At the Washington Health System, our mission statement is simple, yet we believe that it gets to the heart of what we strive to provide each day- Great Patient Care.

We define great patient care as clinically safe, timely, efficient, effective, equable, and patient-family centered for both patients and caregivers. Preventing patient harm is central to our mission.

We’ve adopted a continuous improvement philosophy that seeks to eliminate waste from our system and to improve care by focusing on what is important to patients. Our team members are trained in the methodology of involving front-line staff in the identification of potential harm and in redesigning care. We strongly believe in creating a culture of patient safety to reduce errors as we work toward our goal of zero patient harm.

As we strive to prevent harm, we will share with you our progress in these areas, as well as what we do to improve patient safety and what you can do to help.

We welcome your comments and perspectives on this important topic.

Quality and Safety

Brook T. Ward
President & CEO, Washington Health System

Click on topics belows for more details.

Total Patient Harm Rate is a calculation that attempts to quantify all types of patient harm.  Included in the calculation are medication errors with harm, healthcare associated infections, patient falls with injury, Stage 3 and 4 pressure wounds, early elective maternal deliveries before 39 weeks and venous thromboembolism (VTE; pulmonary embolus and deep vein thrombosis) in surgical patients.  There has been a 41% decrease since FY 12. Washington Health System is actively working on process improvements on each of the indicators in order to decrease the rate.

Quality and Safety

Infection Prevention and Control: We know that one of our patients’ greatest fears when hospitalized is acquiring an infection. These infections take many different forms:  Clostridium difficile (C diff), post-operative wound infections, blood stream infections, urinary tract infections, and pneumonia. Even though we had a decrease in the number of infections, our infection rate has increased slightly in FY 19-20 because there were fewer hospitalizations. Because of the COVID-19 pandemic, fewer patients were admitted to the hospital and many surgeries were postponed until a safer time.  Preventing infections requires a team effort that includes our staff, physicians, patients and their families.

Quality and Safety

What we do to prevent infections:

Hand Hygiene: The most effective way to prevent infections is to wash your hands. Studies have shown that using soap and water or alcohol based hand washing products is effective in preventing most infections.  Hand sanitizers are located throughout the hospital and in or immediately outside each patient room.  Over the past 3 years, we have improved our compliance with hand hygiene. Observations are performed at random days and times; incidences of noncompliance are remediated immediately.

Quality and Safety

Isolation: In order to prevent the spread of infection, we place certain patients in isolation. These patients may already have an infection, or are more susceptible to an infection because of their medical condition.   It is critical that everyone follow the instructions on the door of the patient room to help prevent the spread of infection and / or to protect the patient.   Visitors are required to wear protective equipment such as gloves, masks and gowns when visiting patients in isolation, if visitation is permitted. In order to prevent the spread of COVID 19, patients with suspected or confirmed COVID 19 are not permitted visitors.

Antibiotic Stewardship: There are certain bacteria that are resistant to treatment with antibiotics. The most effective way to prevent additional bacteria from becoming resistant is to use antibiotics only when necessary.  Efforts over the past year in “antibiotic stewardship” have decreased the use of certain antibiotics.

Resources: Our health system employs a board-certified Infectious Disease physician and certified Infection Prevention nurses who strive to make the hospital safe against infection.  Special cleaning technology has been deployed to prevent the spread of C-difficile infections and COVID-19.

What you can do to help:

  • Wash your hands or use hand sanitizer frequently. Hand sanitizer is conveniently located in patient rooms, outside patient rooms, entrances to departments, near elevators, and other common areas.
  • Observe isolation signs and instructions.
  • Follow the CDC’s Coronavirus Disease 2019 (COVID-19) guidelines for Healthcare Facilities including wearing a face mask over the mouth and nose at all times.
  • Understand that an antibiotic should only be prescribed when it is known that a bacterial infection, not a viral infection, is present.
  • Get regular flu shots, and if appropriate, vaccinations for other infectious diseases such as pneumonia.
  • Ask healthcare team members to wash their hands if you are not sure that they washed their hands before caring for you or your family member.

To learn more about healthcare associated infections and COVID-19, use this link to go to the Centers for Disease Control (CDC) website.  www.cdc.gov

Over the years, we have learned that it is not necessarily our older, more fragile patients that are most in danger of falling in the hospital.   Because of this, we consider all of our patients to be at risk.   In the past several years, we have implemented various strategies that have resulted in a decrease in the number of patient falls.  The Healthcare Improvement Foundation (HCIF), a national quality organization based in Philadelphia, estimates that national fall rates are 4.0 per 1000 patient days.  Preventing falls is the responsibility of all members of the health care team, the patient, their family and friends.  Our rate of falls that result in a major injury is 69% less than last year.

Quality and Safety

What we do to prevent falls:

Fall Risk Assessment: When a patient is admitted, a Falls Risk Assessment is completed. This assessment helps our staff initiate various interventions that will minimize the risk of injury.  Those patients with bone disorders, those taking blood-thinners, those who have had surgery during the admission and those who are older than 85 years of age are at particularly high risk for sustaining an injury if they fall.

Hourly Rounding, Ambulation and Equipment: We round on our patients every hour to ensure their needs are addressed. Our cutting edge patient call bell system, Responder 5, allows you to select a reason for calling and allows staff to respond to your needs. We have found in the past that many falls occur when patients attempt to go to the bathroom on their own.   There are medications that can cause dizziness or lightheadedness so we strongly encourage patients to ask for assistance when getting out of bed.

What you can do to help:

  • Always be honest in your responses to the Falls Risk Assessment, including a history of falling
  • Always ask for help when getting out of bed

Our pharmacy processed over 1.6 million medication orders last year. The graph below depicts the rate of medication errors with patient harm. There were no errors that resulted in patient harm this year.

Quality and Safety

What we do to prevent medication errors:

Computerized Physician Order Entry (CPOE):  Physicians order medications directly through a computer system.  This has eliminated the potential errors in drug name and dosage that were often associated with physician handwritten orders in the past.

Dispensing Units:   Most patient medications are stored on nursing units in locked, automated medication dispensing machines.  These machines improve efficiency and dramatically increase the level of safety.

Bar Code Medication Administration: Most medications are bar-coded.  Before nurses give medications, they use a scanner to match the bar code on the patient’s armband to the medication.  This significantly decreases the chance that an incorrect medication will be given, or that a medication will be given at the wrong time, wrong dosage or by the wrong route.

Smart IV Pumps: The pumps that are used to infuse IV fluid have special safety features to protect our patients from inadvertent errors in dosing. The tubing has an automatic closing valve that keeps fluid from infusing when the tubing is not in the pump. The programming within the pump prevents the doses from being set too high or too low.

Medication Reconciliation: The Pharmacy team ensures that the medications you take at home are correct in our record. They may come to your room to make sure we have the most current list of medications with the correct doses, including over the counter products.  If you have a complicated medication regimen, a pharmacist may talk to you so that you understand your medications. Medications are also reconciled prior to discharge.

 

Drug Reaction/ Interaction/ Duplication Databases:  Our Pharmacy uses the most recent information on drug-drug and drug food interactions, reactions and side effects and medications that are duplicates.

What you can do to help:

  • Always keep a list of your current prescriptions and over the counter medications with you. Be honest about vitamins and herbal supplements that you take as these can interfere with other medications that you are prescribed.
  • Ask questions if you are unclear about any of your medications.
  • Obtain all of your medications from one pharmacy if possible.
  • Do not take any medications you bring in from home while you are a patient.

Unfortunately, patients are sometimes admitted with pressure ulcers or develop a pressure ulcer that cannot be avoided because of the patient’s medical condition while they are in the hospital. We work diligently to prevent pressure ulcers from occurring in the hospital.  There have been no serious (Stage 3 or 4) pressure ulcers for the past 5 fiscal years.

What we do to prevent pressure ulcers:

Turning and Repositioning:  Nurses and Care Partners / Nursing Assistants turn and reposition patients to prevent pressure ulcers from developing.

Frequent skin assessments:  Most pressure ulcers can be seen at an early stage and interventions can be employed to prevent them from becoming more serious.

Interventions:  special creams for pressure points, mattresses that distribute the weight of the patient, and early walking during a hospital stay.

Resources:  Our health system employs specially trained and certified Wound, Ostomy and Continence Nurses that specialize in skin care and prevention of pressure wounds.

What you can do to help:

  • Turn and reposition yourself frequently to prevent skin damage from continuous pressure; even while sitting in a chair. Ask the nursing staff for help.
  • Inform the nursing staff if you develop a painful area on the buttocks / tailbone or over other bony prominences.
  • Ask for assistance if you need to move up in the bed. Moving yourself by sliding damages the skin by shearing

Blood clots in the veins, primarily affecting the legs, arms, or lungs, are called venous thromboembolism (VTE’s).  We work to provide appropriate measures to prevent VTE’s from occurring. Most patients receive medication to help prevent blood clots from occurring (prophylaxis) while they are not as mobile as normal.

Quality and Safety

What we do to prevent VTE’s:

Appropriate prophylaxis:  Medications such as Enoxaparin (Lovenox) and heparin are given to patients to thin the blood and help prevent VTEs. Sequential Compression Devices (SCDs) are usually only used when the patient cannot take the medications.

Ambulation:  Patients that are on bedrest or do not walk much are at a higher risk to develop a VTE than those who mobile. At Washington Health System, we promote early ambulation and will assist patients who are unable to ambulate safely by themselves. Patients should ambulate 3-4 times a day.

What you can do to help:

  • As your condition permits, ambulate frequently. Ask for assistance.
  • Turn and reposition yourself frequently to improve mobilization while in bed.
  • Inform the nursing staff if you develop a painful area in the calf or have shortness of breath.

Washington Health System measures patient experience using two nationally recognized systems:   Press Ganey and the federal government’s “Hospital Consumer Assessment of Healthcare Providers and Systems” (HCAHPS).   Surveys are completed by patients after they have had services in our system. Press Ganey surveys are sent to inpatients, emergency department patients, radiology patients and patients who have had ambulatory/outpatient procedures like cardiac catheterizations and endoscopies. Below are our results for Inpatient experience.  The Inpatient chart below represents the percentage of patients who rated the hospital as either a “9” or “10” on a scale of “0” to “10” with “0” being the worst and “10” being the best for their overall experience. Our patient experience scores dropped during March, April and May when no visitors were allowed due to the COVID-19 pandemic. Our goal is to increase positive patient experiences.

Quality and Safety

What we do to improve patient experience:

Patient and Family Advisory Council:  We have enlisted help from community members who have volunteered their time and expertise to tell us what patients really need and expect from our system.  The Patient and Family Centered Care (PFCC) team has been working with hospital staff to create an environment that is respectful, caring and healing.  Some members of the PFCC sit on important health system committees.

Process Improvement Teams: 
We have adopted the “Washington Performance System”, based on the Toyota Production System, for Continuous Quality Improvement. We have formed teams of our staff, both managers and front-line care providers, to look at various aspects of our care to eliminate unnecessary steps and streamline processes for our patients. We have an innovation unit where aspects of patient care are redesigned, tested and then eventually rolled out to other units.

Best Practices:

We have focused our efforts on hardwiring the Best Practices including AIDET, Bedside Shift Report, Hourly Rounding, Leader Rounding, Discharge Follow up Phone Calls, White Communication Boards, Getting to Know You Boards, and Physician –Nurse Rounding.

What you can do to help:   

  • Volunteer to serve as a Patient and Family Centered Care Advocate.
  • Complete surveys if you are sent one. Your feedback is very important to us and is used to determine some of our reimbursement from Medicare and other payers.

Electronic medical records:   Your medical record is almost entirely electronic. Healthcare providers have access to your medical record via secure computer links in the hospital and in their offices. This access increases the availability of your health information in a timely manner and facilitates treatment decisions.   In some instances, our patients can access their data directly from our computer systems through the use of “patient portals”.

Communication among the healthcare team:  Our health system uses an advanced voice communication device called “Vocera” that enables quick, hands-free communication between team members.  We have expanded the use of this technology to include families of patients undergoing surgery and testing.

Hospitalists: Hospitalists are physicians, physician assistants, and nurse practitioners who are specifically trained to care for hospitalized patients. Most of the community physicians have made the decision to focus their attention on their office-based practices and to entrust their patients who are admitted to the hospital to the care of the Hospitalists. Even though your physician may not see you in the hospital, the Hospitalists are providing information on your hospitalization through secure computer links. Your physician has access to all of your test and treatment information, including a complete summary of your hospitalization when you are discharged. Hospitalists provide care 24 hours a day.

Intensivists: Intensivists are physicians and nurse practitioners who are specifically trained to care for critically ill patients In the Critical Care Unit (CCU). The intensivists provide care 24 hours per day.   Studies have shown that patient outcomes improve when care in the CCU is coordinated or provided by specially trained physicians and nurses.

Other Specialists: Depending on your healthcare needs, other specialists that may participate in your care include: Emergency Department Physicians/ Nurse Practitioners/Physician Assistants, Family Medicine Residents, Radiologists, Interventional Radiologists, Pathologists, Psychiatrists, Surgeons, Anesthesia, and Palliative Care to name a few.

Health System Accreditations and Patient Care Achievements:

WHS Washington Hospital is accredited by the Joint Commission. Please click on the link below to access their most current report about the hospital – a compilation of the most important aspects of quality of care and patient safety. The report also compares the hospital’s results with both state and national standards.

Click here for the The Joint Commission Quality Report

  • WHS Washington Hospital has received the American Heart Association/American Stroke Association’s Get with the Guidelines® – Stroke Gold Plus Quality Achievement Award 10 years in a row.
  • The Leapfrog Group recently rated WHS Washington Hospital with an “A” grade for hospital and patient safety.
  • The Hospital and Healthsystem Association of Pennsylvania (HAP) has recognized WHS Washington Hospital for excellence in patient safety.
  • The National Committee for Quality Assurance (NCQA) recognized the Family Medicine Residency Program at The Washington Hospital four years in row.
  • WHS Washington Hospital is designated as a Blue Distinction Center for Cardiac Care through Highmark.
  • Greenbriar Treatment Center, part of the Washington Health System received the Blue Distinction Centers for Substance Use Treatment and Recovery designation through Highmark.

Our recent Community Needs Assessments

Community Needs Health Assessment Joint Implementation Plan 2018
Community Health Needs Assessment Final Report 2018
Community Health Needs Implementation Plan 2017
Community Health Needs Assessment Final Report 2016
Community Health Needs Assessment Final Report 2013

Questions
If you have questions about Quality of Care or Patient Safety at Washington Health System Washington Hospital, please click here to send us an email.