Becker's Clinical Quality & Infection Control

62 QUALITY IMPROVEMENT & MEASUREMENT Press Ganey: Safety, quality, experience and engagement are all interconnected — So why are improvement efforts siloed? By Mackenzie Bean H ealthcare organizations must take an integrated approach to improv- ing safety, quality, experience and engagement, as these attributes function interdependently to influence performance, according to Press Ganey's 2018 Strategic Insights report, titled "A Strategic Blueprint for Transformational Change." Press Ganey researchers conducted a series of cross-domain analyses to assess the influence of safety, quality, experience and engagement on health systems' overall care ratings. ey discovered a "dose-response" effect between domains, suggesting perfor- mance in one domain drives — and is driven by — the performance of other domains. e report offers an in-depth framework on how healthcare organizations can remove the silos surrounding improvement efforts for each domain to better align performance goals and meet patients' healthcare expectations. "When you execute these things together, leveraging a culture of engaged and well-de- veloped healthcare leaders and managers, you can deliver higher performance on safety, quality and experience," Jim Merlino, MD, president and CMO of Press Ganey's strategic consulting division, said during an interview with Becker's Hospital Review. "So the focus of this report is how to do that — how to leverage what we know the data tell us, and how to begin to organize and execute around meeting patients' needs to help achieve better performance." e report centers on six core principles to help leaders achieve performance goals. Strategic Principles • Commit to a goal of "Zero Harm" • Put patients at the center of the plan- ning, delivery and assessment of care • Recognize safety, quality and patient centricity as primary elements of the patient experience and understand their interdependencies Operational Principles • Drive change using data and transpar- ency • Transform culture and leadership • Focus on accountability and execution n How OSU Wexner physicians use 3D heart models to improve valve replacement surgeries By Megan Knowles P hysicians at The Ohio State University Wexner Medical Center in Columbus are teaming up with the univer- sity's biomedical engineering department to improve care for patients receiving aortic valve replacements. Aortic valves must typically be replaced after aortic steno- sis, or the narrowing of the valve opening. Over decades, the valve leaflets may become stiff from calcification, which makes it more difficult to pump blood from the left ventricle into the aorta. To replace diseased valves, physicians can either com- plete open heart surgery through a traditional opening of the chest, or use a less invasive transcatheter method, which deploys a tissue (bioprosthetic) valve through a blood vessel in the leg. To determine the best approach for each patient, physi- cians and biomedical engineers at OSU Wexner create personalized 3D models of the aortic valve and neighbor- ing structures, which help them simulate how a new valve will function. "For most patients, available valves work comparably. However, in some cases the anatomy of the patient may create additional considerations" said Scott Lilly, MD, PhD, an interventional cardiologist and co-director of the structural heart program at Columbus-based Ohio State Ross Heart Hospital. "For example, the patient may have calcified nodules on the valve leaflets, or cor- onary arteries that arise in close proximity to the valve. The ability to reconstruct the areas where the valve is going to rest is important." Dr. Lilly and his heart structural team work with Lakshmi Prasad Dasi, PhD, associate professor of biomedical engi- neering and surgery in Ohio State's Davis Heart and Lung Research Institute, to reconstruct a patient's aorta. They 3D print the aorta from the patient's CT scan using various flexible materials imitating the real aorta and load the model into a heart simulator, which pumps simulated blood through the system. "We can model various therapies, positions and types of valves to better understand problems such as leakage, clotting or coronary obstruction," Dr. Dasi said. "We can observe how different valves not only relieve the stenosis but also minimize the likelihood of blood clots forming on the leaflets, which is the goal of the treatment." n

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