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Measuring Quality

 
=Images= | QC MeasuringNot all medical centers and physicians are alike. Differences in quality matter most when you need sophisticated medical care for a complex condition. The doctor and medical center you choose will have a direct impact on your care - especially when you need treatment for a serious condition or disease.

Quality is measured in many different ways. While there is no universal agreement on which method should be used, the following criteria are often cited as quality indicators:

Medical Center Accreditation
The Joint Commission is an independent, not-for-profit organization that evaluates and accredits nearly 16,000 health care organizations and programs in the United States. Joint Commission accreditation is recognized nationwide as a symbol of quality that reflects an organization's commitment to meeting certain performance standards. To earn and maintain accreditation, an organization must undergo an on-site survey by a Joint Commission survey team at least every three years. Our Joint Commission information is available on the Joint Commission website.  

Physician Training
Board certification, or the international equivalent, means that doctors have completed specialized training that a specialty board requires. To earn board certification, physicians must have practiced for a specified period of time and then pass a difficult written and oral examination. Board certification is generally accepted as a good indication of competence and experience. Ask your physician about her or his board certifications.

Experience Matters
For complex specialized care, experience matters. According to the Annals of Internal Medicine (September 17, 2002), the majority of studies find a lower patient mortality rate for a given procedure when the medical center or physician has high-volume experience performing that procedure. Medical Centers with a wide range of services treat more complex medical conditions. These hospitals are better equipped to manage complications, should they occur. Additionally, for complex diseases your physician has more treatment options available. OSF Saint Anthony is home to four Centers of Excellence that provides care for large numbers of patients. The four Centers are Cardiovascular Services, Illinois Neurosciences Institute, Center for Cancer Care and our Emergency and Trauma Services.

Dedicated Staff
OSF Saint Anthony staff members are dedicated to ensuring patient safety.  Our staff members are often recognized for being leaders in initiating safety protocols that the Medical Center has implemented and in being champions of patient safety.

For example, in March of 2011, two OSF Saint Anthony staff members were honored during the Illinois Nurses Association (INA) 3rd District annual Nurses Expo.  Kathy Stucker, patient safety officer for OSF Saint Anthony Medical Center, was selected to receive the Distinguished Nursing Advocate Award for her outstanding efforts in ensuring patient safety and quality of care.  Since coming to OSF Saint Anthony in 2003, Stucker has been responsible for implementing the National Patient Safety goals; the confidential “4444” occurrence reporting line; the Failure Mode Evaluation (FME) which is used by the airline industry to involve the team in pursuing perfection; the “Fall Huddle” to analyze data and to prevent future patient falls; a change in the reporting processes for epidural pumps; an online educational module for nurses in all the OSF System hospitals to learn about the new processes; an audit tool to avoid “near misses” and many other patient safety programs and protocols.             

Katie Carlovsky, CCRN, acute care nurse practitioner in the OSF Saint Anthony Critical Care Center, was selected to receive the Excellence in Nursing Award for her outstanding skills with patients and their families and for her continuing commitment to patient safety and the best possible outcomes.  As a nurse practitioner, Carlovsky cares for patients at the bedside and is involved in protocol and program development. She was instrumental in the implementation of the “Surviving Sepsis Campaign” at OSF Saint Anthony. She helped develop protocols and monitored the patients throughout their intensive care stay to ensure optimal outcomes. Recently, she has initiated protocols for therapeutic hypothermia. Always a proponent of advance practice, Carlovsky also precepts nurse practitioner students and facilitates physician residents during their critical care rotation. 

 
Satisfied Patients
Patient satisfaction often reflects how willing doctors and nurses are to listen, answer questions and explain treatments; how much time doctors spend with patients; and if the medical center is clean and the food is good. Patient satisfaction data can predict how satisfying your experience is likely to be. Patient satisfaction information can be found on our Patient Satisfaction and Service Quality web page.

Other Sources of Health Care Quality Information

Several industry and government organizations provide information about health care quality and some have proprietary reporting tools. The information these organizations provide can help you make informed, accurate decisions about healthcare quality.

Warning: Different agencies and consumer reporting sites use different definitions, data sets, and time periods and have different (or nonexistent) ways of normalizing data for comparisons (severity adjustments).

Therefore, comparisons between sources are not "apples to apples" and comparisons within a single source have to be carefully analyzed before accurate conclusions can be made (read the fine print!).

The Joint Commission

The Joint Commission and Centers for Medicare and Medicaid Services (CMS) developed a set of research-based quality indicators that are used across the nation. They have established standardized measures of quality in selected patient populations including acute myocardial infarction (AMI), community acquired pneumonia (CAP), congestive heart failure (CH), pregnancy and related conditions and surgical procedures. OSF Saint Anthony is currently participating in AMI, CAP and CHF. This information can be found on our Quality Reports web page and on the Joint Commission Accreditation website.  

OSF Saint Anthony Medical Center follows the guidelines established by The Joint Commission Center for Transforming Healthcare.

In response to The Joint Commission focus on patient safety and to enhance patient flow for patient safety and satisfaction, a Patient Logistics component has been added to the Nursing Services department. Elements of Patient Logistics include determining initial admission status, facilitating patient placement according to clinical decisions and diagnosis, and using the new electronic bed-tracking system through Epic.  The ability to track patient volumes through expected influx to discharge and to coordinate staffing according to patient needs helps to bring about the smooth flow of patients within OSF departments or, when needed, in transfers to regional facilities.

To ensure patient safety, we observe: 

 

Hand-off communications
A hand-off is the transfer and acceptance of patient care responsibilities achieved through effective communication. A hand-off process involves “senders,” the caregivers transmitting patient information and releasing the care of the patient to the next clinician, and “receivers,” the caregivers who accept patient information and care of the patient.

Hand Hygiene
Sanitizer dispensers are placed in all  patient rooms and throughout the facility.  OSF staff members are instructed to either wash their hands at the sink or use the sanitizer both prior to and after seeing the patient.  Our safety culture stresses hand hygiene at all levels.

Surgical Site Infections
Since surgical site infections are a major cause of patient injury, health care cost, and prolonged hospitalization, OSF Saint Anthony is committed to ensuring a low rate of infection. 

Wrong-Site Surgery
When surgery is scheduled, OSF staff may ask the patient several times what procedure is going to be performed and on what site.  This repetition is to ensure that the patient, doctor, nurses and surgeon all agree on and are clear about exactly what will be done during the operation.  Before surgery, patients may be asked to point to the site of the surgery.  As part of the patient safety initiatives we follow,  the area is marked with a special pen by the surgeon. 

Transforming Care at the Bedside (TCAB)
OSF Saint Anthony Medical Center is one of the 32 hospitals throughout the nation that is participating in Transforming Care at the Bedside (TCAB), a program adopted by the American Organization of Nurse Executives (AONE) in which a set of practical, easy-to-use tools are designed and shared to help hospitals improve the quality and safety of patient care on medical and surgical units.  The principles are being used to help design future models of care delivery that will ultimately transform the culture of how nurses care for patients.

The Leapfrog Group
The Leapfrog Group was founded in November 2000 by the Business Roundtable and has support from The Robert Wood Johnson Foundation. Leapfrog's mission is to trigger giant leaps forward in the safety, quality and affordability of health care by: supporting informed healthcare decisions by those who use and pay for health care; and, promoting high-value healthcare through incentives and rewards. More than 165 Fortune 500 corporations and other large private and public sector health benefits purchasers have joined The Leapfrog Group, representing more than 36 million enrollees. For more information, visit its website.

The NRC Consumer Choice Award

National Research Corporation (NRC) annually provides Consumer Choice Awards for the most-preferred hospitals in more than 140 U.S. Markets. Winners are selected from the nation's most comprehensive, nationwide consumer health care profile, the NRC Healthcare Market Guide. Data represents consumer surveys from nearly 140,000 households in the U.S. Consumer Choice Awards for hospitals are based on consumer preference responses. OSF Saint Anthony Medical Center has earned awards from 2002-2005.

Healthgrades
Healthgrades is a private company that uses Med Par public data and proprietary severity adjustment methodology to rank organizations on a scale of 1-5 "stars" with 5 being excellent. Problems abound with this data, which is two to three years old before it is released, and Healthgrades issues its stars based on three years of data. As a result, Healthgrades is not a true reflection of any medical center's current practices. In addition, its severity adjustment methodology can not be reproduced. Another limitation is that Med Par data includes only Medicare patients who are over 65 years old and who are cared for in the inpatient settings.

Illinois Foundation for Quality Health Care
The Illinois Foundation for Quality Health Care (IFQHC) is the Quality Improvement Organization (QIO) for the State of Illinois. QIOs work with physicians and health care professionals to promote high quality medical care for Medicare beneficiaries. IFQHC is contracted by the Centers for Medicare & Medicaid Services (CMS) to perform the designated quality improvement activities. For more information on IFQHC, visit its website.

Illinois Department of Public Health

The Illinois Department of Public Health is responsible for protecting the state's 12.4 million residents, as well as countless visitors, through the prevention and control of disease and injury. The Department's nearly 200 programs touch virtually every age, aspect and cycle of life. For more information, visit its website| Illinois Hospital Report Card.