RANs make the most of cooperation

IRVING, TX – Hospitals are not always excited about sharing best practices or helping competitors improve performance and save money.

But most agree about the need for the healthcare industry to improve clinical quality and patient safety. That rallying cry is bringing an increased level of cooperation among hospitals around the country.

The need to prevent hospital-acquired complications is growing, as payers are following Medicare’s lead in denying payment for care needed to correct preventable problems. And Medicare is raising the ante on October 1, when officials say they will no longer pay for care related to 10 so-called “never events”

Thanks to an initiative sponsored by VHA, Inc., hospitals are collaborating to improve performance in a variety of areas, using a rapid approach to conduct continuous quality improvement efforts. The Irving, Texas-based alliance calls the groups rapid adoption networks, or RANs.

In late July, VHA announced the formation of a RAN involving 21 hospitals from five states to study how hospitals could enable nurses to spend more time at patients’ bedsides. A recent VHA survey showed that nurses spend less than 30 percent of their time in direct patient care.

Many RANs are studying issues that could either maintain or increase revenue or cut expenses. For example, increasing nurses’ time at the bedside could help improve nurse efficiency, which could help hospitals deal with nurse staffing shortages.

The RANs are virtual networks that enable participants to share information in ways that accelerate the pace of improvements, aiming to deliver results in less than a year, said Terri Gingerich, senior director of performance implementation at VHA.

“By working together, meeting in real time and virtually, we can share information about how we each perform within the network, enabling us to achieve rapid clinical improvements and providing better care for our patients,” added Joanne Nathern, chief nurse executive at Montgomery County Hospital in Red Oak, Iowa.

The RANs use process maps called Leading Practice Blueprints, based on VHA members who are top performers in the areas under question, Gingerich said. RAN members then meet regularly for gap analysis and to refine what needs to be done at each facility.

The answers don’t always involve radical changes in care, said Bill Dooley, rehabilitation services director for Concord (N.H.) Hospital. His facility participated in a RAN that studied best practices for pressure ulcers.

“Most of the focus was on process, and that’s where a lot of hospitals needed the help,” he said. “We are used to committee work, and VHA tried to provide encouragement to keep (care improvement) goals narrow in scope.”

Cooperation between hospitals helps move them all closer to the goal of safer patient care, Dooley said, and that provides a variety of benefits, including savings on care delivery.