Cone Hospital review [December, 1988]

              THE • MOSES • H • CONE
®
MEMORIAL* HOSPITAL
December 1988
Focus on Quality:
Managing and Measuring Quality
In Health Care
Last month, David I. Mc-
ibs, Executive Vice Presi-
: at Moses Cone Hospital,
le an article in the "Re-
/ that began a series on
issue of quality in health
care and more specifically,
quality at Moses Cone Hospital.
This month's article continues
the discussion on quality. If
you have questions or corn-
its on the issue of quality
department, please
them to your depart-
head.
t's 11 a.m., and the Cardiac Cath Lab has been
.doing procedures since
7:30 a.m. One procedure took
longer than expected, and
then there was that emergency case. The schedule isn't
running quite as smoothly as
we'd like, but no one is too
upset by it. The patients are
comfortably being monitored
under nursing supervision in a
preparation area on the Short
Stay Unit.
One year ago, this preparation
area didn't exist at Moses
Cone Hospital. Patients were
waiting near the Cardiac Cath.
Lab. They were being inconve
nienced, and their physicians
were concerned about the
situation.
Since waiting time was being
monitored, a trend was identified and a resolution implemented. The new system
was established, and patients
are spending less time waiting.
In fact, in the first quarter of
1988 before the change was
put into affect, 49 patients
waited longer than 30 minutes. In the second and third
quarters, that number dropped
dramatically to 10 and 12
respectively after the new program was initiated. It has continued to decrease.
"In Quality Management,
we look for trends, investigate
their causes, and bring the
right people together to
develop a solution," explained
Tricia Byers, Director of Quality and Record Management.
In last month's "Review" article on "Quality," David
McCombs described quality as
"a moving target," because
quality in health care is not a
fixed standard but something
we must be ever working to
improve. Likewise, quality is
not the same in all areas of the
hospital. The factors that denote quality in the Cardiac
Cath Lab are not the same as
those on a nursing unit or in
Environmental Services.
"The starting point of
developing a good Quality
Management program is in
determining the scope of care
you provide and developing
objective means by which you
can evaluate that care. Every
department measures their
quality differently because the
tasks they are performing, the
equipment they are using, and
the patient they are serving are
all different. The route that
each department takes to attain quality is different because
they have different goals. The
starting point of developing
a good Quality Management
program is in developing criteria and setting individual
standards for each individual
department," said Ann North,
Quality Assurance Coordinator.
Many departments at Moses
Cone Hospital have already
begun monitoring factors their
departments that effect quality management. Rehabilitation
Services has set up a Peer
Review System in which
therapists review other therapists' work. The Anesthesia
Department has developed a
form for all employees use
which is submitted to their
department head on a regular
basis that identifies any potential quality issues. The Nursing
Department is developing
standards for a unit-based quality management program. Environmental Services is currently involved in an indepth
inspection program, has developed standards and is reporting the results of theis inspections back to their employees.
"Every department in this
hospital wants to have high
standards of quality. The
Quality Assurance Department believes that each individual employee has the op-
REVIEW
Moses Cone Hospital
1200 North Elm Street
Greensboro, North Carolina 27401-1020
Address Correction Retptesled
Non Profit Org
Sulk Rate
US  Postage
PAID
Permit No  195
Greensboro, N C
Melody Schell, Editor
portunity to make an impact
on quality," Byers said.
More departments will be
establishing quality programs
during 1989. The Quality
Assurance Department has
added Suellen Wright, Quality Assurance Coordinator, to
their staff. She along with Ann
North will visit departments
and assist them in developing
individualized quality management programs.
"To develop a strong quality management program, each
department has to develop an
ongoing, systematic way of
monitoring their quality. The
Quality Assurance Department can assist individual
departments in refining their
programs, improving their
documentation, and analyzing
their data," North said.
Employees can take action
on quality issues that they currently see within their departments, even before a formal
program has been established.
Quality Care Control Reports
(QCC) are available from your
department head. These
reports are routed to the Risk
Management/Quality Assurance Department. They are
trended and reported to appropriate departments to be
addressed.
"The QCC reports are a
valuable tool and are extremely helpful in identifying quality indicators that should be
tracked," North said.
"Quality Management is
critical within a department.
The more we can look at
quality management as a way
of improving quality of care to
patients, the more Moses
Cone Hospital can improve
the care we are providing to
the community," Byers said.
x C°me ffay-e
Child Care Center
Site Dedication Slated
A dedication ceremony of the Moses
Cone Hospital Child
Care Center will be held on
Thursday, December 15 at 4
p.m. for all employees and
their children.
The announcement of the
definite site selection for the
center was made on Thursday, November 17 following
a two month selection process with developers.
The Child Care Center will
be located in the area south
of the Employee Parking Lot
which is currently occupied
by the Wheelchair Sports
Course, picnic shelter and
volleyball courts. Plans are
being reviewed for the best
relocation of these three
facilities.
The planned Child Care
Center will include an approximately 9,800 square foot
building and a 20,000 square
foot play area. A driveway
will circle in front of it to
assure ease of delivery and
pick-up of all children eligible to use the facility. The
center is anticipated to be
licensed for 200 children.
The Center will be open to
any child from infancy
through pre-kindergarten
whose parent is an employee
of Moses Cone Hospital,
Greensboro Hospital, Hospice at Greensboro, Home
Care of Central Carolina,
Greensboro Diagnostic
Center or Health Equipment
Services of Central Carolina.
Children will be accepted to
the Center on a first-come,
first-serve basis.
The anticipated opening of
the Child Care Center is
August 1,1989. It will operate
from 6 a.m.  until 12 midnight, 365 days of the year.
A Child Care Center Task
Force will be working with a
consulting firm that specializes in "campus" child care
centers to establish detailed
programming for the center.
The Task Force includes
representation from Administration, Human Resources,
Employee Council, the original employee task force on
child care, the Auxiliary and
Dr. Dale Farran, a child
development specialist at
University of North Carolina
at Greensboro.
"This Child Care Center is
going to provide the opportunity for enriching a child's
development and growth
during the sensitive preschool years," explained
Peter Kariher, Vice President
of Health Services. "I want
parents to feel good about
bringing their child to the
Moses Cone Hospital Child
Care Center and to be confident that the highest possible care is being provided.
This Center will offer learning opportunities in a loving
and caring environment."
The Center is being designed to achieve a "Double
A" state licensing status
which impacts quality in
both staffing ratios and facility design. The plans are for
the staffing ratios to clearly
exceed the minimum standards of state licensing,
Kariher said.
If you would like more information on the Child Care
Center or would like to place
your child's name on a waiting list, please call Peter
Kariher on extension 3695.
Eropl
eyee ?arkl„.   \\
Moses Cone Hospital - I