A concerted effort to improve patient safety statewide and a commitment to transparency earned the Iowa and Washington state hospital associations the inaugural Dick Davidson Quality Milestone Award for Allied Association Leadership.

The new American Hospital Association honor recognizes state, regional or metropolitan associations that demonstrate innovation in health care quality improvement. The award, named for AHA President Emeritus Dick Davidson, will be presented this month at the 2011 Health Forum–AHA Leadership Summit.

AHA board member Jonathan Perlin, M.D., who chaired the multidisciplinary selection committee, says the two organizations—which tied for first when scored in the areas of strategic and tactical planning, quality measures, geographical impact, sustainability and innovation—stood out for similar reasons.

"Both are leaders in terms of cultivating transparency in areas like health care-associated infections and creating a public dialogue about the importance of avoiding them," says Perlin, president of the clinical and physician services group and chief medical officer at HCA. "Both were also unique in terms of achieving high statewide levels of influenza immunizations among staff."

Specifically, Washington hospitals' efforts since 2005 to reduce central-line and ventilator-associated infections have resulted in 318 lives saved and a cost savings of $53 million. All Washington hospitals have adopted the World Health Organization's standardized surgical checklist, participate in the Institute for Healthcare Improvement's 100,000 and 5 Million Lives campaigns, and are transparent with surgical-site infection rates. Also, 70 percent of Washington health care staff were immunized against the flu during the 2009-2010 flu season, versus 45 percent in a typical season.

The Iowa Hospital Association joined with the state medical society five years ago to launch the Iowa Healthcare Collaborative focused on improving quality, patient safety and value in the state. IHC, whose board includes members of the business and physician communities as well as consumer and third-party payer representatives, enjoys diverse stakeholder buy-in and was the first model of its kind in the country.

Under IHC leadership, the statewide employee vaccination rate went from 68 percent in 2006 to 91 percent in 2009-2010. All Iowa hospitals participate in the two IHI campaigns, and 97 percent voluntarily report data on four surgical-site infections, central-line infections, two MRSA measures, and the immunization of health care workers.

"Across the nation, quality improvements are occurring more broadly and rapidly, thanks in many ways to the collaborative efforts sponsored by state and local hospital associations," says AHA President and CEO Rich Umbdenstock. "This is the manifestation of Dick Davidson's original vision—collaboration across all member hospitals to improve care for all patients."

Carol Wagner, vice president of patient safety for the Washington State Hospital Association, says "the power of the collective in Washington is truly special but at the same time replicable. The dedication our hospitals have to their patients and communities is like none other, and they have been willing to set audacious goals and work together to achieve them. When one hospital struggles, the others urge it forward."

Kirk Norris, president and CEO of the IHA, says having buy-in from the medical community has given IHC tremendous power and led associations nationwide to seek guidance on adopting a similar model. Iowa also has benefited from having "a high percentage of physicians who are employed by the hospitals," Norris says, "which enables hospitals to do things that are more difficult to do when physicians are independent. Changing physicians' minds with respect to best practices can be hard."