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Taking a Patient Safety Approach to an Integration of Two Hospitals

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Background: Consolidation of inpatient care between two acute care medical centers brings many challenges, including an increased risk of an untoward event during patient transfer and impaired hospital performance during the postintegration period. When the Jesse Brown Department of Veterans Affairs (VA) Medical Center in Chicago integrated two acute medical-surgical inpatient facilities, the challenges intrinsic to simultaneously integrating acute medical-surgical programs and academic training programs necessitated a novel approach.

Strategies Used: Several patient safety-related tools were used for the safe transfer of patients and for sustaining hospital performance after integration. These tools included Failure Mode and Effects Analysis (FMEA) of the move process, process action teams to bridge the differences in standard nursing unit operation, and an integration score card to monitor and evaluate the impact of the integration on organization performance.

Results: Patient care was not disrupted except for a transient reduction in elective surgical procedures during the week before the move. Postintegration data indicated reduced operating room cancellations, sustained inpatient capacity and access, and comparable findings in patient falls and methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci infections.

Conclusion: The impact of several patient safety tools and interventions was reflected in the fact that performance remained constant or improved for the predefined measures of access and quality.

Document Type: Research Article

Publication date: May 1, 2005

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  • Published monthly, The Joint Commission Journal on Quality and Patient Safety is a peer-reviewed publication dedicated to providing health professionals with the information they need to promote the quality and safety of health care. The Joint Commission Journal on Quality and Patient Safety invites original manuscripts on the development, adaptation, and/or implementation of innovative thinking, strategies, and practices in improving quality and safety in health care. Case studies, program or project reports, reports of new methodologies or new applications of methodologies, research studies on the effectiveness of improvement interventions, and commentaries on issues and practices are all considered.

    David W. Baker, MD, MPH, FACP, executive vice president for the Division of Healthcare Quality Evaluation at The Joint Commission, is the inaugural editor-in-chief of The Joint Commission Journal on Quality and Patient Safety.

    Also known as Joint Commission Journal on Quality Improvement and Joint Commission Journal on Quality and Safety
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