Issue link: https://beckershealthcare.uberflip.com/i/1122871
80 QUALITY IMPROVEMENT & MEASUREMENT Patient deaths after colorectal surgery declined from 2008-17 By Megan Knowles T he rate of adults who died within 30 days of colorec- tal surgery dropped from 4.3 percent in 2008 to 2.9 percent in 2017, according to the Agency for Health- care Research and Quality's Patient Safety Chartbook. The chartbook's reports are based on more than 250 measures of quality and disparities covering a variety of healthcare services and settings. From 2008 to 2017, the report found 30-day postopera- tive mortality after colorectal surgery decreased overall and for white patients and black patients. However, in 2017, 30-day postoperative mortality af- ter colorectal surgery was worse for black patients (3.5 percent) compared to white patients (2.8 percent). For Hispanic patients, 30-day postoperative mortality was lower than for white patients (2.2 percent). The report also found mortality in nonteaching hospitals (2.9 percent) was similar to that seen in teaching hospitals (2.8 percent). Colorectal procedures have high rates of postoperative complications, and nonadherence to evidence-based best practices is linked to a higher risk of these complica- tions, the researchers said. n Nurse navigators linked to fewer readmissions, deaths among heart attack patients By Mackenzie Bean A program in which nurse navigators help heart attack patients transition from hospital to out- patient care can help lower readmission and mortality rates, according to research presented at the American College of Cardiology's Cardiovascular Summit in Orlando. The study analyzes the outcomes of the Sanger Heart & Vascular Heart Care Navigation Team, which Charlotte, N.C.-based Atrium Health created in 2017. The program assigns heart patients to a health advocate and nurse navigator who meet with patients at the hospital and help them access follow-up care, answer questions and pro- mote self-care for three months after discharge. Researchers compared data on 560 heart attack patients treated between July 2016 and June 2017 (before the program began) to data on 421 patients treated for a heart attack between July 2017 and June 2018. They found 30-day readmission rates fell from 6.3 percent to 3.7 percent in the year after the program's implementa- tion. The 30-day death rate also fell from 5.75 percent to 4.57 percent after the program was launched, and patient follow-up appointments made before discharge jumped from 78 percent to 96 percent. "This study shows that nurse navigators are an integral part of reducing heart attack readmission and mortality," Amber Furr, BSN, RN, a performance improvement coor- dinator at Sanger Heart & Vascular Institute, said in a press release. "We're not where we want to be yet with cardiac rehab referrals or guideline-driven care, but we have seen an improvement." n aligned not just on financial targets, but also on quality and safety. Another activity that makes a huge difference is having boards go on rounds at the health system to hear directly from patients and caregiv- ers. It helps them put faces and names to what they're hearing about. Boards must also approach serious safety events as more than just statistics. ey should look at what exactly happened, ask how the organization is addressing the issue and hold leadership accountable for implementing strong action plans. Another key area is workforce safety. e board needs to review statistics around workforce injuries or harm and understand the plan on how to improve them. We think workplace safety is underrepresented on board agendas. We cannot deliver high-quality care if our workforce is not protected. Q: How can health system leaders help support a board's effort to improve quality oversight? TG: e most important thing is to see the board as a real asset to leverage. We oen see stories about healthcare leaders sugar-coating things for the board or not letting them see an organization's dirty laundry. I think that is going to require a real shi in how leaders look at their boards. ey need to be open and transparent with board members and let them see issues they could potentially help with. Once that mindset is in place, then health system leaders can support the board by providing education and training, opportunities to visit the front lines and by structuring meetings to feature a greater depth of information on quality. n "Nurse navigators are an integral part of reducing heart attack readmission and mortality." -Amber Furr, BSN, RN, Performance Improvement Coordinator, Sanger Heart & Vascular Institute