JCAHO announces winners of the Codman Award
JCAHO announces winners of the Codman Award
In recognition of excellence
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) announces this year’s organization and individual winners of the fourth annual Ernest A. Codman Award to recognize excellence in the use of outcomes measurement to achieve health care quality improvement.
The recipients of the organization awards in the following categories are:
• Behavioral health: Lake Grove at Maple Valley, Wendell, MA.
• Home care: HomeReach, Worthington, OH.
• Hospital: Mission Hospital Regional Medical Center, Mission Viejo, CA.
• Long-term care: Kings Harbor Multicare Center, Bronx, NY.
• Individual: John W. Williamson, MD, is the individual award winner, in honor of his leadership role in promoting the use of performance measures to improve health care services.
Named for the physician regarded in health care as the "father of outcomes measurement," the Ernest A. Codman Award was created to showcase the effective use of performance measurement, thereby enhancing knowledge and encouraging the use of performance measurement to improve the quality of health care.
The award is available to the eight types of health care organizations accredited by the Joint Commission, in addition to individuals. A panel of national experts in quality measurement and improvement selects recipients of the award.
Dennis O’Leary, MD, president of the Joint Commission, recently announced the award winners. Here are the specific achievements of the 2000 Codman Award winners:
• Lake Grove at Maple Valley reduced the use of physical restraint at the facility by nearly 70%.
This provider of comprehensive treatment services for sexually abusive youths sought to reduce the use of restraints. In addition to reducing restraint use, Lake Grove reported higher client satisfaction with quality of services, which was linked to a nearly 90% injury-free restraint use and all sustained client injuries requiring only minimal on-site first aid from facility nursing staff; a 55.2% decrease in on-the-job injuries; stabilization of occupational stress levels; a 44.3% increase in average length of employment; and an increase in client referrals.
The identification of restraint reduction as a performance improvement initiative in 1997 was based upon the recognition that restraint utilization is a high-risk activity that has the potential to harm the physical and emotional well-being of clients. Administrators determined that restraint use should be monitored, evaluated, and continuously improved to ensure the most safe, effective, and therapeutic techniques are used with clients during a behavioral crisis.
A thorough analysis of the processes leading up to the use of restraints yielded a realization that restraint frequency was symptomatic of several causal factors, including client behavior, staff competency, treatment planning, treatment and supervision methods, and the environment of care. When those factors were targeted for improvement, a statistically significant reduction in restraint frequency occurred.
• HomeReach, the home care division of OhioHealth, identified new ways to reduce accounts receivable days.
Reduction of accounts receivable days is important to the organization’s clinical and financial performance because it enables HomeReach to improve its revenue realization and cash position, enhance opportunities for philanthropic programs, and retain market share.
The initiative resulted in a decrease in accounts receivable days from 116 days in July 1998 to 70 in December 1999. While timeliness improved, a billing audit showed billing accuracy remained greater than 99%. The average time of receipt of signed physician orders also decreased from 33.7 days to 22.4 days, and a recent physician survey showed 91% of the respondents agreed that they received patient information in a timely manner.
• Mission Hospital Regional Medical Center dramatically improved the clinical outcomes of patients sustaining severe traumatic brain injury.
Within three years of the project’s beginning, 70% of the severe traumatic brain injury population experienced a good outcome to moderate disability; 15% sustained severe disability to persistent vegetative state, and 15% died.
That is a dramatic improvement compared with the previous three-year period, when 43% of the patients died and 30% suffered severe disability. Mission Hospital is one of 15 Catholic hospitals in the St. Joseph Health System in Orange, CA, sponsored by the Sisters of St. Joseph of Orange.
• Kings Harbor Multicare Center significantly increased visits to residents by families and friends.
The Transportation Links to Quality Care initiative also strengthened a program of resident trips, individualized excursions, and outpatient transportation. As a result, the facility saw a 50% increase in visits by family and significant others. Kings Harbor, a member of the New York Health Providers and Subacute Network, also reported a 10% to 30% increase in customer satisfaction for residents, families, and the community, as well as an increase from 291 admissions in 1997 to a projected 700 admissions in 2000.
• John W. Williamson, MD, is a pioneer in the field of health care outcomes research and has put that knowledge to effective use.
During the past 40 years, he has worked tirelessly to integrate continuing medical education, health services research, and medical informatics into the foundation of future outcomes assessment and improvement.
He served as a professor at the University of Utah School of Medicine and the Johns Hopkins School of Hygiene and Public Health, in addition to serving as a visiting professor of medicine at the Harvard School of Public Health. He also served as director of the Salt Lake Regional Medical Educational Center of the Department of Veterans Affairs and is the author of 114 publications in the field of care quality improvement.
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