Carmela Coyle: Quality Counts

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By: Carmela Coyle

Nothing is more important to Maryland’s hospitals than the safety of those who put their trust in us during their most vulnerable times. Every day, hour by hour, the more than 100,000 women and men who have the privilege of tending to Marylanders in need strive to provide the safest, most effective care to our hospital patients.

In a new report from the Maryland Hospital Association, the data tell part of the story. Among the findings are that hospitals:

  • * Achieved a 90 percent compliance rate for hand hygiene in 2014, up from 71 percent when the program began in 2010 (proper hand sanitizing procedures are the most fundamental way to reduce the spread of infections)
  • * Reduced hospital readmissions by 4 percent compared to the previous year, faster than the national rate
  • * Maintained zero central line-associated bloodstream infections per month for 90 percent of the participating hospital units (central-line catheters — hollow tubes inserted into the body’s large veins — can cause infections if improperly inserted or managed)
  • * Maintained zero catheter-associated urinary tract infections among 83 percent of participating hospital units (catheters — tubes inserted into the urinary tract — are among the causes of this common infection)
  • * Reduced the number of ventilator-associated complications by 55 percent from the previous year (improper use of ventilators — machines that mechanically breathe for those unable to do so — can lead to infections)
  • * Reduced occurrences of obstetrical hemorrhage by over 20 percent and occurrences of obstetric lacerations by 14 percent

These noteworthy numbers are the result of a commitment by hospitals’ leaders to ensure patient safety and the subsequent follow-through of nurses, doctors and others to turn that commitment into reality.

While quality is a foundational principle of every hospital’s mission, it is also an integral component of a unique agreement between the federal government and the state that allows for an egalitarian payment system in which all payers — insurers, Medicare and Medicaid, private payers — pay the same amount for the same service at the same hospital. The agreement outlines aggressive quality improvement targets that include a 30 percent reduction in infections acquired in a health care setting and a significant reduction in readmissions by 2019.

In fact, all of Maryland’s hospitals now operate under fixed annual budgets, creating a strong incentive to ensure that patients receive precisely the care they need. This payment model, coupled with the quality improvement metrics, make Maryland a national leader in both reducing health care costs and in keeping patients safe.

Hospitals welcome these forward-looking goals and are transforming themselves to achieve them, looking beyond the four walls of the hospital and reaching into their surrounding communities to forge new partnerships with primary care physicians, long-term care facilities, social service organizations, and others.

In many ways, the hospital of tomorrow will not resemble the cloistered complex that it looks like today. But you can be certain that no matter what form Maryland’s hospitals take going forward, their dedication to safety and quality will never waver.


Carmela Coyle

President & CEO

Maryland Hospital Association

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