Applying best practices drives safer, better hospital care

Dialogue with Robert Rainer, MD
Associate Medical Director, Quality and Clinical Effectiveness
Spartanburg Regional Healthcare System

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Q. How have hospitals changed over the past few years?

A. Hospitals are about patients, not the other way around. Somehow we got away from that notion and began caring for patients in ways that benefited hospitals. Fortunately, hospitals are returning to patientcentered care, meaning that we’re taking care of patients in a way that benefits the patient. It’s really very simple. It’s our job to make sure the patients receive the highest quality of care delivered in the safest manner possible. We do that and we will have served our communities well.

Q. What’s driving change?

A. Lawmakers, insurance companies and the public have completely different expectations for their healthcare providers than they did 20 years ago. Today, the pressure is on for doctors and hospitals to deliver error-free medicine. That has become our ultimate goal. With process improvements, we can make that happen.

Q. South Carolina’s hospitals have made improving patient safety and quality a top priority. How have hospitals around the state begun to improve?

A. Many hospitals attribute patient errors to not having firm processes in place. In the past, services varied from patient to patient. Now hospitals across South Carolina are engaged in process improvement initiatives that provide specific instructions on how to handle things. For example, if a patient comes to the Emergency Room complaining of chest pain, there is a very specific process our physicians and staff must follow to ensure safe, appropriate care.

Q. What are some simple process improvements hospitals are doing to enhance quality and safety?

A. To improve a process, you have to understand the process. So many hospitals are doing “value stream mapping.” In effect, they are “mapping” where a patient is going in the hospital—inpatient surgery for example—how the patient moves through the hospital system, and what the best route is to get the patient through the hospital and procedure with the best service possible. When you understand a process, you can identify opportunities for error and improve the process so that the delivery of care is streamlined, it is safe, and the patient receives a higher quality of care and a positive experience.

Q. What is an example of a process improvement that Spartanburg Regional Healthcare System has put in place?

A. We’ve recently implemented a patient handoff checklist, which means the caregiver—physician, nurse or technician—who is handing the patient off to another caregiver must have all areas of their checklist completed. The same goes for the caregiver receiving the patient. If anyone on either end is missing any part of his or her checklist, then the situation and patient need to be reassessed and evaluated before anything moves forward.