Cooley Dickinson Hospital: Quality Health Care is No Accident

It's no accident that during the last four years, Cooley Dickinson Hospital (CDH) in Northampton has built upon an already solid reputation in the Pioneer Valley for excellence in health care. Nursing executives at CDH cite their participation in Patients First and their commitment to IHI's '100,000 Lives Campaign,' as a main reason why Cooley Dickinson has posted an impressive number of significant accomplishments in recent years.

“I think it is fantastic that Massachusetts' hospitals are taking the lead on these patient care and quality improvement initiatives,” explains Carol M. Smith, RN, MBA, chief nursing officer/chief operating officer. Specifically, Smith credits Patients First and IHI as the catalysts behind redefining how Cooley Dickinson determines its mix of direct-care and non-direct care staff and benchmarking for patient acuity and other measures against like-size hospitals. “Most importantly, these initiatives have charged us with being more accountable and transparent through the public reporting of our quality data,” she adds.

Donna G. Truesdell, MS, RN, director of quality improvement at CDH says there's “a fascinating synergy” that's going on with all of these patient care and quality improvement programs. “Cooley Dickinson has always looked for ways to improve patient care and outcomes, but I think these programs have greatly accelerated and centralized our efforts. These initiatives are leading a revolution in health care across the nation.”

Truesdell adds, “Success in quality and efficiency of care are achieved by a skilled medical staff working collaboratively with the hospital staff, and a mindset of constantly looking for opportunities to improve the care and services we provide.”

Some of CDH's significant achievements of late include:

• Participated in all six IHI goals and achieved “mentor” status in the categories of preventing ventilator associated pneumonia, preventing central line infections and preventing adverse drug events by reconciling medications. There are approximately 100 mentor hospitals nationwide that offer best-practices advice and expertise to other hospitals in the IHI program.
• Recognized by CareScience® as one of only six hospitals to achieve both Select National Quality Leader status - a distinction given to the top one percent of hospitals nationwide — and designation as a top performing hospital in 3 of 7 disease categories including heart failure, ischemic stroke and pneumonia.
• CDH was featured in an October, 2006 Newsweek magazine case study as one of 10 hospitals across America that are using innovation, hard work and imagination to reduce errors and save money.

Truesdell cited the case of a patient who recently benefited from the hospital's aggressive, patient-centered, risk-reduction approach. Upon returning from a cruise, the patient developed a life-threatening lung infection that required she be placed on a ventilator. CDH's Critical Care Unit of intensivists, nurses, respiratory therapists and others saved the patient's life by, among other things, following IHI's guidelines on interventions to reduce the risk of infections for patients on life support. The team reversed the patient's condition with a Hi-Low® Evac Endotracheal tube.

Used for the first time at CDH, the specialized tubing was instrumental in continuously suctioning potentially infectious secretions that could have leaked into the patient's lungs. This technique worked so well that the hospital has now switched to continuous suctioning tubing to improve the quality of care all ventilator patients receive at Cooley Dickinson.

Not every advance in patient safety requires this type of change. By following a basic philosophy of “simple protocols, rigorously followed, make the difference at Cooley Dickinson,” staff have found inexpensive ways to enhance safety. For example, hospital staff and physicians hand out medication cards to help patients track their medications. Patients carry wallet-sized cards that list their medications and contact information, a simple idea that at a glance keeps the patient and healthcare team up-to-date on the drugs the patient is taking.

CDH was also involved in the pilot studies for MHA/MONE Nursing Sensitive Measures that are now being used statewide.

“To get these external votes of confidence about our work points to the tremendous teamwork on behalf of our patients by CDH physicians, nurses and other front-line staff,— Truesdell concludes.