TMC wraps up summer challenge asking employees for their best ideas

Tucson Medical Center five years ago embraced the Lean management process, which works to eliminate waste and tap the knowledge of employees to make steady improvement every day.

The Summer of Ideas challenged employees to channel their creativity and share their suggestions across the hospital.

More than 250 ideas were submitted since the July kickoff. Awards were given for the team and the individual with the most ideas, as well as the best “out of the park” idea.

Some of the ideas included a TMC-specific rideshare program, new software for clinicians and an app to help patients and visitors navigate the campus.

LeanAmyThree of the four finalists – and the winner of the category – for the most ambitious idea generators work in Unit 750, an adult medical unit. Unit clerk Amy Hill, who came to TMC six years ago, won a reserved parking space for a month.

“What I really appreciate about TMC is that there is an acknowledgment that those who are closest to the work often have the best solutions to improve a process,” Hill said. “I appreciate that whether it’s finding root causes of a problem or finding the where efficiencies are, we can all have some ownership of making things better.”

Janet Heckman, the manager of Unit 750, applauded the efforts of her staff. “Taking ideas from the front line staff who actually do the work is very important as I may not realize there is an issue,” Heckman said. “I also believe being heard is a huge employee satisfaction point as they feel empowered and heard.”

Ideas were logged on a Lean tool known as an “idea board.” There are 120 idea boards throughout TMC as well as at TMCOne locations and TMC Hospice.

It’s different from a suggestion box in that ideas – as well as any outcomes or solutions – are visible to the entire team, who can contribute to the idea as it matures, said Pat Ledin, the manager of Lean and quality efforts at TMC. “We hoped the Summer of Ideas would serve as a fun catalyst to continue driving engagement and we were really pleased with the participation across so many of our departments, from environmental services to information technology to clinical staff.”

lean ideas

Medical librarian Marni Dittmar, who picked up an extra day off as an award for her most “out of the park” idea, is an example of how the process worked. She not only came up with her idea for new clinical software, but then researched it to determine the benefits and feasibility.

Click here to see a short video about how idea boards are igniting creativity and empowering staff at TMC.

TMC receives prestigious national procurement recognition

procurement team

Tucson Medical Center was one of only 242 hospitals and health systems nationwide that were recognized for significant supply chain savings through efficiencies in procurement.

“As a community hospital, Tucson Medical Center knows the importance of efficiency in managing health care costs, even while never compromising on the ability to deliver high quality care,” said Kim Moon, TMC’s supply chain director.

The recognition is particularly special, Moon said, because of the 3,000 members participating in Vizient Inc’s group purchasing organizations, only 500 are even eligible for the award by participating in Vizient’s Impact Standardization Program, which helps drive down costs through group buys.

Only hospitals that earn at least $250,000 in rebates on an annual basis are eligible for an award. TMC, which has received this recognition annually since 2010, reduced its costs by achieving nearly $400,000 in rebates in 2016.

The program works through capturing rebates and reducing variation through standardization – which helps with bulk purchasing prices, but as an added benefit, improves inventory management and provides greater consistency across the hospital.

“This is not an easy bar to meet, which is why we’re so proud to receive this award,” Moon said. “Through thoughtful sourcing and standardization, we’re able to drive quality patient care, while getting the best value at the same time.”

The effort dovetails with TMC’s other work around building efficiencies throughout the hospital. The hospital introduced Lean management practices in 2013 to help root out waste and streamline processes. And TMC participates in two accountable care organizations that reward value – not volume – in health care.

“As a community hospital, TMC is responsible for the health of the people who live in this community, but we must also maintain the financial viability of our organization and keep healthcare costs under control,” said Steve Bush, TMC’s chief financial officer. “Leveraging our purchasing power is just one of the strategies we are using to do that.”

vizient award

 

TMC adopts new testing system to rapidly identify infections, allow targeted antibiotic treatment

Accelerate Diagnostics 4Tucson Medical Center has adopted a new technology developed by local biotechnology firm Accelerate Diagnostics Inc. that is expected to save precious time in identifying the source of bloodstream infections and determine which antibiotics would be most effective in treating them.

The U.S. Food and Drug Administration in late February allowed Accelerate to move forward with sharing information about the Accelerate PhenoTest BC Kit, which is designed to help save lives and reduce complications by initiating antibiotic treatment significantly more quickly in cases of bacterial or yeast blood infections.

About 2 million people are infected with antibiotic-resistant bacteria annually in the United States and at least 23,000 die as a result, according to the Centers for Disease Control and Prevention. Because these infections escalate very quickly, physicians concerned about a delay in treatment may sometimes employ a more broad-brush treatment. Over time, however, that builds resistance.

Accelerate Diagnostics“When we talk about heart attacks, we say that time is tissue, which is why we need immediate medical intervention,” said John Allen, director of TMC Laboratory Services. “When we talk about sepsis, time is life.

“We’re very excited by the promise of this test to help us find more targeted therapy as quickly as possible to improve patient outcomes and potentially save lives.”

TMC has worked closely with the company since it was recruited to Tucson in 2012, from providing specimens to helping run testing prototypes. “We’re very proud to work with the team at TMC,” said Lawrence Mehren, president and CEO of Accelerate Diagnostics. “Their dedication to providing the best care possible to our community is evident in the work they do each and every day.”

The company, which at the time pledged to add 30 jobs, has experienced rapid growth and now employs more than 100 people in leased space in the Abrams Public Health Center. “In addition to the life-saving work this company is doing, TMC is pleased to foster the biotech presence in our community and support local, ongoing economic development efforts,” Allen said.

Accelerate Diagnostics 3Traditional test results may take up to 48 hours after infection is detected in a positive blood culture. In a fraction of the time, the Accelerate PhenoTest BC Kit can identify more than two dozen species of bacteria and yeast that can cause infection, and help indicate its responsiveness to 18 different antibiotics, according to the FDA. It can also help identify whether the infection is showing indication of antibiotic-resistance.

FDA approval was based largely on a review of a primary clinical study, which determined the test correctly identified strains of bacteria or yeast more than 95 percent of the time in a sample of 1,850 positive blood cultures.

 

TMC celebrates the economic impact of hospitals in building healthy communities, healthy economy

Hospital WeekWhat does $740 million in total economic impact look like?

It comes in the form of:

  • Salaries for 5,800 jobs
  • Vast deliveries of office supplies and medical equipment
  • Nutritious ingredients for 3,200 meals served each and every day
  • Technological innovation and capital investment

In short, it looks like Tucson Medical Center – the area’s sixth largest private employer – and its total annual economic impact, most of which occurs at home in Pima County.

Hospitals play a strong role in improving the physical health of a community, from caring for people in emergencies, performing healing surgeries and welcoming babies into the world.

Hospital Week 2Beyond that important work, National Hospital Week, starting May 7, is an appropriate time to celebrate the economic contribution hospitals make. The sector is the largest employer industry in the state, making up 13 percent of Arizona jobs and contributing $22 billion in direct economic impact.

Last year, TMC invested $58 million back into the community, in the form of providing charity care, engaging the community in wellness and helping to fund Medicaid expansion. In fact, nearly 80,000 people were touched by TMC outreach and education programs in 2016, spread across 751 events.

“As one of this region’s largest employers, and as Tucson’s locally-governed nonprofit community hospital, TMC is proud to play an active role in supporting our local economy and helping improve the community’s health and wellness,” said Julia Strange, TMC’s vice president of community benefit.

TMC supports adoption of alternative payment models that improve care, reduce costs

Tom Bergeron

Tom Bergeron

Payment to health care providers should be based not just on numbers of patients and procedures, but on whether the care they deliver is effective and actually making patients healthier.

That’s the premise behind the federal government’s transition to prioritize quality of care over quantity of services – and it’s an effort Tucson Medical Center supports.

It’s why TMC helped launch Southern Arizona’s first accountable care organization in 2012 – Arizona Connected Care – and is participating in a second, Abacus Health. And it’s why we’re pleased to announce TMC is now a Committed Partner in the Health Care Payment Learning and Action Network (LAN), a public-private partnership launched to drive the effort to provide smarter, more effective care.

The network is designed to help all of U.S. health care attain the goals outlined in spring 2015 by President Barack Obama and Department of Health and Human Services Secretary Sylvia Matthews Burwell. The goals anticipate half of all payments should fall under “alternative payment models” by 2018.

“I would like to thank TMC for its commitment to value-based health care,” said Anne Gauthier, the LAN Project Leader. “TMC’s leadership continues to contribute to the momentum of payment reform across health care.”

Judy Rich, TMC’s President and CEO, was in Washington, D.C. for the fifth anniversary of the passage of the Affordable Care Act, when the goals were live-streamed to a national audience.

“TMC is pleased to join other committed organizations in working to achieve better care, smarter spending and healthier patients,” Rich said. “These efforts are consistent with our own goals and aligned with our mission of delivering quality community care.”

Dan McCabe, MD, and the CEO of Arizona Connected Care, which counts TMC as its hospital member, said accountable care organizations already are delivering impressive results. “We have accepted the challenge because we believe ultimately that patients will be better served, even as we improve the sustainability of the health care system.”

For more information about the LAN, please visit https://hcp-lan.org/

TMC receives 4-star hospital rating from CMS

tmc-for-children-patient-careTucson Medical Center is the only hospital in Tucson to receive a four-star rating in the U.S. Centers for Medicare & Medicaid Services Overall Hospital Quality Star Ratings released on Wednesday.

The ratings are a composite metric of one to five stars, with five being the best. They intend to convey the overall quality of nearly 4,000 hospitals in the U.S and are posted to the CMS’ Hospital Compare site.

“We are very encouraged by the rating. It reflects the focus and hard work of the nursing and medical staff at the hospital to consistently provide high-quality care,” said TMC Chief Medical Officer Rick Anderson, M.D. “Though to be sure, this work is never done. There is always room for improvement, and we will continue to standardize our processes, reduce waste in the system and continue delivering high-quality care that TMC has been known for these 70-plus years.”

The new Overall Hospital Quality Star Rating takes 64 existing quality measures already reported on the Hospital Compare website and summarizes them into a unified rating of one to five stars, with five being the best.

The rating includes quality measures for routine care that the average individual receives, such as care received when being treated for heart attacks and pneumonia, to quality measures that focus on hospital-acquired infections, such as catheter-associated urinary tract infections.

“These easy-to-understand star ratings are available online and empower people to compare and choose across various types of facilities from nursing homes to home health agencies,” according to Dr. Kate Goodrich, director of the Center for Clinical Standards and Quality at CMS, in a blog post announcing the star ratings’ release.

Just 102 institutions out of 4,599 hospitals, or 2.2 percent, earned five stars. Of the rest of the hospitals, 20.3 percent garnered four stars, 38.5 percent received three, 15.7 percent earned two stars and 2.9 percent received a single star.

It takes a village – celebrating achievement of meaningful use, stage 2

It was time to celebrate following Tucson Medical Center’s successful attestation for Stage 2 of meaningful-use requirements for its electronic medical record this past July. On Wednesday, TMC hosted a breakfast to recognize the 150 team members whose hard work and dedication led the organization to achieve this milestone.

“This was a huge, coordinated effort among a lot of different departments, and everybody really stepped up to the plate to make this happen,” said Chief Information Officer Frank Marini. “And the results are really impressive.”

He shared TMC’s results in meeting the objective measures set by the Office of the National Coordinator for Health Information Technology. As shown in the chart below, TMC beat most measures by 20 points or more.

MU chart

The team had remarkable depth and breadth from areas throughout most clinical areas of the hospital and beyond. In addition to significant resources from Information Services, the team included physicians, registered nurses, patient care techs, lab workers, pharmacists, case managers, infection control specialists and more.

Team members represented all the major clinical areas: cardiac, emergency, general/vascular surgery, geriatrics, geropsych, hospice, intensive care (adults, children and newborns), labor and delivery, mother/baby, neurosurgery/neurology, orthopaedic surgery, pediatrics, post-cardiac care, pre-anesthesia testing, transitional care and women’s services. Other ancillary areas included case management, clinical education, diagnostics, imaging, lab, nursing practice, pharmacy and volunteer services.

In addition, non-clinical areas included admitting, communications, community benefit, enterprise-wide scheduling, finance, health information management (formerly medical records), infection control, patient accounting, professional staff, quality, risk management and surgery scheduling.

Because the transitions-of-care measure was critical, representation was needed from outside the hospital campus. The measure called for the ability to send an electronic version of a patient’s medical record and plan of care in a format the receiving physician or care facility could understand. Staff from business development reached out to community physician groups including Saguaro Physicians, Saguaro Surgical and Southern Arizona Infectious Disease Specialists. In addition, the accountable care organization, Arizona Connected Care, of which TMC is a part, was part of the coordinated effort. All of this work had the support of the board of trustees and the C-suite, with the bulk of the Executive Team having a role to play.

TMC continues to optimize its electronic medical record and next up will be Stage 3 of meaningful use, which will focus on improved outcomes. Though the final rules for Stage 3 are still being developed by the government, TMC continues to look at ways to optimize the electronic medical record to increase quality, safety and efficiency in order to improve patient outcomes.

MU stage 2

A group of staff from Information Systems kicks off the morning festivities to recognize the team that work to meet requirements for Stage 2 meaningful use of the hospital’s electronic medical record.


This blog is one in a series as part of the Oct. 22 celebration at Tucson Medical Center for successfully attesting to the U.S. Centers for Medicare & Medicaid Services for meeting Stage 2 Meaningful Use requirements of its electronic medical record. This success was a great and collaborative effort across many areas of the hospital. It represents another milestone achieved toward improved patient care and safety.

TMC Meeting Transitions of Care Measure for Meaningful Use

Tucson Medical Center attested in July 2014 for Stage 2 of meaningful use of its electronic medical record, one of 75 hospital to hit this milestone at the time and one of 200 by Sept. 30, the end of the federal fiscal year. The Office of the National Coordinator for Health Information Technology asked the hospital to discuss in a video how it hit the target for transitions of care, one of the more difficult measures facing hospitals nationwide.

This blog is one in a series as part of an Oct. 22 celebration at Tucson Medical Center for successfully attesting to the U.S. Centers for Medicare & Medicaid Services for meeting Stage 2 Meaningful Use requirements of its electronic medical record. This success was a great and collaborative effort across many areas of the hospital. It represents another milestone achieved toward improved patient care and safety.

TMC ahead of the curve: one of less than 200 hospitals nationwide to attest to Stage 2 of meaningful use for its electronic medical record

1_Meaningful-Use_ArrowIn July, Tucson Medical Center attested to the U.S. Centers for Medicare & Medicaid Services, or CMS, that it has met Stage 2 meaningful use requirements for implementation of its electronic medical record. As a result, the hospital expects to receive $1.9 million this year in incentive payments made available under the 2009 economic stimulus package.

While the use of electronic medical records has dramatically increased throughout the country, many hospitals are finding it difficult to meet Stage 2 requirements. At the end of July, TMC was one of 78 hospitals, out of 4,741 hospitals registered for the incentive program, which had attested to Stage 2. As of Sept. 30, only 143 hospitals had attested.

After successfully attesting, TMC was contacted by the Office of the National Coordinator for Health Information Technology for a conference call to learn how the organization succeeded.

Two areas have proved especially challenging for hospitals around the country: patient electronic access, often realized through the use of a patient portal, and transitions‐of‐care measures requiring an electronic document be sent to the physician or care facility that will care for a patient after discharge.

TMC succeeded, in part, because of a team of more than 150 people from various disciplines, including executives, nursing, health information management, admitting, quality and information services.

The hospital first began investing in its electronic medical record infrastructure in 2002. Then in 2008, the TMC HealthCare Board of Trustees approved a $31 million plan to implement a fully electronic medical record, which went live in 2010. Presently, the organization is working toward connecting its internal electronic records system with other hospitals and health providers to share patient records.

This blog is one in a series as part of an Oct. 22 celebration at Tucson Medical Center for successfully attesting to the U.S. Centers for Medicare & Medicaid Services for meeting Stage 2 Meaningful Use requirements of its electronic medical record. This success was a great and collaborative effort across many areas of the hospital. It represents another milestone achieved toward improved patient care and safety.

Without getting out of bed patients can have their prescriptions filled, video chat with pharmacists

Pharmacist shares information about prescriptions over video conference

Pharmacist shares information about prescriptions over video conference

It’s now easier than ever for patients to fill their prescriptions before leaving Tucson Medical Center.

Patients can have those medications delivered right to their bedside and can even have a counseling session with the pharmacist over a video call without ever leaving their bed.

It goes far beyond a matter of one-stop convenience.

It’s also a matter of safety, since there are a multitude of barriers that could prevent that prescription from being filled after patients leave the hospital, said Pharmacy Director Gilbert Romero. Maybe they don’t have transportation. Maybe they don’t feel up to making that extra stop on the way home and to get prior authorization if they need it. Maybe the prescription is more expensive than they anticipated and they can’t afford it.

“If they’re home and they don’t have their medicine, then they’re not following through with their discharge plan, and that’s when they’re really at risk of re-admission,” Romero said. “Our goal is not only to take care of patients while they’re here, but to make sure they’re on a healthy path after they leave as well.”

If patients run into trouble filling a prescription, they may be helped by drawing on the full resources of the hospital. If a medication is too expensive, case managers can work with that patient to help find a solution. In hardship cases, for example, some medications may be provided for 30 days for free, which at least will serve as a bridge until the patient can see their primary care physician.

Among other conveniences, the Pharmacy:

  • Accepts all large private insurance plans, as well as the state’s Medicaid plans, known more familiarly as AHCCCS.
  • Takes manufacturer’s coupons.
  • Alerts customers via text, email or phone when prescriptions are ready.
  • Offers a great bargain, from inexpensive generics to reasonably priced prescriptions. In fact, for employees, the plan is designed so that the Pharmacy is among the cheapest options in town.
  • Operates during convenient hours; Monday through Friday from 7 a.m. until 7 p.m. – including through lunch hours – and Saturdays from 7 a.m. until 3 p.m. The Pharmacy is closed Sundays and holidays.

Most Wired: Health Information Exchange

Most Wired 2012 artHaving the right tools in place so that care providers can share information is key to creating a successful 21st century health care delivery system. The right technology can connect health care providers across the continuum ‑ including primary care doctors, specialists, assisted-living facilities and nursing homes, hospitals, rehab facilities and public health agencies ‑ to ensure more streamlined continuity of care.

TMC has been at the leading edge of health care information technology. It was the first hospital in Arizona to implement a comprehensive electronic medical record to achieve Stage 7, the highest level to date, on the HIMSS Analytics scale. But health providers use a plethora of electronic records systems – and those systems don’t readily talk to one another. Enter the health information exchange, or HIE, which will provide the infrastructure that will allow the systems to communicate.

TMC is developing this information-exchange capability on two fronts. It is part of a public system being developed at a statewide level by a community-based nonprofit known as the Health Information Network of Arizona. This system, which includes hospitals, health plans and other providers who opt in, is likely to start small when it goes live later in 2012 and will expand incrementally across the state.

TMC, however, is also committed to building its own information exchange to help serve as a building block for its participation in the accountable care organization Arizona Connected Care. With more than 200 providers participating, it’s important to connect these practices, especially in treating those with chronic conditions, especially diabetes and cardiovascular disease.

This private system will be customized to fit the needs of its participation in Arizona Connected Care and will include some advanced features. A basic system allows a user to access patient information. A more sophisticated system could automatically alert the provider that a patient has received emergency care, for example, instead of requiring a provider to search for that information.

TMC is also committed to the public effort as well, since as a practical matter, patients will be getting care from providers who may not be participating in Arizona Connected Care. Read more at Initiative to Link Doctors for Delivery of Stronger Patient Care.

TMC case study highlights achievements of instituting Stage 7 EMR

Last month, Tucson Medical Center was among 16 hospitals and health systems recognized at the HIMSS12 annual conference in Las Vegas for achieving the pinnacle of implementation of its electronic medical record. Since 2005, the Healthcare Information and Management Systems Society’s Analytics’ EMR Adoption Model has tracked the adoption of ell has tracked the adoption of electronic medical record applications within hospitals and health systems across the United States. Institutions work to complete the 8 stages (0 – 7), with the goal of reaching Stage 7: an environment where paper charts are no longer used.

As part of its recognition of these systems and facilities, HIMSS published case studies on 14 Stage 7 hospitals, including Tucson Medical Center, that provide insight and guidance that other health care organizations can emulate. They are also a summary of each winner’s journey to the top of the EMRAM.

Only 65 hospitals in the United States have Stage 7 EMRs. A study by HIMSS and The Advisory Board show they have a very real competitive and quality advantage, as they support the true sharing, information exchange and immediate delivery of patient data to improve process performance, quality of care and patient safety. New research from HIMSS Analytics and The Advisory Board affirms these gains, showing that hospitals with advanced EMR systems report achieving a broad range of benefits, including quality, safety and operational efficiencies.

The data collected for the report, EMR Benefits and Benefit Realization Methods of Stage 6 and 7 Hospitals, indicates that highly advanced EMR environments can produce substantial benefits for individual hospitals and the health care system as a whole. The survey is the first to report results from hospitals that have achieved Stage 6 or Stage 7, providing unique insight into how ERM systems are working for hospitals further along the development track.


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