RHQN Members: Featured Member — St. Joseph’s Hospital, Chewelah

The Rural Healthcare Quality Network (RHQN) is pleased to recognize St. Joseph’s Hospital, Chewelah as our Featured Member of the Quarter (Q2 2007).

St. Joseph’s Hospital has once again demonstrated that they can compete with larger institutions when it comes to delivering care based on best practice.  As a member of the Providence hospital system, St. Joseph’s Hospital is one of three critical access hospitals in the United States taking part in the Premier Medicare Demonstration Project, and as a result of that participation has received recognition and also financial rewards for their outstanding performance. This is no easy feat, since they are a critical access hospital with very small volumes.  Having small volumes means having to perform close to 100% most of the time in order to demonstrate excellence, which is not the case for larger facilities. 

Quality Leader for St. Joseph’s, Susan Burmeister, states that in her opinion strong teamwork is the key to success at St. Joseph’s.  The nurses and doctors have a good rapport, there is no finger pointing and each discipline accepts that although they may have specific responsibilities, they are working together to ensure good clinical outcomes.   Over the last few years Susan has persistently led the quality efforts at the hospital and reports that the hospital is strongly in favor of developing an evidence-based culture based on best practice. Staff and clinicians know that it is “the right thing to do”.

Being part of the Providence System and the Rural Healthcare Quality Network has been helpful.  Susan states, “sometimes the work is duplicative, but that has also helped the push to perform and achieve successful outcomes”.  Susan also publicly recognizes high performers among staff and providers.

Susan admits that the success at St. Joseph’s did not come without a lot of hard work and planning.  After evaluation, system changes took place around the admission and discharge process.  For example, a risk assessment is now conducted on every single admission, so that quality measures such as immunization status and whether or not the patient has had an echocardiogram in the six months is addressed, and leads staff to “prompt” providers so that they can be aware of the fact that an immunization may need to ordered or an echocardiogram scheduled. 

Pre-printed materials such as the RHQN heart failure stickers and Micro Medics pre-printed discharge instructions, (with all six components of the discharge instructions) has also been helpful, and the use of these types of intervention materials have been incorporated in the discharge planning process.  Susan reports that St. Joseph’s is moving toward an electronic medical record which she believes will make it even easier to build in prompts and reminders so that all clinical guidelines are addressed and make it easier to become a high reliability organization.