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2008: Quality

In An Emergency Quality Counts
Dr. Robert Plass, Medical Director
Rideout Emergency Department

These patient comments illustrate the high quality of care provided in the emergency room at Rideout Memorial Hospital. And we just keep getting better.

This year, we are on track to treat more than 53,000 patients - a 47% increase since 2004. During that same time frame, we have cut patient waiting time in half. Every patient is examined as soon as possible by a doctor or a physician assistant who also orders necessary lab tests and X-rays. In addition, the ER has hired more physicians, nurses and technicians to keep up with increasing patient volume. We have also significantly reduced the "door-to-admission" time for the hospital patients admitted through the ER.

Under Medical Director Dr. Robert Plass, the ER has teamed up with other departments to create an Emergency Process Improvement Committee. In just one short year, this team has:

  • Improved lab and radiology result turnaround times.
  • Streamlined the registration process.
  • Increased housekeeping services.
  • Made food available for patients on site in the ER.

 "These changes help to shorten wait times, improve care and increase patient satisfaction," says Dr. Plass. "Plans are also in the works for expansion to provide more privacy. Our goal is to continue to improve the entire patient experience." As one patient noted: "Care has definitely improved. Keep up the good work!" We intend to do just that.

In an emergency, dial 9-1-1 or seek treatment at Rideout Emergency Department,

Golden State Donor Services Recognize Our Star Quality
Steve Frost, RN, Director of Nursing
Rideout Memorial Hospital

At Rideout Health Group, we believe that saving lives is rewarding, in and of itself. Nevertheless, we were honored when Golden State Donor Services (GSDS) presented its 2007 "Shining Star Champion Award" to Steve Frost, RN, Director of Nursing at Rideout Memorial Hospital for his outstanding service in saving lives through organ donation. What's more, GSDS honored the entire hospital staff by presenting Rideout Memorial Hospital with its "New Shining Star" hospital award.

"I was surprised to be recognized for doing a job that anyone should just expect - trying to make an emotional experience comfortable for donor families," Steve says.

"The credit really goes to the entire staff," he adds. "It's a collaborative effort by the doctors, nurses and counseling staff to ensure compassionate support to organ donor families. The families come through the process with the rewarding knowledge that one person's gift can save the lives of several others."

GSDS is a nonprofit, independent organization authorized by the Federal Government to accept organ and tissue donations for transplantation. The organization's service area covers 11 counties in Northern California, including Yuba County, as well as  Santa Rosa.

Rideout Memorial Hospital is one of approximately 30 hospitals working with GSDS to meet the urgent need for organ donations. As Steve notes: "The need for transplants far exceeds the number of organ donors. Organ donation is truly the gift of life."

Leading the Way with Rapid Response: Going Beyond Vital Signs to Vitality
Susan Henderson, MSN, NP, CCRN,
Critical Care Educator, Supervisor of Clinical Education

Quality of care is our highest priority here at Rideout Health Group, and our new Rapid Response Team is the latest example of that. Under the guidance of Dr. Frank Sebat, Medical Director of Feather River Critical Care, this team of key Critical Care, Emergency Department and Respiratory Therapy staff will be available 24 hours a day, seven days a week to respond to any patient anywhere in the hospitals whose condition is deteriorating.

The development of the Rapid Response Team is part of our response to the Institute for Healthcare Improvement's "Protecting 5 Million Lives from Harm" campaign and the Joint Commission's new National Patient Safety Goal is "to improve the recognition and response to changes in patient condition." This means that the nurses are assessing not 5 but 10 signs of vitality.

"This broader assessment enables our nurses to pick up subtle changes and intervene sooner if a patient's condition worsens", says Critical Care Educator and Supervisor of Clinical Education Sue Henderson, MSN, NP, CCRN. "Taken together, these 10 Signs of Vitality provide our teams with even more information for making medical decisions, allowing them to recognize critical illness earlier, leading to improved outcomes and better care.

"Hospitals have until 2009 to implement their Rapid Response Teams," Henderson notes. "Your hospitals are way ahead of the curve in enhancing the quality of patient care because our Rapid Response Team is already recognizing additional signs over the required standards for 2009.

Newborn Hearing Screenings: Leading the Way in Improving the Quality of Life
Sheryl Lawrie, RNC, BSN,
Nursery and Neonatal Intensive Care Supervisor

Statewide statistics indicate that two to four out of every 1,000 babies have a hearing impairment at birth. That means Fremont Medical Center, with 2,500 to 2,600 births per year, could potentially identify four to eight babies per year who need to be referred for more in-depth evaluation.

"The objective with newborn hearing screenings is to detect hearing loss as early as possible so we can intervene sooner to correct the problems," says Nursery and Neonatal

Intensive Care Supervisor Sheryl Lawrie, RNC, BSN. "All babies are tested prior to discharge from the hospital. Babies who do not pass that test are re-tested again later on an outpatient basis, and those who still do not pass are referred to an audiologist to determine the cause of the hearing loss."

Fremont Medical Center's experience in providing newborn hearing screenings dates back to 1996, when the American Academy of Pediatrics recommended screening all at-risk newborns for hearing loss. With the support of donations from the Yuba-Sutter community, we purchased hearing screening equipment and elected to screen all newborns - not just at-risk newborns. Subsequently in 2000, the California Department of Health Services contacted us to participate as one of 10 facilities in developing a statewide program mandating the universal screening of all newborns. That program - the California Newborn Hearing Screening Program - became mandatory for all hospitals in 2006.

"Our staff members are all well-trained and evaluated for competency in conducting hearing screenings," Lawrie notes. "Our competence and our years of experience are reflected in the high quality of the results we produce. Our performance ranks well above state requirements, and we have a very low rate of referring babies who do not actually have hearing problems."

Treatment for newborn hearing loss can range from using hearing aids that amplify sounds to cochlear implants - small electronic devices that can help provide the sense of sound to a baby who is severely hard-of-hearing.

"The earlier you can intervene, the better able you are to help the baby develop properly in terms of speech and socialization," says Lawrie. "With our high-quality screenings, we're catching hearing losses early, when it will help the most."

And that is sweet music to any mother's ears.

Pain Management: Enhancing Patient Recovery and Satisfaction
Debbie Clifton, RNC, BSN,
Chair, Pain Care Council, Administrative House Supervisor

Pain research investigators have made tremendous inroads into understanding pain relief and the benefits of pain management. When patients are hospitalized and their pain is controlled, it generally results in faster recovery, improved rates of healing and overall decreased length of hospital stay. That's why prevention and aggressive management of pain are essential elements of our quality patient care at Rideout Health Group (FRHG).

"In response to the need for enhanced pain control, we established a Pain Care Council and developed a program to train nurses in pain management," says Chair of the Pain Care Council and Administrative House Supervisor Debbie Clifton, RN, BSN. "We now have 19 Pain Resource Nurses throughout the hospitals and are well on our way to the goal of having a Pain Resource Nurse on every shift in each unit of the hospitals."

Pain management at FRHG is a collaborative effort between physicians and the nurses. The Pain Resource Nurses have completed 24 units of continuing education in pain management nursing and additional training from nationally recognized pain management expert Chris Pasero, RN. FRHG physicians also have received advanced training in pain management from Dr. Scott Fishman, Chief of the Pain Medicine Division at UC-Davis.

"Their education in pain management has empowered our nurses and attending physicians to continue seeking relief for their patients, approaching pain management from different angles and working together as a team," Clifton notes. "As a result of their efforts, we have seen a dramatic improvement in our patient satisfaction scores in the area of pain control."

Lumerta Award: Our Surgical Care Quality is Golden
Arlene Stark, RN,
Supervisor of Surgical Services

Earlier this year, Rideout earned one of the prestigious "Gold" Collaborative Recognition Awards for Surgical Care Improvement presented by Lumetra, California's federally designated Quality Improvement Organization. The award recognizes our participation and outstanding achievement in the Surgical Care Improvement Project (SCIP).

SCIP was designed to help hospitals improve the prevention of surgical-site infections, deepvein thrombosis (development of blood clots in the veins), cardiovascular complications and respiratory complications. Hospitals receiving the Lumetra Gold Award achieved the highest target goals for reduced infection rates and other surgical complications.

"We are honored and proud to receive this award for continued improvement in surgical care," says Supervisor of Surgical Services Arlene Stark, RN. "It recognizes the effectiveness of our efforts to reduce surgical infections and other complications, including the use of prophylactic antibiotics prior to surgery, appropriate removal of hair from surgical sites as warranted and preventing hypothermia that can lead to post-surgical complications."

The long-term goal of SCIP is to reduce the incidence of surgical complications nationally by 25% by the year 2010. Hospitals earning the Lumetra Gold Award achieved an accelerated improvement of a 25% reduction rate across all measures this year.

"At Rideout, we really do believe that our patients come first, and we provide our surgical nurses with the training and education to help them provide patients with top-quality care," Stark notes. The training sessions offered through the Lumetra collaborative are just another example of that. "The proof is in the results," she adds. "The feedback from our patients has been very positive. They have remarked on the great quality of care.

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