Sustainability and Corporate Strategy

Located in an area surrounded largely by private residences and small businesses, Northside Hospital’s mission is committed to the health and wellness of the community as well as becoming a regional leader in select medical specialties.  The values to support this mission, are: Excellence, Compassion, Community, Service, Teamwork, Progress and Innovation.  To align the culture within the organization with these goals, employee volunteerism and community service are promoted by the organization.  Within the hospital units themselves, “we are committed to balancing clinical excellence with safe, high-quality, compassionate care for our patients” (www.northside.com, 2014).  Like most hospitals, Northside actively seeks feedback through patient satisfaction surveys, conduct extensive quality and performance evaluations, and is continuing to grow its campuses as well as branches throughout the metro Atlanta area, demonstrating great financial stability.

To sustain this growth and success as an organization, many internal business processes must also be addressed on an ongoing basis.  One such measure is a patient’s length of stay in the intensive care unit.  Garland and Connors (2013), reported in a recent study that there is up to a 10% increase in mortality when transfer from and ICU to a medical-surgical area is delayed by 9-20 hours.  This lapse in time and the associated poor outcomes must be improved in order for Northside Hospital to remain a regional leader within our community.  Some objectives aimed to achieve this are, entering transfer orders in a timely manner, prioritizing rooms that need to be cleaned, inputting when rooms are ready efficiently, SBAR reporting processes, and multidisciplinary team rounding to improve communications and planning between team members.

Performance measures to track these activities have been developed.  The three most widely used models to rate ICU performance on mortality are the Mortality Probability Model (MPM), the Acute Physiology and Chronic Health Evaluation (APACHE), and the Simplified Acute Physiology Score (SAPS) (Philip R. Lee Institute for Health Policy Studies, 2014).  Recent literature indicates that the choice of model has little impact on hospital performance assessments (Afessa, 2006).

One strategy that was adopted on the unit to that will aid to sustain this initiative is the use of tele tracking; a system adopted by many hospitals in recent years to improve hospital patient flow and optimizing hospital operations.  Through tele tracking, nurses and hospital staff on the unit are able to enter data for a patient transfer in a timely manner.  Patient placement facilitators can also be placed on this tracking system, to assist with the prioritization of rooms to be cleaned.  When ready, Environmental Services is able to input when the rooms are ready for occupancy (Brown and Kros, 2010).  This is only one of several innovative initiatives that can be to connect organizational capacity, efficient business processes, customer value, stakeholder satisfaction, sustainability performance, and market and financial outcomes for Northside Hospital (Rohm and Montgomery, Balanced Scorecard Institute, 2011).

References

Afessa, B. (2006). Benchmark for intensive care unit length of stay: one step forward, several more to go. Critical Care Medicine.  34(10). 2674-2675.

Brown, E.C., Kros, J. (2010). Reducing room turnaround time at a regional hospital. Quality Management in Health Care. 19(1). 90-102

Garland, A., Connors, A.F. (2013). Optimal timing of transfer out of the intensive care unit. American Journal of Critical Care, 22(5), 390-397; doi: 10.4037/ajcc2013973

Philip R. Lee Institute for Health Policy Studies. ICU outcomes (mortality and length of stay) method and data. Retrieved from http://healthpolicy.ucsf.edu/content/icu-outcomes.

Rohm, H., Montgomery, D. (2011). Link sustainability to corporate strategy using the balanced scorecard. Balanced Scorecard Institute. Retreived from www.balancedscorecard.org

This entry was posted in week 1. Bookmark the permalink.

2 Responses to Sustainability and Corporate Strategy

  1. Olga Turner says:

    Hi Erin,
    I appreciate your comments. I think that there are many interventions and the environment itself that poses risks for complications in the ICU. I have been doing a lot of reading on why mortality increases so much with that little bit of extra time. I think it is the additional time of having things like the foley in, the monitotring lines., the additional time in bed. Why don’t we take it out the minute we get the transfer orders? I think it is for that “just in case” reason that the patient still goes backwards and ends up needing to stay after all – like the reason we don’t take out an IV until the very last minute before a patient is rolled out the door on discharge.

  2. Erin Sing Biscone says:

    Olga,

    It is striking what a difference an extra half a day in an ICU can make in a patient’s outcome. I enjoyed hearing you speak about it today. Reading your post, I began to wonder why this is the case. It makes me think a little of home vs. hospital birth. In theory, hospital birth should be much safer, because of the ability to deal with emergencies quickly. Research, however, tells a different story, and the reason seems to be that routine interventions done in the hospital can cause negative outcomes. Therefore hospital birth has different, but essentially equal, dangers from home birth.

    Do you think excessive interventions in the ICU could be the cause of the negative outcomes? To what do you attribute it, if not that?

    Erin

Leave a Reply

Your email address will not be published. Required fields are marked *