Klein Six of the Valley’s hospitals are among the country’s top performers, according to the newly released Joint Commission report. The six area hospitals are: Providence St. Joseph Medical Center in Burbank; Encino Hospital Medical Center in Encino; Providence Holy Cross in Mission Hills; Kaiser Permanente’s Panorama City Medical Center; Los Robles Hospital and Medical Center in Thousand Oaks; and Kaiser Permanente’s Woodland Hills Medical Center. The list includes 620 hospitals nationwide, each reporting composite accountability rates of 95 percent or better and a 95 percent performance target for every accountability measure that it reported to the Commission, a nonprofit that accredits 82 percent of hospitals nationwide. “Ending up on this list is a confirmation of our commitment to high quality and our adherence to high standards of care,” said Dr. Bernie Klein, chief medical officer and interim CEO at Providence Holy Cross. Measures include following accepted protocols when patients are treated for heart attack, heart failure, pneumonia, and pre- and post-operations. For example, the protocol for heart attack patients include aspirin upon arrival, aspirin at discharge, ACE inhibitor or angiotensin-receptor blocker at discharge, beta blocker at discharge, fibrinolytic therapy within 30 minutes, PCI therapy within 90 minutes, and statin prescribed at discharge. While the list represented the top 18 percent of Commission-accredited facilities, at least one high-profile area medical facility did not meet the standards: Glendale Adventist Medical Center. “Quality patient care is always our top priority at Glendale Adventist,” said spokeswoman Alicia Gonzalez. She could not speak directly to the Joint Commission report. The Commission began gathering data in 2002, but only started issuing its Top Performers report last year. Officials say that since that public accountability element was introduced, the performance of many hospitals has increased. The report shows 88.8 percent of hospitals achieved a composite accountability measure performance of 90 percent in 2011, compared to 20.4 percent the previous year. “The Joint Commission began releasing this information as a way to shine a light on hospital performance and encourage excellence. The significant increase in the number of hospitals achieving Top Performers status demonstrates that these organizations are intently focused on delivering high quality care within their communities,” said Mark R. Chassin, president of the Joint Commission, in a statement. Following the steps Top-ranked hospitals follow a carefully scripted process to make sure staff adheres to a proven protocol. At Holy Cross, nurses and doctors are assisted by quality improvement specialists who investigate whether admitted patients exhibit any of the tracked symptoms such as heart attack or pneumonia. “We manage it in real time,” Klein said. If a nurse or doctor has not immediately started that protocol according to the data in the electronic records or the physical chart, then the quality improvement specialist will alert hospital staff. At Kaiser’s Panorama City Medical Center, Medical Director Dr. Mary Wilson said record-keeping technology also has helped caregivers to better identify what might be happening to a patient more readily, and thus begin proven protocols more quickly. “What really helps us is that we have electronic medical records,” Wilson said. “It helps us to integrate outpatient-world care with inpatient-world care. We see the episode of care as part of their continuum of care.” The report does not take into account patient outcome, as other similar studies do, but, according to the Commission, the 45 accountability measures of evidence-based care processes are closely linked to that standard. Klein noted that for Holy Cross, actively focusing on the protocol adherence keeps the medical staff on board, too. “We have engaged our excellent physicians and nursing staff to focus on sustained, long-term improvement,” said Klein. He said the hospital’s staff has routine meetings to look at any missed opportunities and multi-disciplinary meetings to look at the best and most efficient ways to improve care, including sharing Holy Cross-specific data on practice and outcomes with the medical staff. Kaiser Panorama City developed systems by which medical staff champion a particular improvement project, and coach colleagues toward a measurable marker. Wilson noted the hospital’s commitment to reducing the risk of blood infections as one such goal. “We have a team of doctors who work to reduce blood infections,” she said. “And they work to reduce and reduce until we’re the best. They tackle the critical goals.”
