World Class Heart Care

Myra RicceriMyra Ricceri, PMP, CLSSCGB, FLMI, ACS, is a Sr. Operations Project Manager at Alegent Creighton Health. She recently sat down with the Society of Cardiovascular Patient Care to discuss the world's first triple award in heart care.

Alegent Creighton Health just became the first system in the world to achieve Accreditation and Certification for all SCPC service lines. Other than process improvement, what were the benefits to Alegent?

By including all six of our facilities in the scope of our project, we were able to take the best of what was happening at each campus and share it with the other campuses. We found that we didn't need to start from a 'blank slate' on several items because initial work was underway at least one of our sites. Now, we have standardization across all our sites, gaining efficiencies in operations, streamlined communications with EMS, patient education materials, etc. The governance process for making all this happen was facilitated by utilizing our Heart and Vascular Institute (HVI) infrastructure. We formed the HVI a few years ago, and that structure really has helped us get consistency across all our campus locations, provided one sponsor for all our major cardiovascular undertakings, and has helped to get everyone singing from the same page of the same hymnal!

So, it sounds like there were efficiencies doing it all at once instead of piecemeal?

Oh, absolutely! And, the project team meetings we held were quite fun. All campuses were represented, and we made every attempt to equalize the 'homework assignments' – spreading them across the facilities. Almost all of the documentation we submitted for accreditation was done on a system-wide basis whenever we could. So, one campus could be accountable for gathering the required documentation for all. We did it once, instead of six times. The only exception to that was where we had to have state-specific protocols because one of our locations is in Iowa, where the rest are in Nebraska. Just prior to submitting our materials to the Society, we held a system-wide session that we called our "Binder Review". EMS jurisdictions were present, Cardiology, ED, in-patient units, etc. We literally went through our 3-ring binder page by page to make sure nothing had fallen through the proverbial crack. It proved to just further reinforce the teamwork we had established throughout the previous months as we worked to assemble everything.

That's innovative. Was it helpful as a system to have group discussions together where you could share your "mutual challenges" in a closed environment that didn't include outsiders, or non-Alegent employees?

It really was. Sort of like a brainstorming session on steroids! The scheduling of stress tests at one of our campuses wasn't going as smoothly as we wanted it to, and by getting all campuses together at the same time, we were able to revise that campus' process to bring it in line with the other campuses' process that were running quite well. We saw an instant improvement in staff and provider satisfaction, as well as a decrease in the patient no-show rate. That being said, though, we also had some sessions that DID include non-Alegent employees. For example, we had EMS around the table when we were going deep into the items in that section of the Tool. It was very educational to understand their challenges, and devise ways we could help each other improve the care we were giving to the cardiovascular patient. They, in turn, learned a lot about what goes on after they deliver the patient to one of our facilities.

Smart. So, aside from the obvious process improvements, do you think a residual benefit was team building? Do you think relationships were built throughout the Alegent system that now help keep everyone "singing from the same hymnal" as a natural byproduct?

I think relationships were strengthened rather than built. We took a system approach in the previous cycles of Chest Pain accreditation where our Chest Pain Center Coordinators were already functioning as a well-oiled machine. With the recent addition of Creighton University Medical Center (CUMC) to our system, it's been like adding a new member to the family. I was amazed at how alike many of the processes at that facility were to the processes at our other five sites. A few differences because CUMC is a trauma center, as well as an academic institution, but all in all, basically the same. That has made the standardization of processes across our system much simpler than if we had started miles apart. Because of utilizing our HVI structure, and continuing with that set up in future years, we will continue to sing in harmony!

With those relationships strengthened, and since everyone is on the same page, the holistic system approach worked best. Do you think that it will save money -- or have an ROI - with the process and the "team element" working together?

Undoubtedly! Alegent Creighton Health recently launched a major focus on Lean process improvements so we can make sure we are functioning in the most efficient manner possible. We made sure we followed Lean principles in any process we designed, while always keeping the patient as the center of everything we were doing. As a result, we have a win-win … good for us in terms of efficiency, and good for the patients in terms of improved cardiovascular care.


This content has been republished with the permission of the Society of Cardiovascular Patient Care.