The annual Innovators Award challenge brings out HCA’s best thinkers . In 2013, more than 1,500 ideas were submitted, and winners were chosen at every facility and at the division level. From those, three national winners have been announced. Each national winner received $10,000, as well as the “Tommy” award, a likeness of company founder Dr. Thomas F. Frist, Jr.
Our previous two blogs featured the Service Excellence and Financial Impact winners, so now we move on to the Quality and Patient Safety winner: Timothy Foley, Nurse Practitioner at MountainView Cardiovascular and Thoracic Surgery Associates. His award-winning Echo Alert Protocol helps patients with cardiac issues see physicians and get into treatment sooner, leading to higher satisfaction and improved outcomes.
Echo Alert Protocol
Hospitals have many measures in place to follow up with cancer patients following a diagnosis, and that helps with early treatment and positive outcomes. That element often is missing in cardiac care, and so Timothy Foley set about creating a way to get these individuals started on a comprehensive care path.
“We saw the opportunity to get these patients treated sooner after they received a diagnosis of valvular heart disease, especially those with a problem rated as severe, so we could get them in front of the right group of people who would take care of them,” Foley says. “That means making sure they see a cardiologist and cardiothoracic surgeon, but also making sure their primary care physician knows what’s going on.”
A clinical coordinator works to keep the cardiologist, admitting physician, primary care physician and other care-team members in the loop, while also ensuring that the patient knows what he or she needs to do in order to further care as well.
“We performed a retrospective review of all in-house echocardiograms performed over a 12-month period at our facility. We found a large population of patients who met criteria for the diagnosis of severe aortic stenosis. When we took a closer look at these patients care at our facility including instructions for follow-up we discovered a significant opportunity to improve the delivery of care for these patients. From ensuring appropriate documentation of the diagnosis at the point of echo, to facility-based coordination of care, virtually all aspects of care delivery were improved”.
By bringing together providers and a quality-assurance team, a treatment group was created that compares to navigation efforts now in place in many HCA facilities for breast and other cancers. A protocol driven, facility based quality initiative was constructed and implemented at the facility using clinical practice guidelines for the management of patients with valvular heart disease from the American Heart Association and American College of Cardiology to direct patient care delivery.
“We have two different pathways for the patient with valvular heart disease identified within our facility,” explains Foley.
“If a patient is classified as severe, this triggers an echo alert. This process brings a team of providers to the patient for comprehensive evaluation. This allows timely patient education and a team approach to care delivery. If the diagnosis is moderate or mild, then we will make sure that the patient has comprehensive education regarding their diagnosis and specific instructions for follow up with their primary care physician and cardiologist. This lets us manage both those populations effectively and safely.”