CMO Message: May 2024

May 6, 2024
  1. Mission MinuteHow well do you know Emilie Gamelin? Did you know that Mother Emilie Gamelin was the foundress of the Sisters of Providence? Her life story serves as an example to carry on the Providence Mission in the same spirit that inspired her life and works. Read more about her here: Session 3_Mother Gamelin Bio

  1. Length of Stay (LOS) and Medically Ready for Discharge (MRD) – The Medically Ready for Discharge (MRD) date is a new feature in Epic as of April 14 that is the forecast date the patient no longer needs acute care services in the hospital and is ready for the next site of care. This date is the responsibility of the Primary Physician or APC. We need to document new or update existing MRD by 36 hours of admission and daily thereafter. The Expected Discharge Date (EDD) is based on the average LOS based on the patient condition or Geometric Mean Length of Stay (GMLOS) for the most likely diagnostic related group (DRG) identified by the clinical documentation specialist. The EDD is the expected date that the patient will be logistically ready to transition to the next care setting. Placing a discharge order changes the MRD to “Ready Now” if the MRD was still in the future, and auto-updates the EDD to the current date.

LOS to Date – LOS at both ministries looks to be favorable to budget and about the same if not decreased slightly at both ministries for April 2024. Data is finalized on the 15th of the following month, so we won’t know April “officially” until mid-May, but PSPH looks to be around 6.42 (down from 6.51, goal <6.58) while PCH looks to be around 4.63 (down from 4.9, goal <4.80)! Keep up this great work to ensure all our patients get the bed in the unit that they need when they need it.

  1. Quality CornerCAUTI and CLABSI. Particularly in the South Puget Sound, we have seen a recent spike in CAUTIs and CLABSIs for the first quarter of 2024, particularly compared to our other ministries in North and Central Puget Sound. The North Division is restarting working groups to take a deeper dive into this data. I anticipate more work around clearly documenting a continued need for central lines and catheters and more attention to education, placement, cleaning, and care for lines and drains. If you have other thoughts, let me know! *See our data below for both ministries since 2021; Standardized Infection Ratio (SIR) is the summary measure used by the National Healthcare Safety Network (NHSN) to track healthcare associated infections or HAIs.

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