Are Patients Getting Safer, Higher Quality Care?

At Intermountain Healthcare, we started 2018 by making a commitment to ask ourselves five questions every day. While these questions might look simple to those who don’t work in healthcare, you and I know how challenging they are. We chose them because we knew they were the questions our patients, our families, our neighbors and our friends would care about most. They are:

1. Are our patients getting safer, higher quality care?
2. Are we making healthcare more affordable?
3. Are we treating patients well as customers?
4. Are our communities healthier?
5. Are we making our organization stronger so we’ll be around forever?

Each of these deserves a deeper look and discussion. For now, let’s explore the first about patient outcomes in safety and quality.

Patient stories about their experiences with us aren’t always flattering. They’re candid about what didn’t go well and what we and others can do to improve — and we welcome that. Often the source of much of their disappointment rests in social problems we didn’t create, but can help solve. Intermountain has a history of leading out to serve our neighbors, making our communities stronger by making healthcare better. Measures of safety and quality at Intermountain continue to show steady improvement.

What makes our progress especially impressive is we’ve done it while undertaking our work to redesign Intermountain for the future. I know this redesign hasn’t been easy. Our task now is to honor all of those who have contributed to Intermountain by working together to do good and to make a difference for the people we’re so privileged to serve.

Why redesign now? Because, to paraphrase a familiar scripture, ‘where much is given, much is expected.’ At Intermountain, we’re strong. We have a history of anticipating the future and being proactive. This has never been more important. We’re living in a world (especially in healthcare) that’s changing at a faster pace than ever before. We’re among those few organizations who are in a position to be thoughtful and intentional about how we design our organization, rather than reacting to dire circumstances.

In fact, we were cited in a recent article as an organization that has set the right strategy for what’s ahead. We’re taking advantage of new technologies and knowledge to structure ourselves to deliver safe, consistent, extraordinary care at an affordable cost to every patient wherever, whenever, and however, they interact with us.

As Greg Poulsen, our senior vice president of policy, said, “We’re in a position that we don’t have to yet view Amazon and others as a threat, but as an indication that costs to consumers can be lowered through new approaches and new technologies, and that our commitments require us to be as good to our patients as they are to their customers, and as good as we can possibly be for our communities.” He adds, “Our caregivers realize that putting any unnecessary financial burden on our neighbors is a violation of the trust placed in us.”

Are our patients getting safer, higher-quality care? Yes. Intermountain has an international reputation as a leader in raising quality in medicine, thanks in large measure to the work of Dr. Brent James. He introduced statistical methods and management theory to raising quality at Intermountain beginning back in the late 1980s. And in 2017, we met 90 percent of our ambitious quality goals, building on remarkable clinical achievements made year after year. Safety has long been a priority as well, and thanks to our Zero Harm efforts, we’ve seen a 42 percent drop in safety events.

It’s our stories that make these statistics meaningful. Last week I visited our West Valley Clinic where Jessica Zentner, a nurse care manager, shared a story that shows how powerful taking a One Intermountain approach can be.

A patient had come in to receive treatment for acne, and is as now the procedure, she underwent a screening for depression. The results indicated the need for a further test, which revealed this patient was suffering. In fact, Jessica said, it came to light that the patient had been dealing with severe depression for a long time and hadn’t confided in anyone. She had even recently attempted to overdose, which no one knew about until this appointment.

Jessica created a safety plan and was able to find a therapist for the patient. “Her mother continues to express happiness over the progress her daughter is making,” she said. “I was so grateful that sticking to our simple depression screening process had such a profound effect on someone who had been suffering alone for so long.”

This piece is part of a series written by Marc Harrison, MD, CEO of Intermountain Healthcare, that will focus on five questions that can serve as a guide to help organizations provide a higher level of care. Dr. Harrison is a specialist in pediatric critical care, with extensive clinical and leadership experience, including 10 years with the Cleveland Clinic.