other and patients to convey important information – at shift change, upon discharge or anytime when uncertainty exists.
In addition, our relationship with Healthways allows us to identify patients with heart failure who are at risk for poor self-management and readmission. Transitions coaches assess patients’ risks and identify their unique needs beginning in acute care. Working directly with Healthways coaches and Transitions House Calls, these coaches plan for follow-up and consultation with the patient, family and physicians.
Improving Physician Satisfaction
Our physician partners are critical to driving innovation, leading our clinical teams and improving patient satisfaction. Texas Health Resources performs more than 7,000 visits each year to gather physicians’ feedback on our organization and identify opportunities for improvement.
Physicians also are urged to participate in an annual physician satisfaction survey, conducted by a third-party. Results are shared with senior leadership to identify strengths and weaknesses of each facility. From 2009 to 2012, mean scores have continued to improve.
Quality Measurement & Reporting
Texas Health strongly supports evaluating the care provided by our staff to ensure best practices are being followed and identify improvement opportunities. We believe that by making data publicly available, we empower our patients to make informed decisions to actively participate in their care, which improves patient satisfaction and outcomes.
We assess clinical performance primarily by:
- Participating in the Premier Health Alliance QUEST project to measure and compare how frequently we deliver evidence-based care in a safe, effective and efficient environment against other hospital and ambulatory settings.8
- Assessing steps we take to prevent or treat heart attacks, heart failure, pneumonia, infections and hospital-acquired complications per the Centers for Medicare & Medicaid.9
By using and sharing best practices, increasing how often patients receive evidence-based care and reducing variations systemwide, Texas Health improves faster than industry benchmarks. Across our system, 97 percent of our patients receive the evidence-based care appropriate for their diagnoses.
8 The Quest collaborative is a group of 340 U.S. hospitals working to advance innovation, improve quality and safely lower the cost of care.
9 The Centers for Medicare & Medicaid’s core measures evaluate clinical performance and financially compensate hospitals for above-average work.
Recognition for Quality
Many of our hospitals were recognized for their quality of care:
Our system received the Texas Award for Performance Excellence from the Quality Texas Foundation for being a role model organization that demonstrates exceptional performance in all areas of organizational management.
Eleven hospitals earned the American Nurses Credentialing Center’s Magnet or Pathways to Excellence status.
Nine hospitals received an A ranking from The Leapfrog Group.
Texas Health Harris Methodist Hospital Fort Worth earned the Consumer Choice Award from the National Research Corporation for the 17th consecutive year.
Texas Health Harris Methodist Hospital Fort Worth was the first hospital in Texas named an Emergency Center of Excellence.
Texas Health Presbyterian Hospital Dallas was recognized by the American Heart Association for the fastest heart attack treatment.
Eight hospitals won Texas Health Care Quality Improvement Awards from the TMF Health Quality Institute.
Texas Health received the Richard A. Norling Premier Alliance Excellence Award for leadership in accelerating care quality and cost improvements.
Texas Health Harris Methodist Hospital Azle received the QUEST Award for High-value Healthcare.
Texas Health Harris Methodist Hospital Fort Worth received the Advanced Certification for Palliative Care.
Several hospitals were named Top Performers on Key Quality Measures.