STAGE 7 SPOTLIGHT NCH Healthcare: $8,690,000 in Avoided Costs

HIMSS Analytics

Healthcare systems around the world are working toward improving patient experience and health of populations, and reducing cost per capita. Optimizing their performance in this way requires healthcare professionals to understand:

  • The unique needs of their patients and their organization.
  • The possibilities and limitations of their systems.
  • The key metrics needed to track, measure and report on their progress.

To do this, healthcare organizations use the Electronic Medical Record Adoption Model (EMRAM). The EMRAM is a strategic eight-stage framework for optimizing the use of EMR systems to improve the quality of care and reduce overall costs. Worldwide, healthcare systems have turned to the EMRAM for guidance as they work to make healthcare technology advances and enhance their day-to-day processes.

In order to reach Stage 7, the highest level of the EMRAM, a healthcare system needs to demonstrate effective healthcare technology advances and use of information technology to improve the quality, efficiency and cost of healthcare. Let's dive into the Stage 7 achievement process of the NCH Healthcare System.

The Challenge

Considered one of the most progressive healthcare systems in the country, the NCH Healthcare System is a not-for-profit alliance of more than 700 independent physicians and medical facilities in dozens of locations throughout Collier County and southwest Florida.

With a total of nearly 700 beds, the NCH Healthcare System believes in comprehensive, patient-centered care. The system has won a number of awards, including the Hidden Scar Center of Excellence, and was named a "Best Regional Hospital" by the U.S. News and World Report in 2018.

Despite its accolades, the NCH Healthcare System was experiencing a challenge: Sepsis.

Sepsis, a life-threatening infection, remains the leading cause of death in hospitals — even though about 80 percent of sepsis cases originate outside of the hospital. Additionally, about 70 percent of patients diagnosed with sepsis had chronic illnesses that required frequent care; meaning that there are usually a number of opportunities for healthcare providers to prevent, recognize and treat sepsis before it becomes a medical emergency.

The challenge NCH faced was to stop sepsis and save lives.

The EMRAM Implementation

In 2012, the Emergency and Critical Care departments of the NCH Healthcare System championed a quality project initiative to reduce sepsis mortality.

The team implemented the qSOFA, a quick scoring system used to identify patients at risk for a sepsis infection, within the EMR system. The scoring system uses three criteria — low blood pressure, high respiratory rate and altered mental state — to identify patients at a greater risk of life-threatening sepsis.

Using notification alerts within the EMR, clinicians at NCH were able to more easily monitor patients' risk for sepsis ahead of time. When sepsis cases were diagnosed, they could treat the illness more quickly and effectively.

The Results

Sepsis mortality rates at NCH decreased from 28 percent in 2012 to 6.5 percent in 2017. Additionally, due to the increased prevention of sepsis and the reduction in return visits and ongoing care for severe cases, the NCH Healthcare System was able to save $8,690,000.

The original initiative continues to evolve. The healthcare professionals at NCH have embraced a culture of improvement based on evidence-based data points, best practices and analytics that is individualized to their ED and inpatient environment.

The Takeaway

“At NCH Healthcare System, our mission is to help everyone live a longer, happier and healthier life," said Jonathan King, the system chief nursing officer at NCH Healthcare System. “With our ‘Stop Sepsis: Save Lives with QSOFA’ project, we were able to utilize our IT system to reduce sepsis mortality by a significant amount.”

Like NCH, healthcare systems around the world have used the EMRAM as a roadmap for making healthcare technology advances at their organizations and, ultimately, saving lives. Join the ranks of leading Stage 7 healthcare systems today.

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