Today, working in healthcare sometimes feels like trying to solve a mystery. We’re looking for clues, building the evidence base and trying to turn that evidence into action. And the stakes are high, because our actions directly affect our friends, our families… and ourselves.
What makes a detective so special is how he/she can look at the same things you or I do, and see things we can’t see. But, as the detectives like Sherlock Holmes remind us, heroes don’t always look like heroes. In fact, healthcare providers are heroes in their own right, presented with complicated situations where they analyze the evidence, and tackle new mysteries each day.
Healthcare’s best mystery solvers work together, recognizing that the changes needed are too complex and challenging for any one person or organization to solve alone.
In Sherlock Holmes fashion, I’ll give an example of hospitals working to solve healthcare’s mysteries together.
A group of about 350 U.S. hospitals collaborating to improve quality and reduce costs have identified several ways to ramp up patient safety for sustained mortality improvements. Together, these hospitals have avoided more than 160,000 deaths, and reduced mortality by 38% when compared to what was expected.
About 7 years ago, these hospitals came together to share their data transparently and identify gaps in quality and cost performance. They identify causes of mortality through physician and nursing peer review and by conducting in-depth reviews of mortalities, sentinel events and near misses.
They then engage in improvement efforts around changing the system of care to prevent issues from recurring. These efforts include a clearly determined cadence, well-defined metrics with targets, a firm culture of accountability, and deep executive engagement – or what we call “quality cycle management.”
To give an example, at the beginning of this work, they found that sepsis was the #1 cause of deaths in excess of expected. To tackle the problem, they set up specific initiatives around sepsis, starting with implementing practices that the organizations performing the best already had in place.
These included techniques for early detection in the emergency department, early measurement of serum lactate levels, prompt initiation of antibiotics after blood cultures and aggressive fluid necessitation. As a result of these interventions, preventable deaths from sepsis among these hospitals have dropped by 22%.
Similarly, these hospitals achieved a 6% reduction in mortality in each of the clinical conditions of stroke, heart failure and respiratory infections, including pneumonia.
These are real numbers, real patients and real hospitals working together.
It’s the power of collaboration. When hospitals come together to measure and compare their performance, they can use their data to solve healthcare’s mysteries. It’s about testing simple ideas and sharing what works, building bridges of knowledge and improvement across the healthcare system.
And recent research proves this group of hospitals is doing as much as 10% better in the area of mortality than a national comparison other hospitals. Not to mention, they’ve saved $13.2 billion dollars.
To quote Sherlock Holmes, “When you have eliminated the impossible, whatever remains, however improbable, must be the truth.”