Recommendations
- Workshops for implementing state-of-art approaches.
- Establishment of monitoring and tracking processes.
- New rules to redesign healthcare processes.
- Pursuit of six major aims.
- Accessible scientific evidence for specialists.
The workshops will help nurses address the common challenges while treating patients. With monitoring and tracking processes, they will have to report errors. The new rules impact many aspects of nursing, including communication, customization, and transparency (Institute of Medicine, 2001). The aims determine care provision conditions: safety, efficiency, patient-centricity, timeliness, effectiveness, and equitability (Institute of Medicine, 2001). Lastly, accessible evidence will allow for informed, evidence-based decision-making on the spot.
Quality Indicators
- Patient satisfaction through a national survey.
- The number of readmissions within 30 days.
- Death rates during the period of admission.
- Organ transplantation (mortality, survivability, and waitlists).
- Healthcare-associated infections (while admitted).
The Jackson Memorial Hospital shares several quality indicators for transparency, such as patient satisfaction obtained through surveys, reflecting communication and support issues. Another shows the number of readmissions within 30 days of leaving the hospital. An important criterion is patient death rates, which are compared to the national value. The organ transplantation indicator reveals mortality, survivability, and waiting time. The rate of healthcare-associated infections mirrors the adherence to safety procedures.
Healthcare-Associated Infections
- Clostridium difficile laboratory-identified events.
- Central line-associated bloodstream infections.
- Catheter-associated urinary tract infections.
- Surgical site infections (colon surgery).
- Surgical site infections (abdominal hysterectomy).
One evidence demonstrating that the Jackson Memorial Hospital adheres to the HDM’s vision is the rate of healthcare-associated infections. Clostridium difficile laboratory-identified events and infections of the central line-associated bloodstream and the catheter-associated urinary tract are better than the national value (Jackson Health System, n.d.b). Meanwhile, surgical site infections for colon surgery and abdominal hysterectomy are the same as the nationwide rate (Jackson Health System, n.d.b). It could happen due to the workshops and an improved monitoring process.
Organ Transplantation
- Pediatric heart (mortality and survivability).
- Adult pancreas (mortality, waitlists, and survivability).
- Pediatric kidney (waitlist and survivability).
- Adult liver (waitlist and survivability).
- Pediatric intestine (waitlist and survivability).
Another evidence confirming the Jackson Memorial Hospital’s adherence to the HDM’s vision is organ transplantation indicators. The ones for adult pancreas are all higher than the national rate (Jackson Health System, n.d.c). Others, such as pediatric heart, intestine and kidney and adult liver, excel in two of the three indicators (Jackson Health System, n.d.c). They demonstrate that the hospital is pursuing the six aims, especially timeliness and effectiveness.
Death Rates
- Chronic obstructive pulmonary disease patients.
- Heart attack and failure patients.
- Coronary artery bypass graft surgery patients.
- Patients with serious treatable complications.
- Other (pneumonia and stroke patients).
A convincing indicator is the hospital’s death rates for various patient groups. All of them, including cardiovascular patients, those with serious treatable complications, and others, who suffer from pneumonia, pulmonary disease, or stroke, do not diverge from the national value (Jackson Health System, n.d.b). It can be surmised that the hospital follows the new rules, adhering to such principles as transparency, safety, and evidence-based decision-making.
Care Changes
- Expanded number of available services.
- Constant supervision by multidisciplinary teams.
- Pastoral services for spiritual care.
- Appropriate treatment according to research-based guidelines.
- Inclusive and culturally competent treatment.
Throughout the years, the Jackson Memorial Hospital underwent major changes in care. It expanded its services in radiology, stroke rehabilitation, and other fields. Every patient is now accompanied by a multidisciplinary team of five specialists. The hospital offers pastoral services for spiritual care, covering most religions. All treatment is appropriate and proceeds according to research-based guidelines. Moreover, it is inclusive and culturally competent, which is important for minority patients.
Governance Changes
- Stronger reliance on the community.
- More comprehensive medical staff regulations.
- Prominent role of various committees.
- Democratic decision-making on all levels.
- Stricter credentialing procedures for the staff.
The hospital had some changes in healthcare governance, including stronger reliance on the community. The medical staff regulations became more comprehensive, and various committees, such as the multidisciplinary ones, gained a prominent role in policy-making and supervision. Nowadays, the hospital is characterized by democratic decision-making on all levels, starting from the officers. Lastly, the credentialing procedures for the staff are particularly strict to prevent unprofessionalism.
Training Changes
- Great variety of accredited programs.
- Focus on performance and professionalism.
- Appropriate supervision of students and residents.
- Wide variety of research opportunities.
- Diverse environment that promotes fairness.
The hospital offers a great variety of programs, most of which are accredited. The focus in training is on performance and professionalism in students and residents, which are closely supervised. They have access to a wide variety of research opportunities in cancer, diabetes, and other diseases (Jackson Health System, n.d.d). The training occurs in a diverse environment which reflects the actual working conditions and promotes fairness.
Communication Changes
- More opportunities to direct concerns.
- Constant in-team communication regarding care.
- Greater transparency through community reports.
- Multilingual support for patients and staff.
- Open channels for specialist-patient communication.
Communication at the Jackson Memorial Hospital has improved, allowing for more opportunities to direct concerns. Multidisciplinary teams can discuss approaches to individual care without many barriers. The organization demonstrates greater transparency through community reports, staff information, and quality data. It offers multilingual (English, Spanish, and Creole) support for its patients, both local and international. Open channels exist to facilitate specialist-patient communication online or by phone.
Partnerships Changes
- Local universities specializing in medicine.
- Center for Haitian Studies, Inc.
- Injury Free Coalition for Kids (Miami).
- Research institutes (diabetes and ocular).
- Foundations (National Parkinson’s and Jackson Memorial).
The hospital has many partnerships in various fields, starting from education (local universities). It cooperates with the Center for Haitian Studies regarding minority patients. The organization collaborates with the local Injury Free Coalition for Kids in pediatrics. It is also actively involved in the developments of researches institutes, such as the Diabetes Research one (Jackson Health System, n.d.a). Moreover, the hospital has a foundation and partners with National Parkinson’s.
Executive Summary
After analyzing the Crossing the Quality Chasm report, five recommendations were chosen that will impact care provision. They include workshops for implementing state-of-art approaches, the establishment of monitoring and tracking processes, the new rules to redesign healthcare processes, the pursuit of six major aims, and accessible scientific evidence for specialists. Afterward, the Jackson Memorial Hospital’s quality indicators were selected to determine whether those points managed to transform care provision. The following comprehensive criteria are present: patient satisfaction, the number of readmissions within 30 days, death rates during the period of admission, organ transplantation (mortality, survivability, and waitlists), and healthcare-associated infections while receiving treatment.
Three of them (death rates, organ transplantation, and healthcare-associated infections) are used to demonstrate that the hospital adheres to HDM’s vision due to surpassing or equaling the national value.
Since the recommendations were introduced, the Jackson Memorial Hospital underwent changes in care, governance, training, communication, and partnership. It has become more inclusive, expanded its services, and strengthened multidisciplinary teams.
The governance is more community-driven than before, adhering to democratic principles and improving the regulations. The training aspect is expansive, covering all possible programs, and rigorous, aiming to prepare professionals who are capable of working in a melting pot environment. The communication changes are significant in improving transparency, specialist-patient interactions, and other aspects, including cross-cultural support. The partnerships are characterized by their variety, educational angle, and diversity as the hospital attempts to understand its patients better. Overall, it appears that the organization considered the original recommendations and attempted to make certain changes, most of which have been successful.
References
Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Web.
Jackson Health System. (n.d.a). About Jackson Health System. Web.
Jackson Health System. (n.d.b). Complications. Web.
Jackson Health System. (n.d.c). Transplant. Web.
Jackson Health System. (n.d.d). Why choose University of Miami/Jackson Health System for your training. Web.