Hospitals and hospital leaders across the state are celebrating significant milestones on their calendars in recent days, but there is a particularly notable occasion that IHA would like to recognize: the 5^th anniversary of the Iowa Healthcare Collaborative (IHC).

In 2005, through the visionary board leadership of the Iowa Medical Society (IMS) and IHA, a new organization was formed:  A hospital and physician-led statewide collaborative, the first of its kind, with a mission to facilitate exceptional health care quality and safety for all Iowans.  Financially supported by IHA, IMS, major health systems both within and on the borders of Iowa and community partners, IHC truly is a major “collaborative” effort.  

Recently, IHC held its annual conference with the theme of “Leading Transformation.”  This is a very appropriate moniker as we recognize many accomplishments by Iowa hospitals and physicians worthy of celebration:

• In 2010, here is a sampling of what the numbers show for Iowa hospital implementation of bundles of best practice defined by the Institute for Healthcare Improvement nationally.  (In each case, fewer than 20 percent of Iowa hospitals had implemented when first measured in 2006.):

                   - 62 percent have fully implemented rapid response teams.

                   - 84 percent fully implemented the acute myocardial infarction (AMI) care bundle.

                   - 84 percent fully implemented the surgical site infection bundle.

                   - 76 percent fully implemented the methods to high alert medications.

                   - 79 percent fully implemented pressure ulcer care bundle.

                   - 90 percent fully implemented heart failure care bundle.

• Influenza vaccination of health care workers in Iowa hospitals has increased from 68 percent in 2007 to 91 percent in 2010, one of the top rates in the U.S.
• IHC has initiated a statewide hospital reporting of health care acquired infections for eight measures.  In the three years of voluntary reporting, the variation in coronary artery bypass graft surgical site infection has been cut in half, hysterectomy surgical site infections reduced by 25 percent and a dramatic seven-fold reduction in central line infections variation.  Iowa hospital averages best national averages in each category.  And improvement is already being shown in MRSA infection rates after only two years of reporting.
• Looking at Centers for Medicare & Medicaid Services indicators of quality in reporting, Iowa hospitals have improved from complying with the AMI bundle of services from 86 percent in 2005 to 94 percent in 2009; for pneumonia from 85 percent to 90 percent; and for surgical care from 73 percent to 90 percent.
• Iowa hospitals rank in the top 10 percent of states in the U.S. in each of the patient satisfaction measures.
• Iowa hospitals better the national average in the 30-day readmissions for AMI, heart failure and pneumonia.
• Iowa hospitals have shown steep declines over the last five years in deaths in low-mortality DRGs, accidental punctures or lacerations and central line-associated bloodstream infections.
• More than 50 percent of Iowa hospitals now employ Lean health care improvement to eliminate waste and improve efficiency.
• More than 250 medical professionals and hospitals have participated in the IHC efforts to deploy the “medical home” model of primary care across Iowa. 
• Thousands of Iowa hospital employees and physician leaders have actively participated in information sharing and collaboration through IHC-sponsored conferences and workshops.  A common theme: To be the best, learn from the best.

Impressive, but there is more work to be done.  Health care-associated infections need to be driven down to zero.  All Iowa hospitals need to deploy 100 percent of the clinical bundles of service (evidence-based medicine) as the medical care of the patient dictates.  Readmission rates are still too high.  Health care workers beyond Iowa hospitals need to be immunized for influenza.  Better coordination of patient care is a must.  And there is much inefficiency in the system still to be eliminated.

Milestones are important as markers on a long road and as reasons to pause for celebrating accomplishments.  More importantly, they remind us of the road ahead and the work needed to continue a productive and successful journey.

Featuring hospital and health care headlines from the media and Web from November 6-November 13.

Support ’em with makeovers
Jane Klingson, a volunteer cosmetologist at the Trinity Regional Medical Center Cancer Center, sees her work with the Look Good … Feel Better program as more than a chance to make a difference.  It’s helping cancer survivors or women fighting cancer get back what they might have lost to the disease.  November 9, Fort Dodge Messenger)

Iowa State engineers develop 3-D software to give a view inside the body
James Oliver picked up an Xbox game controller, looked up to a video screen and used the device’s buttons and joystick to fly through a patient’s chest cavity for an up-close look at the bottom of the heart.  And there was a sight doctors had never seen before: an accurate, 3-D view inside a patient’s body accessible with a personal computer.  (November 11, Genetic Engineering & Biotechnology News)

Unity receives grant money to help flood victims
Help is available for Muscatine County residents still feeling overwhelmed by the 2008 flood or other natural disasters.  Unity Healthcare New Horizons recently received a $19,360 grant to help prevent substance abuse in connection with natural disasters and to treat flood survivors who are struggling with substance abuse or other issues. (November 7, Muscatine Journal)

Local medical team returns from Kenya
Michele Burnes, a physician’s assistant at the Urbana Family Medical Clinic and at Virginia Gay Hospital, and Sharon Dieter, a nurse at Virginia Gay Hospital, recently returned from Kenya, where they were part of an eastern Iowa team working at a medical clinic founded by Spanda, Inc., a non-profit organization founded by Cedar Rapids optometrist DeAnn Fitzgerald.  (November 11, Cedar Valley Daily Times) 

McDonald house, Miller provide needed support
Brenda Miller’s job goes beyond fund-raising and administrative work. As executive director for the Ronald McDonald House, she often lends an ear to family members who need to talk or celebrate a milestone in their child’s life. She also works with a 26-member board of directors and manages a staff of four people.  (November 11, Des Moines Register) 

Construction begins on new VA Clinic
It’s official – and being Veterans Day, the time and place were only fitting. On behalf of the U.S. Dept. of Veterans Affairs, members of the VA Central Iowa Health Care System formally announced the future opening of its third Community Based Outpatient Clinic Wednesday at the former Econo Foods building in Marshalltown.  (November 12, Marshalltown Times Republican)

State workers debate merits of givebacks
Unions in Iowa so rarely give up the hard-fought provisions locked into their contracts that some state employees are warning fellow workers not to do it now – even if it means 479 of them will be laid off.  (November 12, Des Moines Register) 

U.S.  Headlines

Making health care better
The crisis behind the health care debate is about one thing above all: the scattershot nature of American medicine. The fee-for-service payment system – combined with our own instincts as patients – encourages ever more testing and treatments. We’re not sure which ones make a difference, but we keep on getting them, and costs keep rising. Could the evidence-based medicine practiced at Intermountain Healthcare could be the cure for American health care?  (November 8, New York Times Magazine)

An interview with Dr. Donald Berwick
Dr. Berwick about the dynamics of the health overhaul debate. He says that most of the focus has been on cutting costs and finding the money to cover the uninsured. But often lost in the legislative tussling is a third, just as important goal: Improving the quality of care.  (November 12, Kaiser Health News) 

U.S. health care sector is a fairly green giant
According to the first estimate of the sector’s carbon footprint, the healthcare industry emits less than its share of the gases that promote global warming, compared to its size in the economy. Hospitals, nursing homes, drug companies and the rest of the sector contributed 8 percent of U.S. emissions. Hospitals are the biggest offenders, a finding that may motivate more of them to audit their energy usage and plant rooftop gardens – as one big Chicago hospital has done.  (November 11, Associated Press) 

Doctors embrace social networking
Doctors around South Florida and the rest of the country are using the social networking tools to bring patients’ families and the general public into operating rooms, sometimes sharing step-by-step medical procedures. They favor the real-time updates and videos as a way to reduce the fear factor of surgeries and educate people about the realities of certain procedures, especially new ones.  (November 11, Miami Herald)

The medical industry grumbles, but it stands to gain
The business world found plenty to complain about as it assessed the House bill that would make sweeping changes in the healthcare system and extend insurance coverage to millions more Americans. Insurers do not like the provision to create a new government-run insurance program. Drug makers oppose billions of dollars in rebates they would have to give to the government over 10 years. Medical devices are not happy about the proposed 2.5 percent tax on their products.  (November 8, New York Times) 

Current ‘death panel’ uproar echoes decades-old controversy
It was early summer. A senior federal health official wrote a memo suggesting that living wills – documents that can convey patients’ wishes about when to end life support – could help curb health-care costs. The memo leaked to the media. By August, a New York Times’ column said the official ‘likes euthanasia.’ Sound like this year’s angry August? Well, this story unfolded in 1977.  (November 10, Kaiser Health News) 

Dutch view of choice in U.S. care: it’s limited
The health system in the United States may be twice as expensive as those in Europe, and the population may be less healthy, but at least Americans have access to many more choices of doctors and insurers. Right?  No, says Ab Klink, the Dutch health minister.  (November 9, New York Times)

 

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