Improving Quality and Safety at SVMC

Contact Patient Safety
(802) 447-4054
100 Hospital Drive
Bennington, VT 05201
mac1@phin.org

Quality and safety has always been important in health care, but only recently have hospitals focused on improving the systems that doctors and nurses use to provide care. Read on to learn more about how SVMC is working to make our hospital the safest in the nation.

Thrombolytic Therapy for STEMI in the Emergency Department 

Research shows that patients having a particular type of heart attack — called a STEMI, which stands for ST Segment Elevated Myocardial Infarction — benefit from getting clot-dissolving drugs within 30 minutes of arrival. Read more about how SVMC's emergency department achieved 100-percent compliance with this best practice.

Using 2-D Barcodes to Enhance Bedside Medication Safety  

Barcodes improve the accuracy of medication delivery and patient safety at SVMC, but they must be used. Learn how SVMC developed a 2-D barcode system and then increased the scan rate from 88 percent to 99.5 percent of all medication administered on our inpatient units. Read More

Reducing the Thirty-day Readmission Rate at SVMC

Nationwide, roughly 20 percent of Medicare patients discharged from a hospital stay are readmitted within 30 days of their first stay. This is both a cost and quality problem. These stays drive up the cost of care, but more importantly, they are hard on patients quality of life. Read more about how SVMC reduced its thrity-day readmission rate to below 10 percent.

Previous Quality Improvement Projects

SVMC Makes Pharmacy Workflow Leaner
Fed up with an inefficient work environment, the SVMC Pharmacy Department used Lean Quality Improvement methods to re-design the pharmacy lay-out, improve work flow, remove clutter, and improve the ability of the staff to focus on their work. As part of this effort, they also sought to design a more effective drug inventory management system. Read more about SVMC's efforts to make the pharmacy leaner.

BOOSTing Outcomes for Older Adults
In 2008, SVMC and five other US hospitals were selected by the Society of Hospital Medicine to take part in a national project. The project sought to improve care of older patients as they transition from the hospital or home to another care facility. Known as Project BOOST (Better Outcomes for Older adults through Safe Transitions), the goal was to reduce hospital readmissions by improving the inpatient discharge planning process. The project began in the fall of 2008 and concluded in late 2009. Read more about better outcomes through safer transitions.

Better Provider Hand-offs Equal Safer Patient Care
One of the most common problems in hospital care is the failure of caregivers to effectively communicate about their patients’ care. Hospitals are complex, multi-task-oriented, fast-paced and highly stressful workplaces. At the same time, much depends on effective verbal communication during shift changes and as patients move fromp lace to place.  SVMC has instituted a new communications rubrick, called SBAR, for improving verbal handoffs. Read more about the SBAR communications system.

Team Redesigns Workflow in Medical Surgical Nursing Units
Nursing units in hospitals can often be chaotic and inefficient. SVMC worked with nurses on two medical-surgical nursing units to redesign the care process to improve safety and efficiency. Read More

Beside Medication Verification Reduces Errors
A project funded by the Agency for Healthcare Research and Quality allowed SVMC to examine whether electronic systems actually improve bedside care. The project included developing a new patient safety culture at SVMC and implementing an electronic medication system that nurses use when giving patient medications. The project was successful in reducing transcription errors but reductions in medication administration errors were not statistically significant. Read More

New Process Improves Medication Reconciliation
Knowing what medications a patient is taking when he or she enters the hospital is important to good care. Many hospitals have inefficient systems that do not collect a good list of which medications a patient is taking. And, most patients know how annoying it is to be asked a half-dozen times what medications they are taking. SVMC's work to redesign the entire process for medication reconciliation has improved efficient and safety at the hospital. The results were outstanding... Read More  

SVMC Reduces Medication Errors for Patients on Blood Thinners
Blood thinners can be very dangerous. They are a leading cause of medical errors that can cause patients harm. As a follow-up to a successful 2005 program to reduce medical errors in patients on blood thinners, SVMC started a new program to focus on surgical patients. The hospital developed a system to evaluate all surgical patients on injectable anticoagulation therapy before and after surgery. This new system already is leading to safer surgery for SVMC patients. Read More

Team Reduces Time to Diagnose Breast Lesions
A team of experts at SVMC worked to revamp processes to reduce the average time it takes to diagnose women with suspicious breast lesions. Now, thanks to their efforts, the average is only 12 days. Women with less complicated cases, such as younger women who are not taking blood thinners, can be diagnosed in about a week. Read More

Barcoded Wristbands Improve Medication Accuracy
SVMC recently began using barcoded wristbands as part of its electronic medication administration system. The new system improves the accuracy of patient identification and helps ensure that the right medications get to the right patients. To learn more about how SVMC is leading the way in this new technology, read Patient Identification: Producing a Better Barcoded Wristband. This article on our work was written by SVMC's own Charles Still and Ed Lanoue and published in Patient Safety and Quality in Healthcare. It is posted our website courtesy of the magazine, which holds the copyright.

SVMC Improves Care for Patients at the End of Life
Most people want to die at home, but making that happen is often challenging. In 2006, SVMC launched a special project to help improve end-of-life-care. That included making sure that dying patients and their families understand their options at the end of life, improving communications among everyone caring for a patient, and helping patients and families understand the benefits of hospice. To date, the project has increased the number of days patients use hospice, reduced unnecessary hospitalizations, improved pain management and increased patient and family satisfaction. Read More

General Surgery Improves Post-Op Colectomy Care
When the SVMC general surgeons learned that they were having a string of poor outcomes with their colectomy cases, they requested a comprehensive review of these cases in an effort to learn what might be going wrong. The patient safety improvement initiative that resulted is now completed. Early results show a drop in infections and length of stay for colectomy cases. However, not enough outcome data has been tabulated to be certain that these changes are real and permanent. Read More

SVMC and the Centers for Living & Rehab
Reduce Pressure Ulcers
Once considered an occasional and unfortunate by-product of hospital care, pressure ulcers are now seen as a preventable source of unnecessary harm. In 2006, SVMC worked with the Centers for Living & Rehabilitation to recognize and reduce pressure sores in the hospital. SVMC now has better protocols for preventing pressure ulcers, and fewer hospital patients go on to the Centers for Living & Rehab with an existing pressure sore. Read More