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Committed to Quality

March 29, 2011
by Mark Hagland
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Clinician and clinical IT leaders at Methodist Le Bonheur Healthcare put it all out there—on the Web

Among the integrated healthcare systems around the nation whose leaders have committed firmly and publicly to continuous quality transformation has been Methodist Le Bonheur Healthcare, a seven-hospital system based in Memphis. The system has received numerous recognitions for its quality of care, and has been a leader in receiving incentive payments from the Hospital Quality Incentive Demonstration (HQID) program, co-sponsored by the Center for Medicare and Medicaid Services and the Charlotte-based Premier Inc. health alliance. Among other strategic decisions, the senior leaders of the system have committed to public posting of their quality outcomes data across a broad range of key clinical areas, for a number of organizations (including The Leapfrog Group, the Joint Commission, Hospital Compare, and others), and in fact, a great deal of data has been made instantly available on the organization’s website.

Recently, Jerry Maliot, M.D., senior vice president and chief quality officer for the health system, and Alastair MacGregor, M.D., senior vice president and CMIO, spoke with HCI Editor-in-Chief Mark Hagland regarding their organization’s journey around quality, clinical transformation, and transparency. Below are excerpts from the interviews.

Transparency for Clinical Outcomes
Healthcare Informatics: Please tell us about your very publicly stated commitment to transparency and accountability for the clinical outcomes of your integrated health system.

Jerry Maliot, M.D.: It goes back to our mission, that we’ll partner with our medical staffs, families, to be a leader in providing high-quality, cost-effective, patient-centered care. That’s our mission. And if you accept that as a mission, then transparency is going to end up being a very significant part of that. And since I came into my role in 2007, and our board insists on it, and I insist on it, is a culture of transparency. Of course, we protect patient data security.

Now, if you really decide that transparency is a way to transform ourselves, to push ourselves, to embody our values and mission, we have to look at our patients, families, and members of our business community who are purchasers, and if you look at the data, it’s all over the place. There’s evidence-based data. And there’s Hospital Compare [the Medicare program’s Hospital Compare program]. And if you want central line infections, you need to go to the state registry. And ventilator-acquired infections and hand hygiene have not yet hit the radar. And Leapfrog has its own measures. And this is exhausting for us, even though we do it every day.

Jerry Maliot, M.D.

HCI: So you’ve agreed to be on the leading edge with this, and make the data easily available on your own website.

Maliot: Yes. And it’s just a lot easier now to take a look at us and see us exposed. The other reason is, if you look at data like central line infection data that can be compared, through Hospital Compare or QualityCheck, you see Methodist rolled up, which is a virtual view. The actual view depends on all our different facilities. And a year and a half ago, I decided this is something I wanted to do, and I went to my boss, Gary Shorb, our CEO, and he said, go get it done. And before I met with him, I met with the quality committee of the board of directors. The board meets every other month, and the 21-ish members of the quality committee meet monthly. And we share everything with that committee.

HCI: When you look at the progress made, what stands out for you as exceptional or noteworthy in your organization’s journey?

Alastair MacGregor, M.D.: With all that Jerry’s doing with quality and feeding back information to the stakeholders—as leaders, we all have a balanced scorecard; and it’s not only his leadership in measurement, but what’s important is holding our operational leaders accountable. I also think that the development of our electronic medical record is getting to a very exciting point, indeed an inflection point, in my view.