In the News

Valley Baptist Uses Six Sigma to Improve Patient Care; Participates in 100,000 Lives Campaign

HARLINGEN, June 14, 2006 –  Valley Baptist Medical Center-Harlingen and Valley Baptist Medical Center-Brownsville are working to improve care for Valley patients through participation in the Institute for Healthcare Improvement’s landmark 100,000 Lives Campaign -- as well as being among the first hospitals in the country to institute the Six Sigma quality improvement program.

Through the 100,000 Lives Campaign, Valley Baptist and other hospitals have worked to dramatically improve how patients are cared for when they’re most at risk for infection, complications and adverse outcomes. Initially launched in December of 2004, the 100,000 Lives Campaign is the first-ever national campaign to promote saving a specified number of lives in hospitals by a certain date (June 14, 2006) through the implementation of proven, evidence-based, practices and procedures.

Valley Baptist, under the leadership of its President and CEO James Springfield, has made Six Sigma quality one of its top strategic initiatives in order to maximize performance and patient satisfaction throughout the health system. Several of Valley Baptist’s Six Sigma initiatives have focused on evidence-based practice of medicine. Valley Baptist has:

• Activated a Rapid Response Team to respond when a patient’s condition is worsening and may lead to a more serious medical emergency. These life-saving teams at VBMC-Brownsville and VBMC-Harlingen help to evaluate and stabilize patients who show symptoms of instability, such as significant changes in breathing or heart rate. Any bedside nurse or caregiver can call the rapid response team when he or she feels a patient may be on the brink of a possible decline. The team includes critical care nurses and respiratory therapists, who consult with the patient's physician for further instruction. The goal is to rescue patients early in their decline -- before they go into cardiac arrest.

• Worked to improve outcomes in heart attack patients by delivering evidence-based care, including appropriate administration of aspirin to prevent blood clots and beta blockers to help prevent additional heart attacks. When it comes to heart attacks, every minute counts. It’s important for patients to seek care immediately. Early administration of clot-busting drugs -- or treatment with catheters, balloon angioplasty, stents, and other devices to open blocked arteries -- can make the difference between life and death.

Valley Baptist Medical Center-Harlingen implemented Six Sigma initiatives which focused on evidenced-based medical management of acute myocardial infarction patients and heart failure patients, resulting in improved outcomes for these patients. In addition, VBMC-Harlingen implemented a Six Sigma initiative on Coronary Artery Bypass Graft Surgery, which addressed national standards for heart surgery, including the use of aspirin on discharge. Yet another Six Sigma initiative improved the turnaround times in Valley Baptist’s Cardiac Catheterization Laboratory.

VBMC-Brownsville also dramatically improved the outcomes for myocardial infarction patients and heart failure patients. “We have achieved 100 percent on the core measures,” said Dr. Lorenzo Pelly, Director of Quality Improvement at VBMC-Brownsville. Dr. Pelly said the improvements have made an amazing difference in the lives of many patients – including one Brownsville heart failure patient who previously had to be hospitalized several times a year, but now hasn’t been back in nearly two years.

• Worked to prevent adverse drug events by referencing accurate and continually-updated lists of patients’ medications during their hospital stay, particularly at transition points. A Six Sigma initiative at Valley Baptist helped simplify the forms and the procedures for “medication reconciliation” at the hospital. Medication reconciliation refers to the process of creating a complete and accurate list of each patient’s pre-admission medications and then comparing that list against medication orders upon admission, transfer and/or discharge from the hospital.

• Worked to prevent infections from developing in patients who are receiving medicines and fluids through a plastic catheter or tube known as a “central line.”   Infections are prevented by following a series of clinically-proven steps, including proper hand washing; the use of sterile gloves, masks, and sheets; cleaning the patient’s skin with “chlorhexidine” (a type of quick-drying disinfectant soap); careful placement of the catheter; and prompt removal when the catheter is no longer necessary.

• Worked to prevent infections from developing in surgery patients through appropriate use of antibiotics. The effectiveness of antibiotics depends on the timing, duration and the type of antibiotic administered. This was also addressed through Valley Baptist’s Six Sigma initiative on Coronary Artery Bypass Graft Surgery, which included the use of prophylactic antibiotics.

• Worked to prevent pneumonia from developing in ventilator patients by following four scientifically-grounded steps, including raising the head of the patient’s bed. These procedures help save lives and significantly reduce health care costs.

In addition, Valley Baptist implemented a Six Sigma initiative on evidence-based medicine for pneumonia patients which addressed administration of antibiotics, smoking cessation education, and other issues involving pneumonia patients.

James G. Springfield, FACHE, President and Chief Executive Officer of Valley Baptist Health System, said that Six Sigma initiatives represent Valley Baptist’s commitment to quality and improvement. “There is no greater priority for our health system than continuous improvement so that we can provide the best possible outcomes for each of our patients,” Mr. Springfield added.

Six Sigma is a comprehensive, flexible program for achieving, sustaining and maximizing success in business. Six Sigma starts by listening to the "Voice of the Customer" in order to determine the expectations of patients, family members, physicians and other customers of the hospital. Six Sigma then applies facts, data and statistical analysis to manage, improve and re-invent business processes.

The improvements at Valley Baptist have led to national recognition. For example, the U.S. Centers for Medicare & Medicaid Services has ranked Valley Baptist Medical Center-Harlingen number four in the nation in the treatment of heart failure -- an achievement that is being noted in national publications such as Modern Healthcare and U.S. News & World Report.

In addition, Valley Baptist is in the top 10 percent of the nation in management of acute myocardial infarction patients, according to the Centers for Medicare & Medicaid Services / Premier “Pay for Performance Demonstration Project.” Valley Baptist also received the Texas Medical Foundation’s Excellence Award for the Six Sigma project which improved the outcomes of acute myocardial infarction and heart failure patients.

“What we have accomplished to date is a powerful example of how the data-based Six Sigma system is used to improve clinical outcomes,” said Dr. Tomas A. Gonzalez, Vice President of Six Sigma for Valley Baptist Health System. “We continue to discover clinical areas that must be improved by utilizing the Define, Measure, Analyze, Improve and Control Six Sigma methodology.”

More than 340 Valley Baptist employees have been trained in Six Sigma methodologies. Twenty-seven physicians are Six Sigma “yellow belts” and 16 physicians serve on the Six Sigma Physicians’ Council at Valley Baptist.

Nationally, the 100,000 Lives Campaign includes the enrollment of over 3,000 hospitals -- comprising an estimated 85 percent of the acute care hospital beds in the country -- and the creation of a national infrastructure of campaign field offices which offer resources and support to participating hospitals throughout the United States.

“Hospitals are not only demonstrating a dedication to saving lives during the 100,000 Lives Campaign, they are also implementing important changes in health care delivery that will reduce preventable illness and death beyond the campaign’s June 2006 deadline,” said Dr. Donald Berwick, President and CEO of the Institute for Healthcare Improvement (IHI).

The 3,000 hospitals participating in the campaign are located in all 50 states and the District of Columbia. Please click here to learn more about the campaign.

Pam Warner, RN, BSHA, CPHQ, CPMSM, Administrative Director, helped spearhead VBMC-Harlingen’s participation in the 100,000 Lives Campaign.

Support for the 100,000 Lives Campaign

The 100,000 Lives Campaign is supported through unrestricted philanthropy from Blue Cross Blue Shield of Massachusetts, the Cardinal Health Foundation, the Colorado Trust, Gordon and Betty Moore Foundation, the Rx Foundation, Baxter International, the Blue Shield of California Foundation, and the Leeds Family Foundation. National aggregate case-mix data and analysis supporting the campaign’s “lives saved” calculation is generously provided, without restriction for use, by CareScience (a QUOVADX division) and Solucient.