During the past five years, Bon Secours Health System has seen both its systemwide incidence of sepsis and its health care associated infection rate drop by half. Similarly, the use of blood for open-heart surgery patients has been reduced 45 percent, both in the number of patients receiving blood and the amount of blood used.
The improvements stem from the use of "Learning Communities" that develop and disseminate practices to advance Bon Secours' goal of improving quality outcomes, reducing costs and improving patient satisfaction in all its facilities.
Bon Secours, based in Marriottsville, Md., includes 19 acute care hospitals spread across six states on the Eastern seaboard. Shortly after it embarked on its clinical transformation initiative in 2007, Learning Communities were assembled, drawing on expertise from throughout the system. Each community focuses on a specific topic, with the assignment to develop what Chief Nursing Officer Andrea Schmid-Mazzoccoli calls "idealized patient care design."
Learning Communities have been formed for such service lines as cardiac surgery, perinatal care, intensive care and general surgery, and quality programs such as reducing pressure ulcers and health care associated infections to reduce mortality, readmissions and cost, and improving palliative care services.
Headed by a CNO and a chief medical officer, each community is organized to include a chief financial officer from a Bon Secours facility and others — pharmacists, service line leaders, infection control specialists, IT experts — depending on the subject matter. Each hospital also is represented by a physician and a nurse.
When a Learning Community adopts a best practice — for example, no elective labor inductions before 39 weeks of pregnancy — it is included in the performance expectations for the CEOs, CMOs and CNOs at each local hospital.
That accountability is key to Bon Secours' success, says Marlon Priest, M.D., Bon Secours executive vice president and chief medical officer. But his first bit of advice is to choose the right topics for Learning Communities.
"Stay focused on the patients and what's important to them," he says. "Second, have measurable outcomes. Third, be persistent over several years. Fourth, be sure that you spread information from the Learning Communities and have accountability from the top all the way to the bedside."