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Patient Safety - Initiatives
In 2009, after making enormous strides in patient safety, Johns Hopkins entered into an agreement to share its innovations with St. Joseph's Regional Medical Center in Paterson, New Jersey. The aim was to test whether the Hopkins patient safety model would work within another healthcare system. Johns Hopkins began with the development of CUSP (a Comprehensive, Unit-based, Safety, Program) having looked at other industries such as nuclear power, the aviation industry and manufacturing. The acronym is defined by respecting local wisdom, finding out from those on the front line what's broken and partnering with a senior leader to get the resource the unit needs that they've identified. The program is based off of multi-disciplinary caring and an extensive system of communication to prevent minor errors and encourage teamwork.
Issues identified in St. Joseph's Healthcare System were analyzed and a monthly meeting was assembled including a multi-disciplinary team and key problems were similar to those at Johns Hopkins such as medication issues and infection control and overall safety from guests. As a result, communication on units between physicians and nurses have dramatically improved. An example is an hourly round instituted on Reagan 6 north where nurses check on residents each hour to see how they are doing and make sure they eliminate incidents of falls. It has become an expectation that if the nurses see something that affects their practice that they are now responsible to communicate it and bring it forward and at St. Joseph's our Magnet award winning nurses can now do so confidently and effectively.
"Through your failures is how you learn how to become better at what you do. What you try to do is hard line those mistakes so that they are infrequent and if they are made they're identified very early on in the process so you can go back and change the process and that's what this does." Said William A. McDonald, President and CEO, St. Joseph's Healthcare System.
The intensive care unit at St. Joseph's Regional Medical Center has sustained a ventilator associated pneumonia (VAP) free status for 36 months. This VAP rate remains below the 50th percentile of teaching hospitals as reported by the National Healthcare Safety Network (NHSN).
Since the introduction of CUSP, St. Joseph's has seen increased patient satisfaction scores in both CUSP units. In the ICU, the patient satisfaction rate increased by 6 points, from 84 to 90. In the unit known as Regan 6 North, the average patient satisfaction score (as measured by Press Ganey) increased by 4 points from 83 to 87.
Sine the introduction of CUSP at St. Joseph's, the fall rate per 1000 patient days has decreased from 4.4 to 3.3.
The CUSP initiative has enabled St. Joseph's to reduce its fall rate below the 50th percentile of academic medical centers in the U.S. as reported by the National Database of Nursing Indicators (NDNQI).
