Cross Comparison Analysis of Hospital Award Winners: Comparing Baldrige, ANCC Magnet, and U.S. News Report Best Hospitals 2010-11 Honor Roll.

BLOG #4: Wild Card. Cross Comparison Analysis of Hospital Award Winners: Comparing Baldrige, ANCC Magnet Recognition, and U.S. News Report Best Hospitals 2010-11 Honor Roll.

This summer I was allowed the opportunity to intern with an acute care hospital here in the Orlando area. This particular hospital is one that is currently trying to obtain the prestigious ANCC Magnet Recognition Award. One day while discussing details of the Magnet Award with the leadership at this acute care facility the question was raised about the percentage of Magnet Hospitals that are also Baldrige recipients’.

In light of the newly released U.S. News Best Hospitals 2010-11 Honor Roll, I felt this would be an excellent opportunity to cross match the three awards to see if a correlation did exist.

The Baldrige Award for healthcare facilities first began in 2002. Since inception there have been a total of 11 recipients of the Baldrige Award. The analysis will be a cross-comparison of past Baldrige winners with the Magnet Recognition Award, and the U.S. News Report 2010-11 Best Hospital Honor Roll list of the top fourteen hospitals and is listed below.

• As of 2010, 72% of all Baldrige winners for healthcare also received Magnet Recognition.
• 36% of Baldrige winners achieved Magnet Recognition after receiving the Baldrige Award.
• 27% of Baldrige winners achieved Magnet Recognition before receiving the Baldrige Award.
• Only one organization, SSM Healthcare achieved both the Baldrige and Magnet Recognition in the same year.
• Not a single Baldrige winner is on the U.S. News 2010-11 Honor Roll top 14 Hospitals.

Year	Baldrige Award	Magnet Award	US News 10-11 Honor Roll
2009	Atlanti Care. NJ	Yes- 04/08	No
2009	Heartland Health. MO	No	No
2008	Poudre Valley Health. CO	Yes- 00/04/09	No
2007	Mercy Health. WI	No	No
2007	Sharp Healthcare. CA	Yes- 04	No
2006	North Mississippi Med. MS	No	No
2005	Bronson Methodist. MI	Yes- 09	No
2004	Robert Wood Johnson. NJ	Yes- 97/02/06	No
2003	Baptist Hospital Inc. FL	Yes- 07	No
2003	St. Luke Hospital. MO	Yes- 04/09	No
2002	SSM Healthcare. MO	Yes 02/06	No

These results lead to a second search comparing the U.S. News 2010-11 Honor Roll for the top fourteen hospitals, with Magnet Recognition status.

• 35% of the top fourteen hospitals never received the ANCC Magnet Recognition award.
• 64% of the top fourteen hospitals are ANCC Magnet recipients.
• Once again, not a single hospital from the top fourteen-honor roll has received a Baldrige Award.

Rank	US News 2010-11 Honor Roll Hospitals	Magnet Award	Baldrige
1	Johns Hopkins Hospital, Baltimore	No	No
2	Mayo Clinic, Rochester, Minn.	Yes- 97/02/06	No
3	Massachusetts General Hospital, Boston	Yes- 03/08	No
4	Cleveland Clinic	Yes- 03/08	No
5	Ronald Reagan UCLA Medical Center, Los Angeles	Yes- 05	No
6	New York-Presbyterian University Hospital	No	No
7	University of California, San Francisco	No	No
8	Barnes-Jewish Hospital/Washington University	Yes- 03/08	No
9	Hospital of the University of Pennsylvania	Yes- 07	No
10	Duke University Medical Center, Durham, N.C.	Yes- 06	No
11	Brigham and Women's Hospital, Boston	No	No
12	University of Washington Medical Center	Yes- 94/98/02/06	No
13	UPMC-University of Pittsburgh Medical Center	Yes- 10	No
14	University of Michigan Hospitals	No	No

The evidence suggests that the common factor between the three designations is the ANCC Magnet award. Organizations who obtain the ANCC Magnet Recognition have a higher probability to be recipients of other prestigious healthcare recognition awards. It should also be noted that just because a hospital was not listed in the top fourteen honor roll for 2010-11 does not suggest that the hospital is not chosen as one of the best for 2010-11, or has not received recognition in the past from U.S. News & World Report.

References:

U.S. News & World Report Best Hospitals 2010-11: The Honor Roll. (2010). Retrieved July 22, 2010 from: http://health.usnews.com/health-news/best-hospitals/articles/2010/07/14/best-hospitals-2010-11-the-honor-roll.html

American Nurses Credentialing Center: Magnet Recognition Program. (2010). Retrieved July 22, 2010 from: http://www.nursecredentialing.org/Magnet/FindaMagnetFacility.aspx

Baldrige National Quality Program. (2010). Retrieved July 22, 2010 from: http://www.baldrige.nist.gov/Contacts_Profiles.htm

Blog #3: Patient’s Perspective on Adverse Events.

Question: In your own words, explain why or why not the perspective of the patient is the most important determinant as to whether an adverse event has occurred.

No, the patient should not be viewed as the most important determinant as to whether an adverse event has occurred. The patient observations, although extremely valuable and important, are not always available or reliable. If a system is established to utilize the patient as the most important determinant to monitor adverse events, then what happens when the patient is incoherent or does not have any family members to observe treatment? The system of checks and balances would fall apart.

Understandably, the common patient will tend to have a natural deficit in the language of adverse events. Patients might not have a complete understanding of the adverse events, but they do have the first hand perspective of understanding the effects being applied in their treatment. Patient’s lack of understanding for the system checks in place to interrupt adverse events does not mean they do not play a vital role in notifying their care workers of an event. Essentially, an observant patient or family member is a key player in the balance for the system of checks and balances, but only a component of the entire system. If a patient is coherent and mentally keeping track of what is going on, then in the event there is a repeated process then the patient can notify the care worker of the event. This helps to strengthen the overall system.

The patient, when in a state to participate, can offer much value to a system that utilizes patient input. This could be in the form of a digital survey interlaced with the patients viewing device for example. The patient could answer a couple of quick multiple-choice questions that would be calculated and uploaded to the EMR. Then, based off those answers the system could flag the EMR if an adverse event has occurred or is about to occur.

Patients need to focus on recovery, not system process to ensure adverse events are not occurring. This speaks volumes about the state of our current healthcare system. Errors occur at such an alarming rate that the environment of healing is now approaching a quasi healing/monitoring system where the patient is being asked to make sure things are being done correctly. This is not a standard of care we should be embracing. The organizational structures and communications must improve for the benefit of the patient. It is good to have patients who take a vested interest in their own health, but patients should not have to worry about maintaining a “defensive observation” while entrusting their care to a healthcare organization.

Blog #2. Nursing Education: A Collaborative Effort at Quality Improvement.

Recently, I was allowed to attend a unique meeting of local healthcare organizations, and local colleges in a round-table like discussion on the educational standards of local nursing programs. By the end of this meeting I personally had a new appreciation for all the hard work, and collaborative effort between competitors to improve the nursing education. It was encouraging to witness the inner workings of a mix of competitors coming together in a collaborative, and unbiased effort to improve quality.

The meeting began with the host college touching on nursing program enrollment, graduation rates, and practicum examples for the previous semester. The other colleges in attendance then followed one another with statements of their own institutional figures pertaining to each of their respective nursing programs. After this, the dynamic of the discussion shifted to problems with the curriculum, examination, and real-world training through practicum experiences. Some problems the colleges noted had to deal with practicum training not matching classroom teaching. One college official was very concerned that students are being taught one way, only to be told to practice a different way when integrated with a local organization.

After the college officials had an opportunity to present their observations from the last semester, the local healthcare providers then presented their observations of the nursing students. The most common theme from this side of the table had to deal with students overall lack of professional skill sets. Statements highlighted student’s general lack of understanding how to communicate, failure to act professionally, critical thinking qualities, and lack of basic interpersonal relationship skills. There was little mention of any clinical observations; overall the healthcare providers seemed pleased in that area.

The discussion then shifted to an open discussion for ideas how to improve on the concerns raised by all stakeholders. All the stakeholders agreed on some new approaches that would be tested over the next semester in an effort to improve the aforementioned conditions, and a few others not mentioned.

This meeting was a wonderful opportunity to witness educational, and institutional competitors come together to ensure that the quality of nurses being turned out by the local educational institutions are performing at the highest standards. All the stakeholders understand how critical it is that an open communication exists between all parties because they all expect the best quality of care for their patients. It is my belief that this kind of transparency, and collaboration between competitors will lead to higher quality in the Orlando area.

What does quality mean to me?

Quality can mean any number of things. One could philosophically claim that quality is whatever an individual deems ones comfort level is when defining quality. A short answer in an economic exchange between two parties could claim quality is any product or service created or performed with care and attention to detail in an effort to provide the best product or service. But, in all actuality it depends on the context in which the question is being asked.

For the context of this course in healthcare we focus on what quality means when applied to this arena. Quality in healthcare encompasses key components that all relate to the delivery, safety, and well being on an individual. Healthcare quality is the total sum of these components expressed in the empirical outcomes for the patient.