Intermountain has an international reputation as a leader in healthcare quality improvement. These questions are frequently asked about our Clinical Programs and quality goals that set the groundwork for medical best practices.
Q. How are the clinical quality goals established?
A. Intermountain’s Board of Trustees establishes annual goals for clinical quality improvement. The goals are set for Intermountain’s 10 Clinical Programs and also for other clinical areas. The process typically begins with recommendations from the Clinical Programs and Services (and other areas), although recommendations can also be suggested by other areas within Intermountain or by the Board itself. The recommendations are vetted by Intermountain’s leaders and then submitted to the Board for evaluation and action.
Intermountain has been a leader in the healthcare field in having clinical quality goals featured prominently among annual Board goals. In 2014, clinical quality goals have been established in 13 areas, including our Clinical Programs.
Q. How committed to quality improvement in medical treatment and positive patient outcomes is Intermountain?
A. Here are just a few examples that represent Intermountain's many efforts:
- Clinical quality goals. Intermountain’s Board of Trustees establishes annual goals for clinical quality improvement. The goals are set for Intermountain’s 10 Clinical Programs and for other clinical areas.
- Intermountain Institute for Healthcare Delivery Research. Under the direction of Intermountain’s Chief Quality Officer Brent C. James, MD, MStat, the Institute has trained thousands of Intermountain employees, as well as thousands of physicians and other clinicians from across the U.S. and around the world, in the principles of healthcare quality improvement.
- Quality awards. Intermountain has received top national awards for providing quality healthcare, including:
- The ACMQ Institutional Leadership Quality Award (2013) presented by the American College of Medical Quality (ACMQ). Intermountain was honored for its “iconic dedication to quality” and “innovative use of data analytics techniques for quality improvement.”
- The Quality Health Care Award presented in 1996 by the National Committee for Quality Health Care.
- The Healthcare Forum/Witt Award: Commitment to Quality presented in 1991 by The Healthcare Forum and Witt Associates.
- A national model. In 1989, Intermountain’s approach to quality management was accepted as a national model by the Hospital Research and Education Trust, the research affiliate of the American Hospital Association. Intermountain’s focus on quality improvement has helped the organization achieve medical outcomes that rank among the best in the nation.
Q. What are Intermountain's Clinical Programs and how do they improve patient care?
A. Intermountain’s Clinical Programs focus the efforts of physicians, nurses, and other caregivers and employees on the processes of care within Intermountain. Clinical quality goals have been established in 13 areas, including our Clinical Programs.
In 2014, Intermountain created two new Clinical Programs: the Musculoskeletal Clinical Program and the Neurosciences Clinical Program. Here are some recent achievements on Clinical Program projects:
- Cardiovascular. Heart patients at Intermountain’s hospitals consistently experience among the lowest mortality rates for cardiac surgery in Utah (severity adjusted), as well as fast emergency response times and other indicators of excellence. In addition to saving lives, these achievements have reduced heart damage to patients and have lowered hospital readmission rates. In 2014, the program is working on goals to integrate the treatment of heart failure patients and reduce hospital readmissions.
- Oncology. Intermountain is a leader in oncology-related clinical trials in Utah, providing patients with leading-edge modes of treatment. Patients benefit from a multidisciplinary approach to care, in which teams comprised of medical, radiation, and surgical oncologists; radiologists; pathologists; plastic surgeons; nurses; and other clinical experts collaborate in patient care. In 2014, the program is focusing on improving the appropriate use of genetic screening to determine if families are at higher risk for colon and endometrial cancer.
- Women and Newborns. This program has had many successes, including a reduction in C-section births, premature births, and elective inductions prior to 39 weeks of gestation. These successes have resulted in improved outcomes for mothers and newborns. Also, perinatal care managers help expectant mothers who are experiencing problems with their pregnancies. In 2014, the program is focusing on measures related Neonatal Intensive Care Units and on estimating the number of babies with early-onset bacterial infection.
- Intensive Medicine. This program has achieved clinical improvements in such areas as prevention of Ventilator-Associated Pneumonia (VAP) and the diagnosis and treatment of sepsis. In 2014, the program goals address decreasing mortality rates among patients with severe sepsis.
- Primary Care. Intermountain is improving routine physician care provided to patients in a number of ways. Previous successes include the establishment of care managers who help patients with diabetes and asthma comply with physician treatment plans. Another initiative was the integration of mental/behavioral health resources with primary care, to address the mental health components of physical illnesses. Another involved obesity management. In 2014, the Primary Care Clinical Program is focusing on care management for patients with diabetes.
- Pediatric Specialties. Intermountain developed and implemented specific bronchiolitis care guidelines at major facilities, resulting in faster recoveries and shorter hospital stays for children with this lung condition. The Pediatric Specialties program also improved the treatment of infants with fever and the care of children with flu-like symptoms. The program goals in 2014 focus on the care of children with Type I diabetes.
- Surgical Services. This Clinical Program, started in 2006, established care process models for excellence in bariatric surgery, total joint replacement, pain management, colon surgery, and management of surgical patients generally. In 2014, the program is addressing goals related to blood utilization, clinical outcome measures for development teams, and intracase utilization.
- Behavioral Health. This Clinical Program addresses the care of patients with mental or behavioral health issues. In 2014, the program is focusing on decreasing inpatient psychiatric 30-day readmission rates.
- Neurosciences. This new Clinical Program will focus on conditions of the spine and brain, including spinal surgery, stroke, traumatic brain injury, epilepsy, and other related conditions.
- Musculoskeletal. This Clinical Program will specialize in muscle-related and joint-related conditions, including total joint replacement, geriatric hip fractures, physical medicine and rehabilitation, sports medicine, and other related conditions.
Q. Beyond the focus on Clinical Programs, what other clinical quality goals are set by the Board?
A. Clinical Quality Board Goals are also defined in 2014 for the following areas:
- Patient Safety Clinical Service. In the past, this service has created guidelines to protect patients from falls and reduce the incidence of pressure sores (i.e., bed sores). The service has also improved compliance with Intermountain’s hand-hygiene policy. In 2014, the service is focusing on reducing the system rate of catheter-associated urinary tract infections.
- Rural Facilities. In 2014, this area is addressing the implementation of electronic physician orders for patients with the primary diagnosis of pneumonia, labor induction, pancreatitis, and sepsis.
- Intermountain Homecare. In 2014, this division is focusing on improving care transitions to and from Homecare.
- Primary Children’s Hospital. In 2014, Primary Children’s has a goal to increase the involvement of Infectious Disease specialists in decisions to use outpatient antibiotic therapy via infusion, injection, or implantation.
- CMS Value-Based Purchasing (VBP). In 2010, as part of the Affordable Care Act, the federal Centers for Medicare and Medicaid Services (CMS) launched the Hospital Value-Based Purchasing Program. The program seeks to encourage the provision of high-quality care to Medicare patients by providing incentive payments to acute-care hospitals that meet certain benchmarks. Intermountain is seeking these VBP payments. In 2014, Intermountain’s VBP initiative aims to achieve a significant improvement on Intermountain’s VBP process and outcome domains for select measures, as well as sustaining progress for our hospitals that meet or exceed national benchmarks.
Q. How does Intermountain define clinical services and what types of clinical services do Intermountain facilities provide?
A. Within Intermountain, the term “Clinical Services” refers to system-wide services that support the delivery of care. Since Intermountain was founded in 1975, its Clinical Services have existed in various forms (originally hospital-based). In the last 20 years, Clinical Services have been made more consistent system-wide in support of Clinical Quality Board Goals. Intermountain has the following 13 Clinical Services:
- Case Management
- Continuum of Care
- Food and Nutrition
- Imaging Services
- Laboratory Services
- Pain Management
- Patient and Provider Publications
- Patient Flow
- Patient Safety
- Pharmacy Services
- Rehabilitation Services
- Respiratory Services