Cchmc Case

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-What factor(s) trigged the initiation of CCHMC’s continuous improvement program?

Cincinnati Children's Hospital Medical Center" (CCHMC) details how one institution has implemented its own version of health-care reform, taking overall performance levels from well below average to the top 10 percent in the industry. The leadership of CCHMC did a great job of tackling important problems and engaging people throughout the organization in solving them. One of the key players is Dr. Uma Kotagal, a neonatologist with a deep-seated passion for improving the quality of care at CCHMC. In 1996, when Jim Anderson is named CEO, he convinces Kotagal to lead the hospital's improvement efforts as senior vice president of quality and transformation. Anderson, a practicing attorney with expertise in the quality improvement methods used by manufacturing firms, is joined by Chairman of the Board Lee Carter, who articulates his vision for the hospital as, "We will be the best at getting better." The complexity of patient care and the prevalence of system failures created opportunities to improve the reliability and efficiency of the systems through which care was delivered. The improvement effort at CCHMC gains real traction in 2002 with the award of a $1.9 million Pursuing Perfection grant from the Robert Wood Johnson Foundation. In addition to funding an improvement-science training program, the grant requires that the hospital undertake improvement projects. Hence, Kotagal develops hospital-wide protocols with proven efficacy—for example, implementing a "forcing function" into the operating room process that keeps patients out of the OR until they've received antibiotics, thus reducing surgical site infections. For another project, she selects the hospital's Cystic Fibrosis (CF) Clinic, in part because its head physician was the only division leader who showed any interest in participating in improvement initiatives. These factors along with the change in the vision and new...
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