An open letter to the community from TMC’s Chief Medical Officer

Rick Anderson

Dr. Rick Anderson, Chief Medical Officer

The Arizona Daily Star this morning launched an overview of its occasional series on patient safety and medical quality.

It is an important conversation, both nationally and at the local level, and it is one that we take very seriously at Tucson Medical Center.

TMC has a deep commitment to improving the safety of the care we deliver. As an institution rooted in this community for more than 70 years, we never forget what a privilege and honor it is to be entrusted with helping people when they need us most. We are proud that we deliver the most babies and treat the most emergencies, year in and year out.

As one part of our improvement effort, we adopted a Lean management philosophy in 2012, which drives us to work continuously to improve upon the care we provide. These principles started in the manufacturing arena, but it turns out that complex systems share similarities. They are built on consistently performing well on each and every step within each and every process, whether you are building an aircraft or repairing hearts.

As a result, in our public hallways and patient areas, you will see our units each have visual management boards that track key metrics and support patient safety as a core value. With those metrics front and center, we not only can engage patients in conversations about our performance, but are able to respond rapidly when we see that we aren’t reaching our goals.

As a locally governed community hospital, we can be nimble in implementing critical interventions to reduce harm, including reducing the incidence of hospital acquired infections. For instance, urinary tract infections are the most common healthcare associated infection nationally and are strongly associated with prolonged catheterization of patients. We have worked very hard to reduce not only the length of time we use catheters, but whether we need them at all. In March of 2015, our infection rate was higher than the national mean. We are now performing 70 percent better than other reporting hospitals on that measurement.

We took the same approach with central IV lines, which are associated with bloodstream infections. We started a specialized team two years ago to check the lines every day on every patient to see if they can be removed. We are now performing 50 percent better than other hospitals on that rate.

We have responded to intestinal infection, known as Clostridium difficile, in a variety of ways, including purchasing ultraviolet robotic devices that we began using this year, designed to kill pathogens by bathing our operating rooms and patient rooms in ultraviolet light.

Along with these focused areas, we gauge our progress on a number of other measurements. We ask our patients about our performance. We demonstrated our commitment to The Joint Commission, and last year received our full three-year accreditation.

Ultimately, we know that quality patient care is rooted in strong teamwork across the hospital and across shifts. It hinges on open communication, adherence to hand hygiene protocols, engagement of patients and building a safety-centered culture that is fueled by education and ownership of every employee at every level to make things a little better when they leave at the end of each shift.

There is also an important role for patients to play. No matter where you receive care, it’s important that you advocate for yourself throughout your healthcare experience. If you have questions, make sure they’re answered. If you aren’t sure if we washed our hands before we came into the room, ask us. And because few of us are at our best when we’re in discomfort or on pain medication or in unfamiliar surroundings, bring a friend or family member with you to be your advocate when you can’t.

We know that you have a choice in your healthcare. We do not take that trust for granted.

Comments

  1. Anonymous says:

    I worked at TMC for 5 years and only left because I moved out of Arizona. I was always proud to work at TMC and was inspired by my fellow nurses to strive to give the best care I could. That said, the nurse to patient ratio was always as issue, on each of the three units I worked on. Charge nurses often had full patient loads too. When speaking of patient safety, I find it upsetting that this issue is not addressed in your letter.

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Tucson Medical Center | 5301 E. Grant Rd. | Tucson, AZ 85712 | (520) 327-5461
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