Fourteen local hospitals are taking part in a prestigious national program to improve the quality and safety of patient care. It is a virtual network where they develop, share, and implement quality improvement tools and strategies. The effort is part of Aligning Forces for Quality (AF4Q), a national program of the Robert Wood Johnson Foundation (RWJF) to significantly improve health care in targeted communities.
For 18 months, more than 100 hospitals nationwide worked together through AF4Q on this program. During this time, 90 percent of the participating hospital teams improved the quality of care for their patients in measurable ways, resulting in hundreds of avoided hospital readmissions; improved patient safety; standardized collection of information on patients’ race, ethnicity and language preference; and reduced wait times in hospital emergency departments.
The Oregon Association of Hospitals and Health Systems (OAHHS) managed the local hospital effort, bringing together 14 teams to spearhead initiatives to help tackle key issues in hospital care. The overall AF4Q effort in Oregon is led by the Oregon Health Care Quality Corporation.
“Oregon hospitals work daily to provide the best care possible for the patients they serve, particularly in reducing readmissions, improving language services, and addressing patient flow through the emergency department,” said Diane Waldo, OAHHS director of quality and clinical services. “Hospital commitment to quality processes and outcomes is evident in the results from the Robert Wood Johnson Foundation’s Aligning Forces for Quality program. Hospitals continue to demonstrate that consistent care processes indeed result in improved clinical outcomes.”
“We are delighted to have had the opportunity to work with 14 local hospitals and our partners at the Oregon Association of Hospitals and Health Systems on this successful Aligning Forces for Quality initiative,” said Mylia Christensen, executive director of the Oregon Health Care Quality Corporation. “The impressive results for Oregon hospitals participating in this program highlight the importance of collaboration in efforts to improve the quality and safety of care.”
Results for Oregon hospitals participating in the program include:
Reducing hospital readmissions and increasing adherence to care standards.
National data show about one in four Medicare patients admitted to the hospital for chronic diseases return to the hospital within 30 days of being discharged. Hospitals participating in AF4Q worked to ensure that processes were followed and patients had all the information they needed to safely transition from the hospital setting. Results for Oregon hospitals include:
- Six Oregon hospitals reduced their readmissions rate during the collaborative, avoiding about 31 readmissions within 30 days of hospital discharge during the 18-month time period.
- Among participating Oregon hospitals, the average 30-day readmission rate was lower than the national and state average throughout the entire collaborative.
Improving language services for patients who speak or understand a language other than English.
All hospitals in the U.S. that accept government funds are required to provide interpreter services to patients who speak a language other than English, but there has been little guidance to hospitals on the most effective, efficient ways to implement these requirements. Hospitals participating in AF4Q worked to improve the efficiency of language services. Results for Oregon hospitals include:
- All four Oregon hospitals that participated in the improving language services component of the program demonstrated improvement in screening patients for their preferred spoken language for health care.
- Three of the Oregon hospitals also demonstrated improvement in ensuring that limited English-proficient patients had a qualified interpreter at initial assessment and discharge, with one hospital demonstrating a 65 percent improvement over the duration of the program.
Reducing emergency department crowding.
Crowding and poor patient flow impact quality and safety and cause patients to remain in the ED longer than necessary. Local hospitals participating in AF4Q worked systematically to improve ED efficiency. Results for Oregon hospitals include:
- Over the 18 months of the program, participating Oregon hospitals consistently outperformed participating hospitals from other communities on all measures of performance for reducing ED crowding.
- Three of the five Oregon hospitals participating in the reducing ED crowding component of the program were able to demonstrate modest improvements over the 18 months.
“We know that even though many hospitals consistently deliver good care, there’s always room for improvement,” said Susan Mende, BSN, MPH, senior program officer at the Robert Wood Johnson Foundation. “Aligning Forces for Quality has shown that hospitals in Oregon and around the country want to do better and are willing to take steps needed to deliver the best care possible to their patients.”
The 14 Oregon hospitals that participated in the program include:
- Ashland Community Hospital
- Bay Area Hospital
- Lake District Hospital
- Mid-Columbia Medical Center
- Oregon Health & Science University
- Pioneer Memorial Hospital
- Rogue Valley Medical Center
- Samaritan Albany General Hospital
- St. Charles Bend Medical Center
- St. Charles Redmond Medical Center
- Sky Lakes Medical Center
- Silverton Hospital
- Tuality Community Hospital
- Willamette Valley Medical Center