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Ten Reasons for Ratings Differences

By Dr. David C. Pate, News and Community
August 12, 2013


Given that there is such a big difference in the Consumer Reports ratings between the very good hospitals that we have here in the Treasure Valley, here’s why I think St. Luke’s stood out:

St. Luke’s quality and safety focus. We have said we want to be a national leader in quality and safety by 2015, and we are well on our way. We can’t settle, because we know that each complication affects a real patient, someone who could be one of our own friends or family members. We are so serious about making sure we stay focused on patients that we make sure patients and families advise us as members of our Safety Committee and that we involve them in many other aspects of our quality improvement initiatives.

Project Zero. If we are going to be a national leader, then we have to have very bold goals, and our goal is zero post-operative infections. As the new Consumer Reports ratings indicate, we already perform well relative to the rest of the country, but we are working to completely eliminate these infections. We have looked outside health care for solutions and found great ideas through our partnerships with Micron and Boise State University around improving air quality in our operating rooms, since many of the bacteria that cause infections land on the wound from the air. We have already cut our previously better than average rate of infections in half!

Preoperative Assessment Clinic. One of our hospitalists sees high-risk patients pre-operatively in clinic to fine-tune medical care so that patients are in the best possible shape medically prior to their surgery and follows up after surgery. It’s early to have data, but this innovation to the care process seems to be working and preventing complications.

TEAMwork. In health care, every time a physician or any other caregiver varies from best practice without a good reason, we subject patients to increased risk. St. Luke’s has been implementing lean principles to eliminate irrational variation. We apply lean within St. Luke’s as TEAMwork, which stands for timely, effective, accountable, and measurable work. And the more we do, the more our performance will improve.

Surgeons and surgical teams. We are blessed to have extremely well-trained and experienced physicians and staff members who work together extremely well and are always looking for ways to improve. A number of St. Luke’s physicians serve in local, regional, and national leadership positions, and many are involved in clinical research here at St. Luke’s, looking for better ways to treat our patients. And we know that excellent physicians and nurses attract other excellent physicians and nurses.

St. Luke’s nurses. It is the nurses who are with our patients day and night following surgery and who are key to identifying and intervening in problems early, saving lives, and preventing serious complications.  There are only two hospitals with the American Nurses Credentialing Center Magnet designation in Idaho, and they are two of the three Idaho hospitals that received Consumer Reports’ highest rating in the recent surgery survey: St. Luke’s Boise and Meridian hospitals and Kootenai Medical Center. For quite some time, studies have demonstrated that patients achieve better outcomes at Magnet hospitals. 

Best practices. St. Luke’s has adopted cutting-edge best practices, including simulation labs where clinicians can practice clinical situations that may not commonly occur and therefore skills may be difficult to maintain, and video recording to allow clinicians to review and debrief after practice; our eICU, which makes possible extra eyes and alarms so that we can monitor the sickest patients as closely as possible; and ambulation of ventilated patients to reduce the risks of pneumonia. Based on collaborations with colleagues at Intermountain Healthcare in Utah, we get patients up and walking with their ventilators. We are having great results.

Data-driven improvements. St. Luke’s has made significant investments in data analytics. We are using information from many different systems, processing it together, and then getting an output of data that allows us to monitor our quality and progress and make rapid-cycle improvements. The work we have been doing in this area with WhiteCloud Analytics in Boise is pioneering, and puts us out in front of many health systems.

St. Luke’s electronic health record. Our electronic health record is available to all of our physicians throughout St. Luke’s Clinic, and we know that having a single record that every provider has access to means better communication among  providers and less chance for errors.

Care coordination. We are making significant gains in our coordination of care for patients with chronic diseases, who are among the highest-risk patients for surgery. We are using multidisciplinary teams to manage their care more closely and to make sure they get the best possible outcomes.


About The Author

David C. Pate, M.D., J.D., is president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.