Making people healthier does not always involve developing a more potent pill or building a better body imaging machine. Sometimes it pays to keep your eyes open and listen. A few years ago a group of care delivery professionals from GE Healthcare noticed that some hospitals were getting much better results than others. “Their ideas were new and innovative, but they were also incremental and did not turn the facility upside down,” says Denise Kruzikas, a healthymagination director at GE Healthcare. “They made care smoother, faster, and more efficient.”
What were these hospitals doing right and could it serve as a “best practice” for others? “We started looking for the true pioneers,” Kruzikas says. GE’s first visit was to Saint Luke’s Neuroscience Institute in Kansas City, Missouri, a leading stroke treatment center. Doctors at Saint Luke’s, a long-time GE customer, were using GE imaging technology to diagnose stroke patients. They were getting better results than others and the GE team wanted to know why.
Typically, no more than 5 percent of stroke patients receive “interventional treatment,” where doctors remove the blood clot in the brain that blocked an artery. This is because patients were not diagnosed properly or did not arrive at the hospital in time. However, Saint Luke’s developed an innovative stroke treatment protocol and increased this number to 40 percent, say Dr. Marilyn Rymer, medical director at the Neuroscience Institute. When stroke patients leave her hospital, they are doing better, have lower stroke severity scores, and stand a better chance to resume their lives. “Saint Luke’s combines education, outreach, and coordination with efficient care,” Kruzikas says. “They’ve got people, process and technology working together.”
Starting in 2005, Dr. Rymer’s team turned stroke treatment at the hospital into a series of interconnected steps, each with a measurable outcome. The steps ranged from teaching regional hospitals and EMT personnel to recognize stroke, performing a CT scan on suspected stroke patients to help inform treatment, and also starting physical, occupational and speech therapy a lot sooner to speed up the recovery and the quality of life. “It is critical for us to be as fast as we can at all times,” says Bridget Brion, a “Code Neuro” nurse at Saint Luke’s intensive care unit. “Every minute of a stroke one million brain cells die.” “Code Neuro” ICU nurses like Brion work directly with emergency room staff to care for a stroke patient. “Instead of having the emergency room acting as an independent silo taking care of stroke, we have a continuity of care that starts immediately when a stroke patient arrives until they go home,” Dr. Rymer says.
The GE team came in 2009 and took a “full download” of Saint Luke’s stroke data since the beginning of the new program. The researchers looked at patient volumes and outcomes, stroke education, time to diagnosis and treatment, length of stay, and costs.
The analysis showed that between 2005 and 2010, the hospital increased the amount of stroke patients by 23 percent and boosted transfers by 17 percent. Around 40 percent of stroke patients at Saint Luke’s receive interventional stroke treatment such as clot-dissolving medication deployed directly at the site of a blood clot in the brain. The average across the healthcare system is only 3 to 5 percent. Given the important stroke related information it provides in a relatively short time, nearly all stroke patients at Saint Luke’s receive a CT scan followed by specialized post-processing analysis. “The bottom line was that patients were doing better and they were able to get discharged earlier,” Kruzikas says.
Last June, Dr. Rymer traveled to GE’s training and education center in Crotonville, New York, and presented the results as “best practice” steps to stroke doctors from the U.S. and abroad. “Every hospital around the country should be stroke ready and stroke able,” Dr. Rymer says. “That just hasn’t happened.” Stroke is the leading cause of disability among adults in the U.S. Approximately 795,000 strokes occur in the U.S., costing $25 billion in 2007.
The Saint Luke’s study was part of GE’s healthymagination program, whose goals include finding innovative solutions to healthcare and improving access to treatment. The GE team is already seeking out facilities that excel in treating breast cancer, Alzheimer’s disease, and low-dose radiation management. “It’s about using what’s out there in a more efficient and productive way,” Kruzikas says. “We want to address our customer’s need and support best practice models that can be replicated around the world.”