January 2013

Clinical and Process Excellence Initiative Makes Progress in Des Moines and Lincoln


Teams of frontline employees at Mercy Medical Center, Des Moines, IA, and Saint Elizabeth Regional Medical Center, Lincoln, NE, are finding ways to improve clinical operations to deliver quality patient care more efficiently. As the first two sites to begin CHI’s Clinical and Process Excellence (CPE) process, each hospital recently showcased its progress for hospital and CHI leaders in what the teams called “gallery walk” presentations. Mercy’s gallery walk addressed efforts in the emergency department (ED), operating room (OR), inpatient and cath lab focus areas. Saint Elizabeth's gallery walk featured findings and solutions from three teams: ED, OR and inpatient.

At the time of the gallery walks, the teams had identified several solutions for improvement. These solutions will be fully implemented after successful pilots, which are now underway. Already, pilot results are promising, with early successes such as:

  • Catheterization lab solutions piloted in Des Moines increased on-time starts for cath lab procedures from 30% to 70%. The improvement was made by aligning cardiologists and staff in refining the workflow, improving staff communication, simplifying scheduling and streamlining nurse checklists.
  • In Lincoln, efforts to improve point-of-service (POS) collection of patient co-payments in the ED yielded dramatic results. During the first two weeks of the pilot, daily POS collections averaged $1,300 per day, well above the previous average of $205 per day. The improvements resulted from process changes, including consistent direction and scripting for registrars.

Both hospitals will continue to monitor solutions before the initial 18-week phase of CPE concludes for Mercy in late January and for Saint Elizabeth at the end of February.

Of course, there is no real end point with CPE; it is a continuous journey of improvement. As Bob Strickland, CHI’s senior vice president of performance excellence, told the Lincoln Gallery Walk attendees, “CPE is the fabric of who we are, and there is no such thing as completion. We won’t go back to doing what we’ve been doing. Rather, this marks the transformation of how we think about delivering care.” For more information, visit the Clinical and Process Excellence page on Inside CHI.