Collaboration leads to improved operations

Prominent healthcare provider Dartmouth Health embarked on a challenging journey to enhance operational standardization and patient care quality across their Dartmouth Hitchcock Clinics network of 93 departments in Southern New Hampshire. They wanted to standardize operations and regulatory compliance and had a short time frame to accomplish readiness for the Joint Commissions Survey. To address these, they partnered with Vizient for their expertise in Regulatory and Accreditation Compliance. The collaboration led to remarkable results, ultimately transforming Dartmouth Hitchcock Clinics into a healthcare provider with exemplary and unified compliance and operational excellence.

Enhancing operational standardization and patient care quality

In the competitive landscape of healthcare, Dartmouth Hitchcock Clinics (DHC) stood at a crossroads. With 93 departments operating semi-autonomously, they recognized the critical need to integrate its physician practices under a single hospital licensure, which meant meeting Joint Commission standards. Despite their ongoing quality work, they recognized the need for external expertise.

Collaborative partnership leads to transformative initiatives

Having had a long-standing and successful relationship, DHC’s first call was to Vizient. Known for its expertise in Regulatory and Accreditation Compliance, Vizient experts stepped in to guide DHC through comprehensive roof-to-basement assessments across all 93 clinics. This process identified a large volume of opportunities, leading to significant financial and operational reforms aimed at standardizing processes across the board. Some areas addressed included initiating improvements in infection control, medication management, and the physical environment. With these findings, DHC implemented a range of improvements to become fully compliant.

Strategies adopted by Dartmouth Hitchcock Clinics

1. Standardization of operations
   • Implemented standardized procedures across all clinics to ensure uniformity in patient safety and care quality
   • Enhanced overall healthcare delivery by aligning all operations with hospital regulations
2. Specialist recruitment
   • Hired experts including an infection preventionist, a medication management compliance specialist, and an environment of care specialist
   • These roles were pivotal in addressing specific compliance gaps and improving the overall safety and effectiveness of healthcare services
3. Establishment of compliance groups
   • Formed a Joint Commission readiness group along with divisional readiness teams. These groups were instrumental in preparing for and ensuring compliance with the Joint Commission survey process.

Supported by Vizient’s regulatory compliance education and guidance, the DHC team implemented several creative methods to involve, educate, and verify staff competency. One of the innovative solutions implemented was the ‘Skills Day,’ which evolved into a ‘Skills Month.’ It involved setting up a conference room with stations for tests like hemoglobin A1C, lead testing, and pregnancy testing. Staff were evaluated on their ability to perform these tests, with reeducation provided where necessary. All competency documentation was integrated into Human Resource systems, providing evidence of compliance. DHC then successfully incorporated the Skills Month program into its annual sustainability plan, ensuring ongoing annual competency evaluations for staff.

Vizient’s guidance helped DHC avert the risks of non-compliance and operational discrepancies. The efforts culminated in a triumphant outcome with a TJC extension survey result of zero findings, a rare feat signifying flawless compliance. In the subsequent return of surveyors as part of Dartmouth Hitchcock Medical Center’s triannual survey, DHC again showed strong adherence to TJC tenets. Moreover, the transformation led to enhanced patient safety, improved quality of care and improved financial performance.

The impact of these changes was profound. Dr. Padin shared that the drive for these improvements wasn't just about regulatory compliance but enhancing clinical care delivery. The positive effects were clear in their employee engagement surveys, which showed significant improvements. "It was clear that the Joint Commission journey galvanized us as a regional team. People were feeling good about the work that was being done," Padin noted, reflecting the collective pride and commitment to quality care.

Patric also pointed out the importance of “understanding the 'why' behind regulations,” which Vizient effectively communicated. She recalled a moment of skepticism about the rule of keeping items 18 inches from the ceiling, only to have the Vizient team explain the sprinkler system's functionality. This clarity helped garner buy-in from the staff, making the extensive changes more manageable and meaningful.

Exemplary compliance and patient care excellence

Dartmouth Hitchcock Clinics was able to evolve from a network of clinics with diverse and varying standards, to a cohesive entity exemplifying healthcare compliance and operational excellence. Their experience with Vizient not only prepared them for Joint Commission surveys but also instilled a lasting culture of safety and quality improvement. Throughout the process, Vizient accreditation consultants worked with the quality team and leaders to provide education that not only covered the regulations, but emphasized the importance and rationale behind each one. Vizient’s approach, which also included one-on-one teaching and small group training, helped the broader team understand the risks and implications of non-compliance, ensuring they were engaged beyond mere procedural adherence. This transformation set a new benchmark in healthcare, demonstrating the power of strategic guidance and comprehensive planning in overcoming substantial challenges. It underscores the organization’s unwavering commitment to superior patient care and the pivotal role of the Vizient accreditation team’s strategic partnership in navigating the complexities of healthcare management.

About Darthmouth Hitchcock Clinics Southern Region

Dartmouth Health is a comprehensive healthcare system spanning New Hampshire and Vermont, featuring community hospitals, clinics and an academic medical center affiliated with Geisel School of Medicine. It includes the prestigious Dartmouth Cancer Center and Dartmouth Health Children's, along with a wide range of nursing, rehabilitation, hospice and personal healthcare services.