Riverside Medical Center: Dr. John Jurica, Senior Vice President and Chief Medical Officer

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Riverside Medical Center, a 325-bed hospital serving counties south of Chicago, Ill., has made patient safety and quality an integral part of its future strategy through documentation, process evaluation, and electronic tracking tools.

With anticipated changes in the healthcare market, most hospitals are focusing on quality, primarily using the Centers for Medicare and Medicaid Services (CMS) core measures as a guide. Riverside has taken a slightly different approach, focusing more on efficiency to drive quality and address cost at the same time.

About six years ago, Dr. John Jurica, senior vice president and chief medical officer, oversaw an initiative to restructure the case-management process to reduce length of stay. Focusing on length of stay addresses quality and cost.

“We believe that excessive length of stay leads to poor quality, and in turn, poor quality leads to excessive length of stay,” Jurica said. “We took a multidisciplinary approach to reduce length of stay through a variety of processes including case management and patient throughput, and we found that our patient safety and quality metrics improved along with length of stay.”

By addressing case management alone, Jurica said the hospital was able to reduce length of stay by half a day. Jurica said to be a top hospital, you have to look at not only quality metrics, but also processes, productivity, and efficiency.

Having the right tools in place

Riverside Medical Center has been named a 100 Top Hospital by Thomson Reuters for four years in a row. It has also achieved Magnet ® recognition and received the Distinguished Hospital Award for Clinical Excellence from HealthGrades. In addition to being recognized for quality of care, Jurica said Riverside is one of the lowest cost providers in Illinois.

Jurica said the hospital uses awards such as those from Thomson Reuters and HealthGrades as a benchmark to help verify the effectiveness of its quality and safety initiatives. It gives the hospital a way to measure itself currently and to develop a strategy for improvement.

Jurica also said having the proper measurement tools and electronic tools in place is key to providing quality care and improving patient safety. He also noted that as payments for medical care continue to be reduced, electronic tools will become more important to achieve better efficiency and lower cost with less staff.

During the past few years, Riverside has implemented a number of tools to become more electronic and improve quality care and reporting. In 2011, Riverside rolled out computerized physician order entry (CPOE) throughout the Riverside hospital using McKesson software.

The hospital also hired two full-time nurse documentation specialists a few years ago to assist with physician documentation and risk adjustment and reporting quality measures to CMS.

Another recent tool the hospital began using is the Crimson Continuum of Care. This tool helps facilities manage total cost and quality for defined populations and informs risk-based contract negotiations with payers. Physicians can view their risk-adjusted outcomes anytime in a web-based format. Jurica said the Crimson tool is the next phase in monitoring and improving outcomes. It was put into use late last year and has initially been used to support the hospital’s length-of-stay initiatives.

Future directions and expansion

To address current and future models of care and patient expectations, Riverside Medical Center recently underwent a $60-million renovation and expansion project. The project added a new 160,000-square-foot tower with 12 operating rooms; seven labor, delivery, and recovery rooms; a C-section operating room; 18 high-tech private ICU rooms; and 23 family-centered private patient rooms. About 45,000 square feet of existing space was also renovated to upgrade surgery areas and cardiac cath labs.

Riverside Medical Center is part of Riverside HealthCare, a regional health system that includes a multispecialty physician practice and specialty clinics throughout a four-county area. As with most healthcare facilities, Riverside is trying to adapt to and prepare for an uncertain future.

“We know that focusing on safety and quality are going to be important, and we are trying to determine how much of our resources we devote outside the hospital to prevent readmissions,” Jurica noted.

Most community hospitals are looking at new models of care, and Riverside is evaluating models that have been successful elsewhere.

The hospital’s strategic plan focuses on three primary areas–stakeholder experience, which includes patient and physician satisfaction; growth; and quality and patient safety.

“We have teams addressing ICU quality, long-stay cases, the implementation of a clinical-decision unit, and physician-specific quality data,” Jurica said. “It is a juggling act trying to optimize care in all these areas. Ensuring that we have good documentation, engaged teams, and cohesive leadership is necessary to continue being a high-quality provider.”

-by Patricia Chaney

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