Statewide Initiative To Tackle Hospital Readmissions, Infections


The Quality Institute of the Ohio Hospital Association (OHA) recently launched its fifth regional quality collaborative in the state, bringing together hospital administrators, physicians, and other clinicians to tackle statewide goals of reducing infections, readmissions, and adverse events while increasing patient satisfaction. A hospitalist involved in the initiative says it sets an example for other states to follow.

"Hospitalists are on the front lines of quality," says Craig Cairns, MD, MPH, a hospitalist and vice president of medical affairs at Licking Memorial Health Systems in Newark, Ohio. "But it helps to get a statewide or regional group together to share problems and potential solutions."

Licking Memorial, for example, participates in OHA's statewide quality initiatives, including one on physician handwashing and STAAR (State Action on Avoidable Rehospitalizations), a multistate care-transitions initiative developed by the Institute for Healthcare Improvement.

Licking has set a goal of reducing its readmission rate to 10.5%, Dr. Cairns says. "Trying to get the patient back to the primary medical home as quickly as possible can be difficult," he adds. "We work with support people at medical offices to try to ensure a spot for our patients going home."

Because one of the risk factors for preventable rehospitalizations is heart failure, Licking also recently instituted a heart-failure clinic, staffed by two hospital cardiologists.

The first of the regional collaborations started in the Dayton area in 1998, according to David Engler, PhD, vice president of OHA's Quality Institute. The collaborative has posted a 36% reduction in heart-attack mortality over the past three years, the equivalent of 52 lives saved.

"We were brought in to help them on a specific issue: a higher-than-expected acute myocardial infarction mortality rate," Dr. Engler says. "We held collaborative meetings, developed risk management models, and began to track data across sites." Peer-review protocols developed by OHA make it possible to share quality data among the participating hospitals, with participants agreeing not to use these for marketing or competitive advantage.

A total of 133 hospitals participate in one of OHA's regional or statewide quality collaborations.

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