National Quality Initiative Award

A team of Emory Healthcare physicians, nurses and information technology professionals have been awarded the prestigious Excellence in Teamwork in Quality Improvement Award by the Society of Hospital Medicine.

The team, co-led by the Emory Section of Hospital Medicine, Emory Healthcare Information Services and the Department of Nursing accepted the award this week in Washington, D.C. for what is being hailed as ground-breaking work on venous thromboembolism (VTE) prevention, a key indicator of hospital quality.

VTE is a class of blood clots, including deep vein thrombosis (DVT) and pulmonary embolism (PE). Primarily a disease of hospitalized and recently hospitalized patients, VTE is now considered the most common preventable cause of hospital death - facts that spurred the Emory Healthcare team to develop a novel strategy for preventing the deadly clots in high risk patients.

"Try walking into any hospital nursing unit in this country today and asking which patients are not receiving appropriate care for the most common preventable cause of hospital death," says Jason Stein, MD, a hospitalist and co-leader of the Emory Healthcare team. "What you get are confused looks, as if to say ‘how could we possibly know that?' Yet the reality is this vital information can and should be immediately available. If it were, hospital care teams could address unintentional oversights before they become a statistic."

Stein says, "Our traditional model of hospital care in the U.S. health system does not prompt or enable us to answer these population-level questions. The results are missed opportunities to address unintentional oversights, even for life threatening conditions like VTE. In fact, the mediocrity of the U.S. health care delivery system stems from these missed opportunities across a wide-range of quality metrics.

"As an academic health center committed to transforming health collaboratively we discovered we could do something unique with our information technology to pull hospital care into the 21st century," notes Stein.

The strategy created by Emory's interdisciplinary team represents several exciting milestones in hospital care delivery, according to Stein. The Emory team has created perhaps the first transferable, reliable and sustainable hospital quality strategy.

"In real-time we display potential missed VTE prevention opportunities on a dynamic dashboard," says Stein. "The display creates situational awareness which enables the care team to intervene in real-time on behalf of patients."

The data that populates the display can also be used to track unit-level performance over time, an innovation in performance measurement recently termed "measure-vention" by Stein and a hospital medicine colleague, Greg Maynard MD, MS, from the University of California San Diego. The Emory team, says Stein, is particularly proud of the transferability of the strategy, having deployed it successfully in over 50 units across six different Emory Hospitals. In March of this year the Emory Healthcare team successfully exported the strategy to a hospital with an altogether different clinical information system, the 110-bed Emory Johns Creek Hospital, 30 miles north of Atlanta.

Emory Healthcare's Chief Information Officer Dee Cantrell, says, "Our health data systems have advanced us to a point where exciting leaps are possible. We're committed as an organization to develop ways to leverage our data systems on behalf of our patients. The Emory team estimates that thousands of lives could be saved every year if this novel strategy were routinely available in U.S. hospitals."

The Society of Hospital Medicine (SHM) is the largest organization in the country representing hospitalists and the practice of hospital medicine. SHM is committed to promoting excellence in the practice of hospital medicine through education, advocacy and research while promoting high quality care for all hospitalized patients, education and research in hospital medicine, teamwork to achieve the best possible care for hospitalized patients. The Society also works to advocate a career path that will attract and retain the highest quality hospitalists; define the competencies, activities, and needs of the hospitalist community; and supports and promotes changes to the health care system that lead to higher quality and more efficient care for all hospitalized patients.

The Emory Section of Hospital Medicine is the largest academic hospital medicine program in the nation. The program has grown in recent years from three physicians to more than 110 physicians and currently provides services in 10 hospitals including Emory University Hospital, Emory University Hospital Midtown, Emory Wesley Woods Hospital, Emory University Orthopaedics & Spine Hospital, Wesley Woods Long Term Acute Care Hospital, Atlanta VA Medical Center, Emory Johns Creek Hospital, Emory Eastside Medical Center, Cartersville Medical Center and the West Georgia Health System.