High standards, persistent analysis and innovative solutions have paid off handsomely for HHC's Sea View Hospital, the only long term care facility in the nation to receive the coveted Ernest Amory Codman Award from The Joint Commission in the past five years. The award recognizes the effective use of performance measurement to achieve improvements in the quality and safety of health care.
"The Codman Award re-affirms our belief that implementing evidenced-based best practices at every level of clinical care leads to improved patient outcomes and increased patient safety," said HHC President Alan D. Aviles.
Measuring performance and quality in healthcare is no easy task. But staff at Sea View Hospital, HHC’s long term care facility on Staten Island, were determined to improve patient safety as they began to analyze the fall rates among residents. They found that the fall rates seemed to be tied to incontinence rates, and that those rates were higher than expected. The Sea View care team went into action and was able to use the data to bring change and directly impact patient safety.
The program included revised documentation to improve assessment and evaluation of the toileting program, creation of a new assessment tool to detail the toileting needs of each resident and integration of a new “lift” device to transfer residents to the toilet with increased regularity. The facility also designed a staff training and education program about incontinence and toileting, including the relationship between incontinence and falls and pressure ulcers – which are particularly common among nursing home patients who generally face higher risk.
The initiative led to a drop in incontinence rates from 79 percent in 2003 to 38 percent in 2006, while improving quality of life and maintaining the dignity of their long term care residents.
"Sea View’s achievements demonstrate the progress that can be made when performance measurement leads to meaningful practices that benefit patients," says Dennis S. O'Leary, M.D., president, The Joint Commission.
In addition to reduced incontinence rates, pressure ulcers were decreased (from 12.4 percent to 8 percent) and falls dropped from 8.3 percent to 6.1 percent during the same three-year period. The organization also reported decreased staff injuries – often a common occurrence in the physically-demanding practice of helping patients who have limited mobility.
"We are continually striving to enhance the quality of life for our residents." Angelo Mascia, Sea View’s Executive Director said. "This program is another example of the staff’s concern for the needs of our residents."
"I am so proud of the staff at Sea View," Carole Morgan, Sea View’s Director of Nursing added. "This award directly reflects the commitment and dedication of our staff to ensuring the highest quality of life for our residents."