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Inland participates in quality initiative

Release Date: 08/10/2012

Maine hospitals improve care for patients as part of national program on quality and safety of care in hospitals

Maine Quality Counts announces findings from local hospitals’ participation in Aligning Forces for Quality

Augusta, Maine – Staff from local hospitals are being lauded by Maine Quality Counts for their part in a prestigious national program to improve the quality and safety of patient care. The effort is part of Aligning Forces for Quality (AF4Q), a national program to significantly improve health care in targeted communities. Maine is one of just 16 communities selected by the Robert Wood Johnson Foundation (RWJF) to participate in AF4Q.

The Aroostook Medical Center, Calais Regional Hospital, Eastern Maine Medical Center, Franklin Memorial Hospital, Goodall Hospital, Houlton Regional Hospital, Inland Hospital, MaineGeneral Medical Center, MaineGeneral Rehab at Gray Birch,(skilled unit), Mercy Hospital, Mid Coast Hospital, New England Rehab Hospital, Southern Maine Medical Center, and St. Joseph Hospital took part in the AF4Q hospital quality initiative.

For 18 months, more than 100 hospitals nationwide worked together through AF4Q to improve the quality and safety of patient care. During this time, 90 percent of the participating hospital teams improved the quality of care for their patients in measureable ways, resulting in hundreds of avoided hospital readmissions; improved patient safety; standardized collection of information on patients’ race, ethnicity and language preference (R/E/L), which helps ensure that care is equal for all patients; and reduced wait times in hospital emergency departments (EDs).

Funded by RWJF and staffed by experts at The George Washington University, AF4Q is an unprecedented effort to improve quality of care in communities nationwide and reduce racial and ethnic disparities in health care. Hospitals participating in the effort were part of a virtual network where they developed, shared, and implemented quality improvement tools, strategies, and lessons learned.

Maine is in the forefront of improving health care nationwide, and we are delighted to have these 13 hospitals and the First skilled Unit in TCAB join us for this successful Aligning Forces for Quality initiative,” said Lisa Letourneau, MD, Executive Director of Maine Quality Counts. “These hospitals and Skilled Units have shown that real progress can be made in our community when you combine a culture of change with teamwork and a willingness to share.”

The Hospitals and the Skilled Unit in the project spearheaded initiatives to help tackle key issues in hospital care. Local results include:

Reducing hospital readmissions and increasing adherence to care standards.

National data show about one in four Medicare patients admitted to the hospital for chronic diseases return to the hospital within 30 days of being discharged. Hospitals participating in AF4Q worked to ensure that processes were followed and patients had all the information they needed to safely transition from the hospital setting. Results include:
  • Eight hospitals participated in Reducing Readmissions from the Maine Alliance.
  • The hospitals that reduced their readmissions rate during the collaborative avoided approximately 19 readmissions within 30 days of hospital discharge during the reported 18-month period.
  • Among Maine hospitals, the average 30-day readmission rate was better than the national and state average throughout the entire collaborative.
  • Across the Alliance, Maine hospitals exceeded the goal of meeting and sustaining 95 percent adherence to the Measure of Ideal Care for the five quarters of the initiative and consistently performed above the AF4Q average of 93 percent.
  • Seven hospitals have standardized their systems to collect self-reported R/E/L data.
Improving language services for patients who speak or understand a language other than English.

All hospitals in the U.S. that accept government funds are required to provide interpreter services to patients who speak a language other than English, but there has been little guidance to hospitals on the most effective, efficient ways to implement these requirements. Hospitals participating in AF4Q worked to improve the efficiency of language services. Results include:
Three out of four participating hospitals demonstrated improvement in ensuring that limited English-proficient (LEP) patients had a qualified interpreter at initial assessment and discharge. Eastern Maine Medical Center was able to ensure that every LEP patient admitted over the course of the 18-month initiative had a qualified interpreter at initial assessment and discharge.
  • Three of the four hospitals maintained screening rates of 100 percent over the course of the 18 month initiative for preferred spoken language for health care. Mid Coast hospital achieved a 98 percent improvement in screening for preferred spoken language.
  • Three of four hospitals demonstrated improvement in screening patients for preferred written language for health care information with two hospitals maintaining a screening rate of 100 percent over the entire course of the 18-month initiative.
  • Maine hospitals performed better than the AF4Q average on all three measures.
  • All hospitals have standardized their systems to collect self-reported R/E/L data.
Reducing emergency department crowding.

Crowding and poor patient flow impact quality and safety and cause patients to remain in the ED longer than necessary. Delays in care also cause some patients to leave the ED before being seen by a provider. Local hospitals participating in AF4Q worked systematically to improve ED efficiency. Results include:
  • Three of the five participating hospitals were able to improve patient throughput in the ED in the 18-month initiative. Inefficient patient throughput causes patients to spend more time in the ED than necessary and causes some patients to leave before ever being seen by a provider. By the end of the initiative, patients spent 7,849 fewer hours in the ED and 256 patients received care that may have otherwise left before being seen by a provider.
  • Over the 18 months, Maine hospitals consistently outperformed other Increasing Throughput hospitals on the measure of patient throughput for discharged patients and on the measure of patients who left the ED before being seen by a provider.
  • Mercy Hospital stood out as a top AF4Q performer by reducing the average time patients waited in the ED for an inpatient bed by 87 minutes – a 43 percent improvement from where it started.
  • All hospitals have standardized their systems to collect self-reported R/E/L data.
We know that even though many hospitals consistently deliver good care, there’s always room for improvement,” said Susan Mende, BSN, MPH, senior program officer at the Robert Wood Johnson Foundation. “Aligning Forces for Quality has shown that hospitals in Maine and around the country want to do better and are willing to take steps needed to deliver the best care possible to their patients.”

In each AF4Q region, a range of efforts to help doctors, nurses and hospitals improve quality – as well as engage consumers to be better patients – is being tested. For more information, visit www.mainequalitycounts.org and www.forces4quality.org.
Maine Quality Counts is transforming health and health care in Maine by leading, collaborating, and aligning improvement efforts. Our vision is: Through the active engagement and alignment of people, communities, and health care partners, every person in Maine will enjoy the best of health and have access to patient-centered care that is uniformly high quality, equitable, and efficient.