Collaboration Trumps Competition: Hospital Partnerships Saved 746 Lives in 2006
Competition can be good – driving better performance and even lowering costs. But sometimes collaboration bears even more fruit than competition, and more than 80 hospitals throughout Ohio are joining together, sharing data and seeing life-saving results.

In 1999, the Ohio Hospital Association (OHA) worked with the Greater Dayton Area Hospital Association (GDAHA) to create the first collaborative hospital project in the state. Two years later, the initiative had reduced heart attack mortality by 36 percent, earning GDAHA the Joint Commission’s prestigious Ernest A. Codman Award. Since then, the seven hospitals in the Dayton area group have moved on to look at improvements in care for pneumonia, deep-vein thrombosis and MRSA,¹ and four other hospital collaboratives have taken root.

The number of hospitals partnering continues to grow and so does the number of lives saved. Data from just two of OHA’s hospital collaboratives show they saved the lives of 746 Ohioans in 2006, the equivalent of about 15 busloads.

The five quality collaboratives in Ohio are all built on an OHA model to bring key personnel from different hospitals together, including medical directors, to share how they care for patients with specific conditions. With their in-depth understanding of the medicine and processes involved, these scientists look at which practices achieve the best results among the different facilities. They combine the most effective methods into an optimum process that is then tweaked to fit each participating hospital.

The Greater Cincinnati Hospital Quality Improvement Project this spring launched a new Web site at www.gchchospitalquality.org/ where users can see how often each of  20 participating hospitals follow eight recommended care guidelines for heart attack, four recommended care guidelines for congestive heart failure and nine recommended care guidelines for pneumonia. Visitors to the site also can view the average length of hospital stay for nine conditions and risk-adjusted mortality for seven of these conditions. The site currently provides 2006 data and will be updated annually.

The American Heart Association also selected the initiative to present at a poster session April 30-May 2 on how its innovative work reduced heart failure in the Cincinnati area. The sharing of best practices helped area hospitals implement steps of care and improve the consistency with which these measures of care were used by 30 percent. The hospitals now are focusing their attention on reducing the number of patients who are readmitted within 30 days of leaving the hospital for heart failure, specifically – identifying reasons for the returns and ways to prevent patients from requiring an additional inpatient stay.

The Ohio Children’s Hospital Association Quality Improvement Collaborative this month released at a Statehouse press conference the initial results of its quality improvement efforts as a part of its 2008 Advocacy Day. Leadership from the association was joined by Senate President Bill Harris (R-Ashland) and Speaker of the Ohio House of Representatives Jon Husted (R-Kettering), who applauded their efforts. Six hospitals partnered to reduce preventable codes (cardiac and pulmonary arrests) occurring outside of the neonatal and pediatric intensive care units.

The group identified a protocol called a Rapid Response Team that, when implemented, reduced incidences of preventable codes by more than 20 percent. Each participating hospital adapted a Rapid Response Team model to fit within its own patient care environment and culture.

Stroke-related care is among the current focus areas of the Central Ohio Quality Collaborative, which includes 14 hospitals. The group is working to establish benchmarks for public reporting as it strives to find ways to reduce the number of stroke-related deaths in central Ohio. Data has not yet been released publicly. The collaborative also hosts a patient safety conference each spring for more than 400 medical personnel from across the state.

The newest OHA-based collaborative, the Northeast Ohio Quality Collaborative, was formed in 2007 and is currently becoming acquainted with the structure and data processing procedures. With 35 hospitals currently participating, it is the largest collaborative and will focus on improving processes related to congestive heart failure. Hospitals will compare processes of care and readmission statistics to pinpoint best practices and then work to implement these practices region-wide.

Ohio’s hospitals are putting patients first, striving to continually improve their care. OHA commends participating hospitals for their spirit of partnership and commitment to quality improvement. More than 746 lives have been saved – a priceless reward.