A CT Health Care System Went From Fines To Straight As

Hartford Health Care St. Shortly after taking over Vincent Medical Center, Bridgeport Hospital received a 2020 C rating from healthcare analyst The Leapfrog Group.

The independent, charitable group ranks hospitals in 12 different categories based on a variety of criteria, including patient care, safety and payment practices.

In the year By the end of 2021, St. Vincent once again earned a C grade, but rapid improvements earned the hospital an A grade in Leapfrog's ratings in November.

In fact, all seven Hartford health care facilities received an A grade.

"I love that Connecticut is the insurance capital, the basketball capital and we're the health care capital," said Hartford Healthcare President and CEO Jeff Flakes.

Connecticut's health care system is generally well-respected, with Baker Hospital ranking fourth in the nation.

Hartford Healthcare Hospitals was not the only hospital to earn an A rating from Leapfrog, but it was the only multi-hospital system with at least two facilities to earn the rating.

"Our goal in health care is to improve every day."

"We do not tolerate mediocre or risky behavior," said Ajay Kumar, the network's clinical director.

The progress began as Hartford Healthcare worked to improve the performance of each of its facilities, Flex said.

This meant reviewing the network's structure, policies and procedures.

Stephanie Calcassola, vice president of quality and safety at Hartford Health Care, said the network is changing its hiring process to hire more accountability and improvement professionals.

Hartford Healthcare relies heavily on data to see which facilities are performing well and asks staff to share it with colleagues at other hospitals.

"We need to understand where we are and where we're going," Calcasola said.

Hartford Healthcare's size (the network has about 37,000 employees) and success have allowed it to partner with companies like Google, Amazon and the Massachusetts Institute of Technology.

These partnerships will help improve the health care system, Flex said.

"Our job in health care is to improve every day and be better than yesterday," he said.

Updates aren't just a good leapfrog report card either.

For example, Hartford Healthcare reported a 40 percent drop in hospital-acquired infections since 2019.

At the same time, the system reduced the number of serious safety incidents in which staff deviated from generally accepted practices and resulted in serious injury or death to patients by 39%.

"It can be done."

Flax estimates that before Covid, Hartford Healthcare was paying $7 million in fines each year. This year there were no penalties in the health system.

Although Hartford Healthcare serves urban, suburban and rural communities, it shows that world-class health care is possible in Connecticut, he said.

"It can be done here, it can be done anywhere in the country," Ketan said.

Flex said health care professionals around the country are looking to Hartford Healthcare's model.

Among the areas the health system is working on are: checklists to help doctors identify infections sufficiently to provide prompt and effective treatment; waiting times for device removal, downtime, so teams can focus on whether patients need or can pass a catheter, because removal reduces the risk of infection; reduce unnecessary testing and laboratory work; Enter the order in normal operation; giving colleagues an opportunity to express their concerns; Checking and double-checking to avoid human error, for example drug barcodes in a pharmacy; Room staff check medication codes on orders and patients to ensure safe dispensing.

However, leaders said they are not satisfied with a perfect report card. They want to stay there, but they know they're going to keep working for it.

"Coldness or complacency can be one of the worst things that can happen to any organization," says Kumar.

This means we are committed to the changes that will help Hartford Healthcare achieve excellence.

Hartford Healthcare takes a "top-line approach" that encourages employees to raise concerns when they see problems, Kumar said.

Calcasola said department heads regularly go around their departments and ask their employees for feedback.

Hartford Healthcare said it is looking at "preventive situations" to see if changes are needed to prevent future breaches.

"If it was easy, everyone would get an A," Calcasola said.

Mike Savino is a freelance writer based in Connecticut.

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