JHM sets new goals for national leadership in patient safety and quality

In recent years, we have been documenting our progress in patient safety and quality using core measures ranging from prompt administration of aspirin to heart attack patients to the proper care of children suffering from asthma. In the past, we sought to “meet or exceed” the state average on more than 30 of these measures that we report to the Centers for Medicare and Medicaid Services.

In a sense, these measures are like a report card for hospitals. While B’s and C’s may be sufficient for some, we can—and should—do better.

To ensure our goals match the character and history of this great organization and its people, the Board of Trustees committee that oversees the Armstrong Institute of Patient Safety and Quality—which includes trustees and leaders from across Johns Hopkins Medicine—took a bold step forward. Their mandate: The Johns Hopkins Health System will achieve the performance score required in patient safety and quality of care measures to demonstrate national leadership. We must, they decided, be truly excellent in these core measures if we are to be true national leaders.

In their vote, they acknowledged what we already know: We are not satisfied with being “average or above average.” We are Johns Hopkins. Excellence is our tradition and our future.

Our new goal will be to ensure that we score at least 96 percent in all the core measures. This means that in all of our hospitals, for each of the measures, we do the right thing at least 96 percent of the time.

What does this look like? To meet our goals, we really must set our sights on reaching 100 percent compliance. That means that every patient who walks in the door having a heart attack is given an aspirin upon arrival, is counseled about smoking cessation and is prescribed a statin when discharged, as appropriate. Every time. It means that we provide every patient, every time, with appropriate vaccinations and antibiotics before having surgery. It means we follow best practices, every time, when treating every patient suffering from asthma. Not just because a 96 percent score is a laudable goal, and not just because we should be capable of achieving it, but because our patients deserve it.

But achieving this goal will take more than aspiration.

• It will take transparency: We will need to share and make available the data that shows our performance, our progress, our problems, and where we need to focus. In coming months, we will widely distribute unit-level performance data on core measures and hand hygiene via broadcast e-mail.
• It will take defining what behaviors need to change and providing the staff across our organization with the help and support they need to make those changes. Managers, for instance, will receive toolkits guiding them on how to leverage their data for improvement in their units and departments.
• And it will take clear lines of accountability at every level, from local units to hospitals to the entire Johns Hopkins Health System.

It will take all of us—faculty and private practice physicians, nurses and administrators, CEOs and staff, academic and community hospitals—to make this happen. By working together, we will systematically improve patient care processes and outcomes. Look for more information on this critical initiative in the coming weeks and months. Our new commitment to raising standards for the quality of care we deliver honors our noble history and sets us on a path to continue to lead in the years ahead.

Sincerely,

Edward D. Miller, M.D.
Dean of the Medical Faculty
CEO, Johns Hopkins Medicine

Ronald R. Peterson
President
The Johns Hopkins Hospital and Health System
EVP, Johns Hopkins Medicine

Peter Pronovost
Director, Armstrong Institute for Patient Safety and Quality
Senior Vice President for Patient Safety and Quality, Johns Hopkins Medicine

Judy A. Reitz
Vice President for Quality Improvement, Johns Hopkins Medicine
Vice President of Operations Integration, Johns Hopkins Health System
Executive Vice President and Chief Operating Officer, The Johns Hopkins Hospital

Richard G. Bennett
President, Johns Hopkins Bayview Medical Center

Vic Broccolino
President and CEO, Howard County General Hospital

Brian Gragnolati
President and CEO, Suburban Hospital
Senior Vice President, Johns Hopkins Health System

Robert L. Sloan
President and CEO, Sibley Memorial Hospital