From the Desk of Deb Burton

August 30, 2019
Deb Burton

This issue of Best in the West highlights our extraordinary nursing clinical practice and quality. Once upon a time, being Best in the West for nursing care and practice was an inspiration and an aspiration. Now we have arrived, and our work has shifted toward continuous quality improvement. How do we know we’re the Best in the West? Consider just a few examples of breathtaking nursing clinical performance evidence:

Maternal Death Rates
Last year, despite over 71,000 deliveries across Providence St. Joseph Health, we had only ONE maternal death. Absolutely amazing and wholly unprecedented.

Healthcare-Associated Infections and Serious Safety Events
As a system, we achieved Outstanding-level performance in 2018 for reducing Healthcare-Associated Infections and Serious Safety Event rates. Nearly all the included metrics are “nurse sensitive”—that is, they directly reflect the quality of nursing care being provided. To illustrate:

  • In 2012, our system-level inpatient Cather Associated Urinary Tract Infection (CAUTI) rate was 1.58 cases per 1000 catheter days; our Central Line Associated Blood Stream Infection (CLABSI) rate was 1.39 cases per 1000 central line days.
  • As of June 2019: Our system level CAUTI rate dropped to 0.93 cases per 1000 catheter days; our CLABSI rate decreased to 0.51 cases per 1000 central line days. Both achievements far surpass what is statistically predicted for the volume and acuity of our hospitalized patient population.

Sepsis
In 2018, PSJH had over 770 fewer deaths from sepsis than would be statistically expected for our size, acuity and patient population. 

Malnutrition
Also in 2018, we detected and treated over 40,000 hospitalized patients for malnutrition.

Magnet & Pathway to Excellence
Ten years ago, PSJH had four Magnet facilities and none with Pathway to Excellence designation (**the program didn’t exist yet). By the end of 2019, PSJH expects to have 15 Magnet designated facilities, and six with Pathway to Excellence designation. And we have many more in the cue—2020 will be a banner nursing excellence year!

So how is this all possible? Largely it is because we are engaged, compassionate, competent, vigilant, well-educated, accountable and passionate about delivering the best care possible. And we do all of this as a very, very large nursing community. About 40,000 of us to be exact! We are spread across seven states, four time zones, and over a third of the geography of the entire United States. We are in remote critical access hospitals; large, urban quaternary hospitals; vast networks of community-based and home health agencies; over 900 ambulatory settings; and much more. We are deeply blessed with extraordinary teams of care coordinators, expert consultants, nurse scientists, nurse educators, mentors, advanced practice nurses of every kind, and nurse leaders and executives who drive and lead us forward---all in the name of the best care possible for our patients. And the secret sauce? We learn from each other and we all improve together because what is best for our patients doesn’t vary.

Thank you for staying on this improvement journey together. We just keep getting better!