Post on 07-Apr-2016
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COMMITMENT TO EXCELLENCEAbove All Else
Mission
Above all else, we are committed to the care and improvement of
human life.
Vision Together, we will be the premier healthcare destination for all we serve.
Values • Integrity
• Compassion
• Always
• Respect
• Excellence
Table of ContentsQuality Care ...............................................................................2
Patients First ..............................................................................6
Cancer Care
Nursing Excellence
Rapid Response and Efficiency ..............................................12
Heart Care
Stroke Care
Pain Care
Perseverance and Innovation ................................................16
Transplant Care
Teamwork and Determination ...............................................20
Trauma Care
Emergency Medicine
Neonatal and Obstetrical Care
Reproductive Medicine
Health and Wellness ..............................................................26
Wellness at Work
Health Insurance
Accreditations and Honors ....................................................30
Facility Maps ...........................................................................32
On the cover: Joe A. Cates, MD, board-certified vascular surgeon, meets with a family member to share positive outcomes and describe the procedure that removed pancreatic cancer.
Dear Colleague,
Now is a time of swift and dramatic change in healthcare. The Affordable Care Act and the
push for more transparency for healthcare consumers, combined with the total transition to
digital space for secure medical record storage and sharing, have led us to become the masters
of change.
Yet we remain steadfast to our mission to guide our priorities:
“Above all else, we are committed to the care and improvement of human life.”
We deliver compassionate, high quality healthcare by focusing on the medical, spiritual
and mental needs of each patient and family. Achieving the best possible patient outcomes
while efficiently preserving healthcare dollars takes skill, in-depth planning and detailed
follow-through. Working together, our physicians and staff are continuously advancing
every one of our business pillars – clinical quality, patient experience, employee
engagement, growth and finance – to provide healthcare excellence and high performance
for our entire community.
We created this report to illuminate our recent achievements and share our commitment
to healthcare quality at Research Medical Center. Through a combination of patient stories,
important information and data illustrations, we invite you to join our journey as we set
our sights on becoming the best healthcare provider and healthcare employer in the
region. By working together with you, the leaders and healthcare decision-makers of this
community, we can further control costs, broaden access, enhance quality and encourage
healthy lifestyles.
Best regards,
Jackie DeSouza-Van Blaricum
President and CEO
Research Medical Center
1
Above All Else
At Research Medical Center, we take quality
performance very seriously. Working collaboratively
with executive and clinical leaders to progressively
improve patient care, our achievements are
transforming Research Medical Center into a top-
ranking U.S. hospital. To shed light on the levels
of care available within our halls, this Above All
Else Quality Report details our performance across
several centers of excellence. We are proud to share
this journey with our community as we continue to
pursue ever-higher levels of quality and service.
James A. Maliszewski, MD, board-certified internal medicine physician, and Shonté M. Hutson, RN discuss medication management at the bedside.
QUALITY CARE
3
David S. McKinsey, MD, Performance Improvement Committee Chair
Dr. David McKinsey (right) discusses quality improvements with Dr. Joel McKinsey (left) and Tien Nguyen, RN, 4West Charge
Nurse (center).
QUALITY CARE
Excellence in Quality CareHospital quality is measured in many different ways. Everyone, from
healthcare consumers to community and business leaders who make
decisions that drive healthcare choices, deserves to know the quality of
care available at any given hospital. Research Medical Center is deeply
committed to evidence-based healthcare that protects patient safety and
leads to high quality outcomes. Our recent awards and performance data
illustrate our journey of continuous quality improvement in overall hospital
metrics (Figures 1 and 2) and across service lines. We are making high
quality healthcare more accessible in Kansas City than ever before, and it
shows.
A national Top Hospital. Research Medical Center is the only hospital in
Kansas City to earn the prestigious 2014 Top Hospital award from The
Leapfrog Group. We are among an elite group of only 60 hospitals our size
to earn this highly competitive distinction nationwide. The Leapfrog Group
is a nonprofit coalition of employers and other large healthcare purchasers
who advocate for improvement in hospital care. As corporate advisors,
their work has been instrumental in determining what constitutes quality in
healthcare and establishing a common set of safety, quality, and resource
use standards to help purchasers make informed decisions about where to
spend healthcare dollars. By design, only a few hospitals in a given region
perform well enough to exceed these standards, and we are very proud to
be among them.
As a 2014 Top Hospital, Research Medical Center demonstrates exceptional
standards of care that lead to lower infection rates, higher survival rates for
high-risk procedures, decreased length of stay and fewer readmissions.
“A” grade in hospital safety. Through its well-known
Hospital Safety Score rating system, The Leapfrog Group
also awarded an “A” grade to Research Medical Center in
2014. To calculate our hospital’s patient safety grade, The Leapfrog Group
used multiple data sources that combine to illustrate how well we protect
1.6
1.4
1.2
1.0
0.8
0.6
0.4
0.2
0
Improving Overall Hospital OutcomesMortality and Complication Rates, Observed and Expected
2011 2012 2013 2014*
Figure 1Source: Research Medical Center, 2014. *Through September 2014
Better
In H
osp
ital
Co
mp
licat
ion
s
Research Medical Center Mortality Rates
Research Medical Center Complication Rates
Expected
1.09 1.15
0.75
1.151.07
0.78
4
1.6
1.4
1.2
1.0
0.8
0.6
0.4
0.2
0
Improving Care for Life-Threatening Conditions Overall Hospital Sepsis Mortality Rate, Observed and Expected
2011 2012 2013 2014*
Figure 2Source: Research Medical Center, 2014. *Through September 2014
Better
In H
osp
ital
Co
mp
licat
ion
s 1.51
0.97
Research Medical Center
Expected
0.82 0.820.64 0.64
Frederic L. Seligson, MD is board certified in cardiac and thoracic surgery and specializes in cardiothoracic procedures.
Jeffrey W. Cameron, MD is board certified in general and vascular surgery and specializes in complex vascular surgeries.
William M. Beary, MD specializes in endobronchial ultrasounds and electromagnetic navigation bronchoscopies (superDimension™).
5
Figure 3Source: Research Medical Center, 2013-2014.*Through September 2014
our inpatients from accidents, infections, injuries, and errors. Our “A”
grade represents extremely high performance in a rating system that is
quickly becoming the standard measure of patient safety in the U.S.
Top Performer on Key Quality Measures. Also in 2014, The Joint
Commission recognized Research Medical Center as a national Top
Performer on Key Quality Measures® for 2013 performance, marking our
second consecutive year receiving this distinction. The Top Performer
award demonstrates excellence in heart attack, heart failure, pneumonia
and surgical care (Figure 3). We are among only 1,224 hospitals across
the country to receive this most recent recognition from The Joint
Commission (the nation’s leading accreditor of healthcare organizations),
although nearly three times as many hospitals were eligible.
100%
80%
60%
40%
20%
0%Heart Attack
Heart Failure
SurgicalCare
Pneumonia
% o
f Pa
tien
ts
Top Performer on Key Quality Measures
99.5% 98.4% 100% 99.2% 99.3%
Better
100%100% 100%
Research Medical Center 2013
Research Medical Center 2014
Above All Else
Megan Jones, 38, is fighting breast cancer under
the care of Stephanie Graff, MD. Familiar with Dr.
Graff through family and friends who have won
their own battles against cancer, Megan requested
a referral after diagnosis to begin chemotherapy at
Research Medical Center. “From day one, Dr. Graff
made me feel like a friend – someone she really
wants to help, not just a cancer case,” says Megan.
Her treatment is part of a clinical trial for people
who carry an inherited BRCA1 gene mutation that
elevates the risk for developing certain cancer types.Molly Lund, MS, CGC, board-certified genetic counselor, offers personalized and highly targeted care and prevention options to patients.
7
PATIENTS FIRST Cancer Care | Nursing Excellence
Megan Jones and Stephanie Graff, MD
Megan Jones (left) discusses her breast cancer with her oncologist, Stephanie Graff, MD. With board certification in internal
medicine, medical oncology and hematology, Dr. Graff specializes in breast cancer and actively leads a number of clinical trials to
ensure patients have access to the latest developments in cancer treatments.
Excellence in Cancer CareFor those in the fight against cancer, above all else, we believe in bringing
the latest treatments and technologies to Kansas City. From prevention
and early detection to advanced cancer therapies and comprehensive
oncology care services, Research Medical Center delivers excellence right
here, close to home and work for thousands of people in this community.
Network of excellence. In 2014, we were honored to become a cancer
treatment center of the Sarah Cannon Cancer Network of Excellence
(Figure 4). Sarah Cannon, in partnership with Hospital Corporation of
America (HCA), brings innovative minds together across 50 treatment
centers to transform care and personalize treatment for cancer patients
here and across the world. Through our Sarah Cannon partnership, we are
on the forefront of establishing molecular profiling for cancer patients
which will allow us to personalize cancer treatment to the genetic profile
of each patient’s particular cancer.
Quality outcomes. To accelerate improvements in survivorship, we
carefully manage changes in cancer care, treatment and surveillance
programs, and we continually measure our effectiveness against a range
of national quality standards. Some standards are nationally accepted
treatment guidelines proven to yield more favorable patient outcomes.
Others comprise indicators of quality, such as volumes, mortality and
complications. For example, we meet the National Quality Forum (NQF)
measures for post-breast cancer recommended therapies (Figure 5).
Our mortality rate for two high-risk surgeries – lung resections and
pancreatectomies – are lower than the national average (Figure 6)
across all hospitals accredited by the American College of Surgeons’
Commission on Cancer (CoC).
8
Figure 4Source: Research Medical Center, 2014.
Figure 5Source: Research Medical Center, 2011 (most recent publicly reported data); Cancer Quality Improvement Program (NQF 0219, 0559, 0220).
100%
98%
96%
94%
92%
90%
88%
86%
84%
82%Guidelines
for Radiation Therapy
Guidelines for Hormone
Therapy
Guidelines for Chemotherapy
Research Medical Center
Missouri
All CoC Programs
100% 100% 100%
94.4%
97.4%
93.0%
91.1% 91.5%
88.1%
% o
f Pa
tien
ts
Upholding Best Practices in Breast CancerCare Exceeds National Guidelines
PATIENTS FIRST
Better
Advanced cancer-fighting technologies. Research Medical Center offers
some of the most progressive cancer treatments in the region, including
neurosurgeons trained to use the area’s only Gamma Knife® treatment for
brain tumors (pictured on page 15), the only suite for high-dose rate (HDR)
image-guided brachytherapy and the MammoSite® Radiation Therapy
System. These technologies target cancer cells, limit the radiation exposure of
healthy tissue, and deliver faster treatment and recovery times.
Innovative clinical trials. Together with Sarah Cannon, Research Medical
Center brings more clinical research, more clinical trials and a broader range
of cancer care services to Kansas City. Having conducted more than 140
first-in-man clinical trials to date, Sarah Cannon is one of the largest
early-phase research programs worldwide. Research Medical Center is also
a partner in the National Cancer Institute Community Oncology Research
Program, which brings access to additional clinical research trials. These
partnerships make it possible for us to have trial opportunities in breast,
gynecological, prostate, gastrointestinal, lung, head and neck, brain, thoracic,
bone, skin, and blood cancers.
9
Verda J. Hicks, MD, board-certified OBGYN and gynecologic oncology physician, advances minimally invasive surgery using the daVinci® robotic surgical system.
Figure 6Source: Research Medical Center, 2009-2011; Cancer Quality Improvement Program (n=1,200).
Improving Cancer Care OutcomesMortality Rates Better Than National Averages
3.5%
3.0%
2.5%
2.0%
1.5%
1.0%
0.5%
0.0%Lung Resection Pancreatectomy
Research Medical Center
All CoC Programs
2.7% 2.7%
1.6%
3.3%
In H
osp
ital
Dea
ths
Better
Syed Faisal Jafri, MD, board-certified gastroenterologist, consults on a broad range of cancer cases.
Multidisciplinary specialists gather for a clinical case conference at our Liver and Pancreas Institute.
Genetic testing and counseling. Clinical leaders encourage early detection
of cancer risk factors. Research Medical Center offers predictive gene
testing to give patients and families insight into their risks of developing
cancer. Our four board-certified genetic counselors have 65 years
combined experience working with clinicians and patients to provide
personalized information about genetic influences, specific cancer risks,
and targeted screening and prevention options.
Liver and Pancreas Institute. Our Liver and Pancreas Institute (LPI) clinical
case conferences bring together a team of hepatologists, oncologists,
radiologists, surgeons, and other physicians to shorten the time between
diagnosis and treatment for our patients. Patients with even the most
complex cases receive a treatment plan the same day.
Prestigious accreditation. Research Medical Center is accredited by
the CoC as a Community Hospital Comprehensive Cancer Program.
The CoC recognizes cancer care programs that carry out the mission of
comprehensive, high quality and multidisciplinary care. Only facilities that
accession at least 500 newly diagnosed cancer cases each year, provide a
full range of diagnostic and treatment services, and participate in cancer-
related clinical trials are eligible for this accreditation. Through our CoC
accreditation, we have access to reporting tools for benchmarking and
improving outcomes.
Oncology nursing excellence. Research Medical Center exceeds CoC
recommendations for specialty nurse staffing. Half of our nurses treating
cancer patients have also attained the Oncology Nursing Certification,
which is a formal recognition of standards in skill and experience that
promote healthy outcomes.
Industry evidence suggests a strong emphasis on nursing and nurse
communication is central to all gains in patient experience. We are
proud to see nursing excellence reflected in our cancer center patient
satisfaction scores. In the area of communication – how well our oncology
nurses communicate with and listen to patients – we exceeded the
national average in 2014 (Figure 7), a testament to the “patients first”
philosophy we embrace across the organization.
10
PATIENTS FIRST
Figure 7Source: Research Medical Center, 2014; Hospital Consumer Assessment of Healthcare Providers and Systems: Percentage of patients who responded “always” related to satisfaction with communication with nurses.*Through September 2014
Strengthening the Patient ExperienceOncology Nurse Communication with Patients Improves, Exceeds National Average
100%
80%
60%
40%
20%
0%3Q2013 1Q2014 3Q2014*2Q20144Q2013
79%
Research Medical Center
National Average
% o
f Pa
tien
ts
77% 75% 76%84% 84%
Better
11
Excellence in Nursing Research shows positive work environments where nurses can flourish
have healthy downstream effects on quality of care and patient satisfaction.
Through the Pathway to Excellence® credentialing program, we have
implemented a series of evidence-based practice standards known to improve
nurse satisfaction, retention and recruitment. As we strengthen the 12
Pathway Practice Standards this year, our goal is to apply for the American
Nurses Credentialing Center’s Pathway designation in 2015.
Our commitment to pursuing this achievement mirrors our commitment to
true nursing excellence and recognition of the important contributions nurses
make to quality healthcare and the entire patient experience.
A 110-year legacy of developing nursing excellence. The Pathway to Excellence
credentialing program is relatively new, but our strengths in nursing are
anything but. In 2015, Research College of Nursing is celebrating its 110th
anniversary, having grown substantially since its inception in 1905 with
only five students, to more than 400 students today. Despite this growth in
enrollment, the nursing college maintains an 8:1 student-faculty ratio that
fosters rich academic and clinical discussions, and provides wide-ranging
opportunities for nursing student research. Leading the way for patient care
excellence despite nursing shortages, in 1991 the school became one of the
first in the country to offer an accelerated program. Throughout its 110-year
history, more than 4,000 professional nurses have graduated from Research
College of Nursing.
Positive work environments allow nurses to flourish at Research Medical Center.
Nurses at Sarah Cannon at Research Medical Center provide patient care excellence, which is reflected in our patient satisfaction scores.
When Lorraine Jones, 43, arrived at Research
Medical Center, she was clinging to life after
resuscitation from sudden cardiac death. The
cardiology team moved quickly to provide
advanced cardiac care, and despite the severity of
her condition, Lorraine survived. After two weeks in
the ICU, two surgeries and a total hospital stay of
23 days, she was strong enough to go home. “I was
nearly dead when they carried me in, but I walked
out,” Lorraine says. “That speaks volumes about the
life-saving care they provide.”
Willie E. Lawrence, Jr., MD, FAHA, FACC is board certified in cardiovascular disease and specializes in interventional cardiology.
13
Above All ElseRAPID RESPONSE AND EFFICIENCY
Lorraine Jones (left) with her mother Marjorie
Having witnessed the skill and devotion of the cardiac team firsthand, Marjorie says it often felt like Lorraine was getting special
treatment. Now, she says, “I understand it was nothing out of the ordinary – every patient gets that VIP treatment at Research
Medical Center.”
Heart Care | Stroke Care | Pain Care
Excellence in Heart CareCardiovascular disease is the number one killer of men and women in the
U.S. As an accredited Cycle IV Chest Pain Center with PCI (Heart Attack
Care), our highly skilled cardiologists provide round-the-clock, emergency
heart care that exceeds national guidelines. Rapid response and efficiency
in cardiac care are demonstrated through quality measures like door-
to-balloon time – that is, how long it takes to unblock an artery through
balloon angioplasty from the moment a patient enters the emergency
room doors. At just 56 minutes, our average time is currently well below
the national guideline of 90 minutes (Figure 8).
Timely and effective heart attack care. In 2014, Research Medical Center
excelled at all eight core measures for heart attack care. This represents
exceptional compliance with all treatment steps recommended by
the Centers for Medicare and Medicaid Services (CMS) for timely and
effective heart attack care.
Excellence in Stroke CareTime is critical when someone has a stroke, and Research Medical Center
is a local leader in prompt, effective, high quality stroke care. As the first
Certified Primary Stroke Center in the region, we provide interventional
stroke care with the most advanced and effective treatments available.
Our stroke care team includes physician specialists who perform clot
retrieval using the latest devices and technologies.
Quality outcomes. As one of Kansas City’s largest high acuity hospitals,
we treat more patients with very serious, life-threatening health issues
than most other area hospitals. Despite this fact, mortality rates for
neuroscience patients treated at Research Medical Center are much lower
than expected (Figure 9).
14
RAPID RESPONSE AND EFFICIENCY
90
80
70
60
50
40
30
20
10
02011 2012 2013 2014*
63
55.9 58 56
Exceeding Standards for Door-to-Balloon Times
Research Medical Center
National Guideline
currentaverage
562014
Figure 8Source: Research Medical Center, 2014; GWTG, American Heart Association. *Through September 2014
Min
ute
s
1.6
1.4
1.2
1.0
0.8
0.6
0.4
0.2
0
Improving Neuroscience Outcomes Mortality Rates Better Than Expected Levels
2010 2011 2012 2013 2014*
Figure 9Source: Research Medical Center, 2014; Neuroscience MS-DRGs per U.S. News & World Report Methodology; American Stroke Association. Expected levels are established based on the high severity of illness associated with neuroscience patients at Research Medical Center. *Through September 2014
Better
In-H
osp
ital
Mo
rtal
itie
s
90 90 90 90
1.431.24
0.620.78
Research Medical CenterNeuroscience Mortality Rates
Expected
0.87
Better
Iftekhar Ahmed, MD, board certified in neurology and psychiatry, is Medical Director of the Stroke Care Center and TIA Clinic at the hospital.
15
Board-certified neurosurgeons Jonathan D. Chilton, MD (left) and Geoffrey L. Blatt, MD (right) specialize in comprehensive neurosurgeries, including Gamma Knife radiosurgery (pictured above).
Award-winning speed and efficiency. As a regular recipient of GWTG-
Stroke Gold Plus with Target Honor Roll recognition, we consistently rise to
a higher standard of care for our stroke and transient ischemic attack (TIA)
patients (Figure 10). The American Heart Association’s current guidelines for
treatment include an intravenous (IV) t-PA procedure with a key measure
known as door-to-needle time. Lower door-to-needle times are associated
with decreased morbidity and mortality, and in 2014 Research Medical Center
met the national guideline of 60 minutes. In terms of functional recovery, the
majority of our stroke patients return home or continue onto rehabilitation
therapy after discharge.
Excellence in Pain CareThe Center for the Relief of Pain is a unique component of our comprehensive
Neuroscience Institute. Led by internationally recognized neurosurgeon
William Rosenberg, MD, the Center for the Relief of Pain manages complex
pain through advanced interventional techniques and integrative therapies.
The Center is dedicated to improving each patient’s quality of life through
evidence-based care and patient education.
Exceeding Expectations for Ischemic Stroke OutcomesMortality Rates Better Than Expected Levels
Figure 10Source: Research Medical Center, 2014; CMS ICD-9 codes; GWTG, American Heart Association and American Stroke Association.*Through September 2014
1.6
1.4
1.2
1.0
0.8
0.6
0.4
0.2
02010 2011 2012 2013 2014*
Better
In-H
osp
ital
Mo
rtal
itie
s 1.271.45
0.71 0.74
0.46
Research Medical CenterIschemic Stroke Mortality
Expected
When Willie McFail was diagnosed with kidney
failure, he found himself hooked up to dialysis
several hours a week. Knowing how hard it was,
his brother Charlie gave him a second chance
by becoming a living donor. Under the care
of transplant surgeon Daniel Murillo, MD and
transplant nephrologist Pranav Dalal, MD, Charlie
underwent a laparoscopic procedure to donate his
kidney to Willie at Research Medical Center last
May. When asked by a local news station what his
brother’s gift meant for him, Willie’s answer was
simple but powerful: “Life.” Pranav Dalal, MD, board-certified nephrologist (left) and Daniel Murillo, MD, board-certified surgeon (right) discuss patient outcomes at The Transplant Institute.
17
Above All ElsePERSEVERANCE AND INNOVATION
McFail Brothers, kidney recipient and donor
Willie McFail (right) shares a laugh with his younger brother and living kidney donor Charlie (left). The brothers are pictured here in
their hometown of Sedalia, Missouri, six months after the transplant that restored Willie’s quality of life and freed him from dialysis.
Transplant Care
Excellence in Transplant CareThe Transplant Institute at Research Medical Center serves the region with a
nationally recognized kidney transplant program, as well as one of the area’s
only simultaneous kidney/pancreas transplant programs. In its 30-year history,
the kidney and kidney/pancreas transplant teams have performed 1,368 organ
transplants (Figure 11). More than half of those transplants (740 to date)
have been performed since 2003 under the direction of Daniel Murillo, MD,
Medical Director. In 2014, the kidney transplant team performed a total of 62
transplants.
In 2012, The Transplant Institute earned the prestigious Medal of Honor for
Organ Donation from the U.S. Department of Health and Human Services for
exceeding national organ donation rates. Today, we transplant seven percent
more kidneys than expected based on the high acuity level of patients seen
here (Figure 12). Clinical evidence shows patients who receive transplantation
at higher volume hospitals like Research Medical Center are more likely to
have better outcomes.
Quality outcomes. By offering options for the rapidly growing number of
end-stage renal disease patients who require dialysis or transplantation for
survival, The Transplant Institute fills a serious role in the American healthcare
system. Multidisciplinary physicians and nephrologists work with transplant
recipients before, during and after surgery to assure high-quality outcomes
for patients. The Transplant Institute’s success in kidney transplants is
demonstrated by patient survival rates and graft survival rates, which exceed
national averages for one month and one year post-transplant (Figure 13).
18
PERSEVERANCE AND INNOVATION
30%
25%
20%
15%
10%
5%
0%
16%
24%
National ResearchMedicalCenter
Exceeding Expectations in Transplant VolumeKidney Transplant Rates Higher Than National Levels
Figure 12Source: Research Medical Center, 2013; Scientific Registry of Transplant Recipients. The percentage of kidney patients on the transplant waitlist who receive a transplant at Research Medical Center exceeds the national average among U.S. kidney transplant programs.
ExpectedBetter
% K
idn
ey P
atie
nts
Rec
eivi
ng
Tra
nsp
lan
ts
70
60
50
40
30
20
10
0
Kidney Transplant Patient Volume
2011 2012 2013 2014*
Figure 11Source: Research Medical Center, 2014.*Through September 2014
# Pa
tien
ts
Simultaneous Pancreas and Kidney TransplantsKidney Transplants
57
4
5551 52
5 34
Living donor program. Kidneys from living donors generally function longer
and are associated with higher success rates than kidneys from deceased
donors. The Transplant Institute offers an active living donor program, with
a laparoscopic procedure for recovering organs from living donors, and
Research Medical Center operates a dedicated transplant unit for post-
transplant care.
Kidney/pancreas program. With one of the few simultaneous kidney/pancreas
programs in the region, Research Medical Center specializes in care for
patients suffering from a variety of liver, pancreas or biliary tract diseases
or disorders. Our nationally recognized transplant program has earned
a reputation for excellent surgical skill, multidisciplinary care, advanced
research and outstanding patient success rates.
Expanding access in Kansas and Oklahoma. In 2014, Research Medical Center
partnered with Wesley Medical Center to fulfill a need for patient access to
pre- and post-transplant care in the large region surrounding Wichita. We have
also performed transplants on patients from Oklahoma.
19
Delivering Excellence in Transplant OutcomesGraft Survival and Patient Survival Rates Meet and Exceed National Averages
100%
95%
90%
99.24% 99.12%
1 month 1 year
98.23%98.29%
Figure 13Source: Research Medical Center, 2013; Scientific Registry of Transplant Recipients, July 2011 through December 2013 (most recent publicly reported data).
Better
% P
ost
Tra
nsp
lan
t S
urv
ival
Gena Soto, RN, transplant nurse, educates a patient about transplant medications.
Physician specialists and transplant professionals meet regularly to discuss evidence-based care for each patient.
Length of Time Post-Transplant
Graft Survival Rate (Living Donor/Diseased Donor)
National Rate
Patient Survival Rate (Living Donor/Diseased Donor)
At 15 weeks pregnant, Aiden’s mother Amie was in
a car accident that caused massive head trauma,
broken bones and lacerated organs. LifeFlight
Eagle transported her to our Level I Trauma Center,
where physicians from 20 specialties worked
collaboratively to keep Amie and her unborn son
alive. The 4West nursing team provided attentive
care and life support for the next four months, and
despite the extreme severity of her condition, Amie
gave birth to Aiden at 33 weeks gestation. He spent
34 days in the NICU before starting his new life
outside the hospital as a healthy, happy baby boy. Nurses Ruth Woronick, RN (left), Pat Conley, RN (right) and Norma Bolling, RN (seated) discuss patient care on 4West.
21
Above All ElseTEAMWORK AND DETERMINATION
Aiden King and Scott Bjerke, MD
Aiden is pictured here at six months old with Scott Bjerke, MD, Medical Director of Trauma Services. As a board-certified surgeon
and fellowship-trained traumatologist, Dr. Bjerke led the coordinated effort that crossed multiple specialties and disciplines to save
Amie and baby Aiden after a devastating car accident.
Trauma Care | Emergency Medicine | Neonatal and Obstetrical Care |
Reproductive Medicine
Excellence in Trauma Care According to the Centers for Disease Control and Prevention, three out of
every four deaths among young people are the result of injuries and violence.
Since 2011, Research Medical Center has been offering the highest level of
comprehensive trauma care as a Level I Trauma Center for acutely injured
patients in our region. Our comprehensive center of excellence for burn care –
the Grossman Burn Center, opened in 2013.
As a Level I Trauma Center, Research Medical Center provides
24-hour total care for every aspect of injury, from prevention through
rehabilitation. Under the direction of Scott Bjerke, MD, fellowship-trained
traumatologist, we admit more than 1,000 patients with severe injuries per
year (Figure 14). Approximately 20 percent of our trauma patients come from
rural areas, arriving by helicopter or emergency ground transport.
Quality outcomes. Determination and teamwork drive a multidisciplinary
team of in-house critical care and trauma-trained, board-certified surgeons
who provide critical care within 15 minutes of arrival. Together with critical
care nurses, support staff and specialists in critical care, orthopedic surgery,
neurosurgery, anesthesiology, emergency medicine, radiology, and internal
medicine, the trauma team works tirelessly to improve survival rates and
lower costs associated with medical care and work loss. Based on the number
of patients in the trauma registry and their acuity, it is expected Research
Medical Center would have a complication rate of 4.4 percent. However,
our actual complication rate is only 3.8 percent and our mortality rate is 5.0
percent, both below expected levels (Figure 15).
22
TEAMWORK AND DETERMINATION
Figure 14Source: Research Medical Center, 2014. Activations are defined as severely injured patients for whom the trauma team are activated; total patients include activations plus patient consults required regardless of activation. *Through September 2014
Caring for More Trauma PatientsVolume Continues to Grow
1400
1200
1000
800
600
400
200
02012 2013 2014*
Activations
Total Patients
672765
1070
736
11691065
# o
f Pa
tien
ts
8.0%
7.0%
6.0%
5.0%
4.0%
3.0%
2.0%
1.0%
0.0%
4.4%
Mortality Medical Complications
Improving Trauma Care OutcomesMortality and Complication Rates Better Than Expected Levels
Figure 15Source: Research Medical Center, 2013; Diagnosis codes for major medical complications for trauma, injury and poisoning. Expected levels are based on the high severity of illness associated with trauma patients at Research Medical Center.
Research Medical Center
Expected
5.0%
3.8%
5.1%
Better
% o
f Pa
tien
ts
Excellence in Emergency Care Every second matters in an emergency – that’s why Research Medical Center
offers round-the-clock emergency care. Board-certified physicians, critical care
nurses, and support staff ensure that emergency patients are triaged at arrival
and seen by a qualified medical professional in priority order. On average, our
emergency department sees more than 63,000 patients each year at our main
hospital and Brookside campuses.
Increased access to emergency care. To ensure timely, convenient emergency
care, we actively measure and manage patient wait times, which are well
below national averages (Figure 16). Because efficient emergency care
translates to more optimal outcomes, we have implemented continuous
quality improvement initiatives to maintain low wait times. As a result, we
have significantly reduced the number of patients who leave our emergency
department without being seen. At our main hospital campus, this rate has
fallen from 4.4 percent in January 2013 to just 0.1 percent today – below the
national average of two percent.
Megan L. Garcia, MD, board-certified surgeon, treats patients at the Grossman Burn Center, a specialized center for comprehensive acute and reconstructive burn care.
On average, LifeFlight Eagle transports more than 225 patients annually to Research Medical Center.
23
30
25
20
15
10
5
0Jan Feb Mar Apr May Jun Jul Aug Sep
Providing Timely Emergency CarePatients Receive Care Faster as Arrival-to-Greet Time Improves
Figure 16Source: Research Medical Center, 2014; Hospital Compare, CMS.*Through September 2014
Min
ute
s
Teamwork drives low wait times in emergency care. Left to right: Cassandra Montoya, PA-C, Jason W. Eppler, MD and Robyn Miller, Director of Emergency Services.
BetterResearch Medical CenterBrookside CampusNational Average (24 min)Top 5th Percentile (12 min)
7.59 8.23 8.32 8.88 7.889.48
7.8 7.7 8.65
29.7
22.521.1
18.5 19.9
23.8
11.64
16.612.65
Excellence in Neonatal CareThe availability of neonatal intensive care has improved outcomes for
high-risk infants like Aiden King, who are born either preterm or with
serious medical or surgical conditions. Our 19-bed, Level III Neonatal
Intensive Care Unit (NICU) provides subspecialty care for the tiniest, most
vulnerable patient population: critically ill newborn infants.
Our Level III NICU cares for infants born as early as 23 weeks (four
months premature) through full term. The nursery is staffed with
highly specialized neonatologists, neonatal nurse practitioners, nurses,
respiratory therapists, lactation consultants and social workers. Advanced
equipment supports newborns with respiratory difficulties or other high-
risk complications (Figure 17).
Neonatal quality outcomes. Research Medical Center has made
measurable improvements in the quality and cost of neonatal intensive
care. Following a multidisciplinary collaborative quality improvement
model, our neonatal team eliminated central line-associated bloodstream
infections (CLABSI) in the NICU. CLABSI is a high-cost adverse event and
significant contributor to neonatal mortality because these patients have
immature immune systems.
Excellence in Obstetric CareCesarean sections and early elective deliveries come with added health
risks for mothers and babies. Our care teams in obstetrics have improved
quality, safety and performance by implementing evidence-based
practices to assure low C-section rates. With the national C-section rate
remaining above 30 percent, we consistently perform below national
averages on C-sections for first-time pregnancies (primary C-section rate),
as well as total pregnancies (Figure 18). Research Medical Center was
honored in 2014 by March of Dimes for decreasing early elective deliveries
to zero as of August 2014 (Figure 19).
24
TEAMWORK AND DETERMINATION
Neonatologists, neonatal nurse practitioners
Specialized nurses, respiratory therapists
Radiology and lab technicians
Portable X-ray machine
Blood gas analyzer
Sustained life support
Full range of respiratory support
Access to full range of pediatric medical and surgical subspecialists
Advanced imaging capabilities
Comprehensive care for all critically ill infants born at any gestational age or birth weight
Highly Specialized Level III NICU
Figure 17Source: American Academy of Pediatrics, 2012.
Figure 18Source: Research Medical Center, 2014; Agency for Healthcare Research and Quality national average for inpatient quality indicators #33 and #21. *Through September 2014
Obstetric OutcomesC-Section Rates Better Than National Averages
2014*
2013
2012
2011
2010
35%30%25%20%15%10%5%0%
30%
20.93%
19.2%
17.8%
17.6%
16.8%
Research Medical CenterPrimary C-Section Rate
Research Medical CenterTotal C-Section Rate
NationalAverage
10%
9%
9%
8%
10.58%
17.96%
Better
Excellence in Reproductive Medicine From saving lives to giving life, we are committed to our philosophy of
touching lives with hope, healing, comfort and care. We complement cutting-
edge diagnostic and treatment technology with highly specialized and skilled
physicians who translate research and evidence-based best practices into
advanced life-giving techniques.
Women seeking in vitro fertilization (IVF) choose Research Medical Center for
our success rates, a measure known as clinical pregnancy rates (CPR). Our
affiliated women’s care practice, Midwest Women’s Healthcare Specialists,
outperforms IVF centers both locally and nationally with a 65.2 percent CPR
for women under 35. By comparison, the national CPR rate in 2012 was only
47 percent.
Board-certified OBGYN physician Gregory C. Starks, MD, a renowned specialist with more than 30 years’ experience, leads our Fertility and Family Planning program.
Neonatal nurse practitioners and nurses provide subspecialty care in our Level III NICU.
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20%
15%
10%
5%
0%
17.0%Research Medical Center
National Average
Figure 19Source: Research Medical Center, 2014; The Leapfrog Group (most recently publicly reported data).
14.0%
11.2%
4.6%
2.4%0% 0% 0%
4%
2010 2011 2012 2013
Optimal Obstetric OutcomesEarly Elective Deliveries Remain Low
Better
% o
f Pa
tien
ts
To succeed in our continuous journey of healthcare
excellence, we firmly believe in exchanging ideas
and input with our local community leaders. As part
of this commitment, we held our first Community
Advisory Board meeting last November. At the
inaugural session, Jackie DeSouza-Van Blaricum,
President and CEO, shared our goals and
achievements in health and wellness with Kansas
City business leaders, while hospital executives and
physicians spoke about our bold quest to be the
best healthcare provider and healthcare employer
in the region. At a recent Town Hall meeting, Jackie DeSouza-Van Blaricum shares patient satisfaction reports with the patient transportation team.
27
Above All ElseHEALTH AND WELLNESS
Jackie DeSouza-Van Blaricum and Ted McKnight
Jackie DeSouza-Van Blaricum and Ted McKnight, a broker at CBIZ, Inc., share ideas for building healthier workplaces at a recent
Community Advisory Board meeting. Discussions spanned topics such as advances in cancer care and research, health and
wellness, and health insurance.
Wellness at Work | Health Insurance
Workplace HealthWith employee healthcare costs continuing to rise, employers turn to
Research Medical Center for resources that improve employee health and
stem costs associated with absenteeism and reduced productivity. For
many employers, the biggest obstacle to achieving a healthier workforce
is employee engagement, so our workplace health programs include
targeted engagement strategies to generate interest and participation that
brings results.
Wellness at Work. Through our Wellness at Work program, Research
Medical Center works with local employers to create a healthier Kansas
City. Our Wellness at Work program includes programs and tools to
encourage and support employees as they pursue healthier lifestyles. Our
goal is to equip employers with the means to help improve employee
health, which in turn leads to lower healthcare costs for the firm and
the employees.
Through the following program components, Wellness at Work directly
addresses employers’ health-related goals in the workplace by offering
the following:
• Online and risk-based screenings that may identify employee health
risks early
• Timely access to primary care physicians and other providers for annual
wellness visits and urgent healthcare needs
• Targeted engagement strategies that increase employee involvement
• Targeted education and interventions that encourage accountability
and impact poor employee health habits
• Best-in-class health solutions delivered in partnership with health plans,
employee benefit brokers and/or local community resources
Many organizations in Kansas City use our education and wellness
initiatives to help employees learn how to reduce health risks before
chronic or major conditions develop. Other employers offer our health
and wellness educational services to their employees in the workplace.
Available onsite as health education and online as wellness screenings,
tools are readily available for employers and individuals to influence
healthier lifestyle changes such as quitting smoking, losing weight,
increasing fitness levels, or managing diabetes and other chronic
diseases.
Because our vision for Research Medical Center includes initiatives that
address the needs of our people, we offer our own employee wellness
28
HEALTH AND WELLNESS
Lifestyle management
weight
nutrition
stress management
smoking cessation
Disease management
targeted health intervention for chronic diseases such as coronary artery disease, hypertension and diabetes
Sports management
sports injury prevention
injury treatment
Employee and work place health
post-offer and pre-employment screenings
return to work services
healthcare experts to address prevention to intervention
across a range of conditions
Workplace Health Programs
Stephen C. Salanski, MD, Program Director of the Research Family Medicine Residency, trains 2014 resident Suzanne Ozborn, MD.
Research Medical Center’s health and wellness programs extend from workplace to community.
29
programs. Studies show a positive correlation between employee wellness
and the organization’s reputation, overall performance and cost of care – three
factors that can also have a direct or indirect impact on patient satisfaction.
By promoting and supporting healthier lifestyles among the people who work
at our healthcare campuses, we aim to improve satisfaction levels of our
employees and patients alike.
Founded on evidence-based principles, Wellness at Work influences positive
health behaviors for participating Kansas City-area employers. Financial
return for employers comes from helping high-risk employees increase their
health awareness and accountability through relevant and accessible health
education, seminars and coaching, and keeping healthy employees fit
and active. We also encourage employers to educate their staff about the
importance of annual wellness visits with a primary care physician and other
recommended healthcare providers.
Health insurance premium reduction programs. At Research Medical Center,
we have implemented a health insurance premium reduction program to
reward our employees for meeting wellness goals. Such financial incentives
are encouraged by the Affordable Care Act (ACA). ACA supports participatory
workplace wellness programs, such as fitness center reimbursements for
positive participation in health seminars, risk assessments and other wellness-
related activities. Some employers offer non-discriminatory, health-contingent
wellness programs tied directly to individual performance to specific health
goals.
30
ACCREDITATIONS AND HONORS
TARGET: HF HONOR ROLL
2014 Top HospitalResearch Medical Center is the only hospital in Kansas City to earn the prestigious Top Hospital distinction from The Leapfrog Group in 2014. Nationwide, only 94 hospitals achieved this honor, and among them, only 60 were similar in size to Research Medical Center.
Top Performer on Key Quality Measures® 2013, 2012For the past two years, Research Medical Center has earned national recognition as a Top Performer on Key Quality Measures by The Joint Commission. Our Top Performer awards, which are based on 2013 and 2012 hospital performance data, represent our exemplary care for heart attack, heart failure, pneumonia and surgical patients.
“A” Grade Hospital Safety Score, 2014The Leapfrog Group evaluates hospital data to assign a letter grade rating that represents how well each hospital protects patients from accidents, infections, injuries, and errors. Research Medical Center proudly achieved a top “A” grade rating in 2014.
2014 Get With The Guidelines® Heart Failure – Gold Plus Honor RollFor the second year in a row, the American Heart Association has recognized Research Medical Center for exceptional heart failure care. This award confirms our consistent adherence to GWTG performance achievement indicators and quality measures.
2014 Get With The Guidelines® Stroke – Gold Plus with Target Honor Roll2014 marked the second consecutive year that Research Medical Center was recognized by The American Stroke Association for exceptional stroke care. This award confirms our consistent adherence to GWTG performance achievement indicators and quality measures.
2014 Mission: Lifeline® – BronzeResearch Medical Center received the Mission: Lifeline award from The American Heart Association for demonstrating consistent adherence to all performance achievement indicators and quality measures to improve the quality care for ST-elevation myocardial infarction (STEMI) patients.
Awards & Honors
2014 Leader in LGBT Healthcare EqualityResearch Medical Center earned top marks from the Human Rights Campaign (HRC) Foundation for our commitment to equal care for lesbian, gay, bisexual and transgender (LGBT) patients. We are among just 426 hospitals nationwide to receive distinction as a Leader in LGBT Healthcare Equality in 2014, which is based on findings from HRC’s annual Healthcare Equality Index.
2014 March of Dimes RecognitionFor decreasing early elective deliveries (EEDs) to zero in 2014, Research Medical Center was honored by the March of Dimes as part of their Healthy Babies are Worth the Wait® (HBWW) initiative. The goal of HBWW is to give babies a stronger start in life by encouraging the prevention of EEDs, or non-medically necessary deliveries before 39 weeks gestation.
2013 ACTION Registry® – GWTG™ Platinum Performance AchievementResearch Medical Center consistently followed treatment guidelines set forth in the ACTION Registry–GWTG Premier for eight consecutive quarters and met a performance standard of 90 percent for specific performance standards.
2012 HHS Organ Donation Silver Medal of HonorThe U.S. Department of Health and Human Services awarded the Silver Medal of Honor to Research Medical Center for achieving at least a 75 percent organ donation rate from eligible donor families in a consecutive 12-month period.
2013 UDSMR Top Performer AwardFor excellence in acute rehabilitation services, Research Medical Center earned the Top Performer Award from Uniform Data Systems for Medical Rehabilitation (UDSMR). This achievement is based on 2013 performance data that placed us in the 92nd percentile among nearly 800 qualifying facilities nationwide.
31
Hospital AccreditationResearch Medical Center earned The Joint Commission’s Gold Seal of Approval® for accreditation by our continuous dedication to compliance with The Joint Commission’s state-of-the-art standards for healthcare quality and safety in hospitals.
Advanced Certification in Heart FailureResearch Medical Center received advanced certification from The Joint Commission for demonstrating that we meet the requirements for Disease-Specific Care Certification, plus additional, clinically specific requirements and expectations.
Chest Pain Center Accreditation with PCIThe Accredited Chest Pain Center at Research Medical Center earned accreditation from The Society of Cardiovascular Patient Care by demonstrating our expertise and commitment to quality patient care in multiple key areas.
Certified Cardiac Rehabilitation ProgramThe American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) certifies our cardiovascular and pulmonary rehabilitation program offers the most advanced practices available and provides the appropriate and effective early outpatient care of patients with cardiac or pulmonary issues.
Advanced Certification in Stroke (Primary Stroke Center)Research Medical Center received an advanced certification from The Joint Commission for our programs that meet the requirements for Disease-Specific Care Certification, plus additional, clinically-specific requirements and expectations.
Vascular Testing AccreditationResearch Medical Center received a “seal of approval” by medical experts in the field of Vascular Testing for our accreditation by The Intersocietal Accreditation Commission.
Level I Trauma Center in MissouriResearch Medical Center earned Level I Trauma Center status, the highest designation available, from The Missouri Department of Health and Senior Services for our 24-hour in-house coverage by general surgeons, and prompt availability of care in specialties such as orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology, internal medicine, and critical care.
Accreditations & Certifications
National Accreditation Program for Breast Centers (NAPBC)National Accreditation Program for Breast Centers (NAPBC), the gold standard for breast center accreditation, recognizes Research Medical Center for our commit to providing the best possible comprehensive care to patients with diseases of the breast.
Breast Imaging Center of ExcellenceOur Breast Imaging Center of Excellence designation recognizes that we have earned accreditation in mammography, stereotactic breast biopsy, and breast ultrasound (including ultrasound-guided breast biopsy).
Mammography AccreditationThe gold seal of accreditation from the American College of Radiology (ACR) represents the highest level of image quality and patient safety. Following peer-review evaluations by board-certified physicians and medical physicists, Research Medical Center earned the ACR gold seal of accreditation for mammography.
Computed Tomography AccreditationFor meeting ACR Practice Guidelines and Technical Standards as demonstrated in a peer-review evaluation, ACR awarded the gold seal of accreditation to Research Medical Center for computed tomography.
MRI AccreditationFor meeting ACR Practice Guidelines and Technical Standards as demonstrated in a peer-review evaluation, ACR awarded the gold seal of accreditation to Research Medical Center for Magnetic Resonance Imaging (MRI).
Ultrasound AccreditationFor meeting ACR Practice Guidelines and Technical Standards as demonstrated in a peer-review evaluation, ACR awarded the gold seal of accreditation to Research Medical Center for ultrasound imaging.
Nuclear Medicine AccreditationFor meeting ACR Practice Guidelines and Technical Standards as demonstrated in a peer-review evaluation, ACR awarded the gold seal of accreditation to Research Medical Center for nuclear medicine.
•
•
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Research Medical Center2316 E. Meyer Blvd Kansas City, MO 64132Phone: (816) 276-4000
Research Brookside Campus 6601 Rockhill Road Kansas City, MO 64131Phone: (816) 276-7000
Research Psychiatric Center2323 E. 63rd StreetKansas City, MO 64130Phone: (816) 444-8161
RESEARCH MEDICAL CENTER FACILITIES
33
METHODS AND FOOTNOTES
Executive Team
Jackie DeSouza-Van Blaricum, Chief Executive Officer
Lisa St. Aubyn, Chief Executive Officer, Research Psychiatric Center
James Bower, MD, Chief Medical Officer
Paige Baker, RN, MSN, Chief Nursing Officer
John Krajicek, Chief Financial Officer
Eric Becker, Chief Operating Officer
Methodology
Research Medical Center collects internal, patient-level data based
on the Centers for Medicare & Medicaid Services Diagnostic Related
Group (MS-DRG) classification system and International Classification
of Diseases (ICD) codes. Detailed data indicate the volume of Medicare
patient discharges, mortality, lengths of stay, charges and costs, as well
as the associated severity code for each DRG.
Standards and Data Sources
Data are compared to state and national averages for the most recent
publicly reported period. Where possible, Research Medical Center has
reported 2014 data through the third fiscal quarter (September 2014).
Publicly reported standards and data sources include:
Agency for Healthcare Research and Quality
www.ahrq.gov
American College of Surgeons Trauma Quality Improvement Program (TQIP®)
www.facs.org/quality-programs/trauma/tqip
American Heart Association/American Stroke AssociationGet With The Guidelines®
www.heart.org
Core Outcome Measures in Effectiveness Trials (COMET) Initiative
www.comet-initiative.org
Hospital Compare
www.medicare.gov/hospitalcompare
Hospital Consumer Assessment of Healthcare Providers and Systems
www.hcahpsonline.org/home.aspx
Scientific Registry of Transplant Recipients (SRTR)
www.srtr.org
The Advisory Board Company: Crimson Continuum of Care
www.advisory.com/technology/crimson-continuum-of-care
The Leapfrog Group
www.leapfroggroup.org
Acknowledgments
Above All Else Quality Report is published by Research Medical Center.
Project Leaders: Corrine Everson, Vice President of Marketing, and
Megan Fischer, Vice President of Quality Improvement
Photography: Mark McDonald
TARGET: HF HONOR ROLL
Top Hospital, The Leapfrog Group, 2014
Mission: Lifeline® – Bronze, 2014
Top Performer on Key Quality Measures®
2013, 2012
Leader in LGBT Healthcare Equality, 2014
“A” Grade Hospital Safety Score,The Leapfrog Group, 2014
ACTION Registry® – GWTG™ Platinum, 2013
Get With The Guidelines® Heart Failure – Gold Plus Honor Roll, 2014
HHS Organ Donation Silver Medal of Honor, 2012
Get With The Guidelines® Stroke – Gold Plus with Target Honor Roll, 2014
UDSMR Top Performer Award, 2013
2316 E. Meyer Blvd
Kansas City, MO 64132
(816) 276-4000
ResearchMedicalCenter.com
©2015 Research Medical Center