Cleveland Clinic, Licking Memorial Health Systems Receiving Ohio Patient Safety Institute Award

Columbus, Ohio (June 6, 2018) – Today, the Cleveland Clinic and Licking Memorial Health System received the Dr. Frank Dono Best Practice award during OHA’s Annual Meeting Quality Summit. The summit was attended by leaders and clinical experts from Ohio hospitals who gathered to participate in continuing education sessions.

The quality teams at Cleveland Clinic’s Emergency Services Institute, the Heart and Vascular Institute and the Critical Care Transport collaborated to establish a project to advance STEMI (STElevation Myocardial Infarction) performance by reducing “Door to Balloon” times, establishing standard treatment protocols for appropriate departments, decreasing variability and reducing emergency department arrival to departure times. STEMI is a very serious type of heart attack during which one of the heart's major arteries is blocked. Over an 18-month period of this project significant work was conducted to develop and disseminate improvement strategies to all the system’s emergency departments.

By using an interdisciplinary team of professionals and data analysis, the Clinic achieved these key interventions: emergency department physician activation of the Cath lab, emergency management services pre-notification of the EDs when transporting STEMI patients, utilization of interventional cardiology providers to determine standard care paths, creation of ED acute care teams based on trauma care methodologies, established a STEMI Safe Handoff Checklist, greater collaboration with critical care transport teams, and incorporation of critical care transport service.

By focusing on high reliability, teamwork and innovation, the team was able to achieve their lowest STEMI times ever. For patients arriving and receiving treatment at the Clinic, the mean time in the ED has fallen from 20 minutes to 16 minutes, four minutes below the established goal time of 20 minutes. Mean time in the ED for STEMI patients has been sustained at 18 minutes or less for nearly two years.

In an effort to reduce the number of sepsis-related deaths by 30 percent over three years (2015-2018), Licking Memorial Health System joined the Ohio Hospital Association’s Institute for Health Innovation and the Sepsis Alliance to improve community awareness of the signs of sepsis. Taking broad and aggressive action to achieve significant reductions in inpatient sepsis mortality, LMHS established a multidisciplinary sepsis team, including physician champions, nurses, pharmacists, laboratory staff, information systems and process improvement staff that supervises the development of numerous improvement activities throughout the continuum of care received by sepsis patients.

One year after the initiation of the campaign, the hospital’s inpatient mortality rate from sepsis decreased nearly 70 percent and gains have been successfully sustained for six consecutive quarters of performance. LMHS has noted a significant increase in the identification and coding of sepsis since this project began.

The OPSI Best Practice Award is presented annually to Ohio health care providers that display excellence in the following areas:
  • Improving patient safety
  • Developing innovative programs to improve patient safety
  • Creating best practices that other Ohio health care providers can adopt/adapt
  • Developing a culture of collaboration that improves patient safety
OPSI will recognize three hospitals as honorable mentions for the award including:

Cleveland Clinic Akron General (Akron) – “Enhanced Recovery After Surgery.” A quality team assembled in 2016 to design and implement a new nationally standard ERAS program for all elective colorectal surgery at the hospital. This multi-disciplinary approach included general surgeons, anesthesia, pharmacy and nursing. Through individual commitments and determination the team was able to establish a new program within eight weeks resulting in a decline in colorectal surgical site infection rates elevating the hospital to being in the top decile nationally and rated as “exemplary” by the National Surgical Quality Improvement Program of the America College of Surgeons. The new program showed a significant decrease in opioid administration and
improvements in patient satisfaction as a decrease in hospitalization occurred by an average of three days.

Cleveland Clinic Lutheran Hospital (Cleveland) – “Promoting Hand Hygiene.” A team of health care professionals developed a program – SNAP (Scrub Now And Prevent) to promote the importance of hand washing and to increase hand hygiene compliance. By using the word “snap” health care workers are able to remind colleagues about the importance of hand washing. This program was implemented in 2014 and results have produced a 90 percent compliance rate for hand hygiene and a reduction of infections. This program was implemented in all inpatient units, the emergency room and the post anesthesia care unit. Hand hygiene is monitored on a monthly basis by external observers who provide timely updates to unit supervisors for immediate follow-up. This initiative was successful through leadership support, and team engagement resulting in improved health outcomes.

Cleveland Clinic Union Hospital (Dover) – “Effective Antibiotic Stewardship.” A team of the hospital’s infectious disease specialists and pharmacists convened to develop a new antibiotic stewards program in 2013 that resulted in an overall decrease in antibiotic utilization, antibiotic drug spend and multidrug resistant isolates. By identifying best practices and national guidelines the team created a new program that expanded policies and procedures for the facility, created an interactive electronic surveillance tool with specific categories of classification for antimicrobial review, established greater communication among providers and health care workers, expanded education programming for staff, and a new review of patient data to monitor the effectiveness of the stewardship program.

The OPSI Award is named in honor of Frank Dono, DO, a long-time leader and pioneer of patient safety and quality. Throughout his 50 years as a health care professional, Dono was a pioneer in the cause for patient safety, and his leadership was instrumental in helping develop strong safety standards and practices in health care.

About OPSI:
Founded in 2009, the Ohio Patient Safety Institute (OPSI) is an organization dedicated to improving patient safety in Ohio. The Institute is a subsidiary of the Ohio Health Council, which was founded by the Ohio Hospital Association, the Ohio State Medical Association and the Ohio Osteopathic Association. Through this collaboration and common effort, OPSI has the ability to work with hospitals and physicians in Ohio to improve patient safety for all Ohioans.