Physician-Patient Relationship

When pandemic hit, Geisinger excelled with patient safety focus

Jennifer Lubell , Contributing News Writer

At a time when COVID-19 upended U.S. health care organizations, executives and front-line health professionals faced challenges that risked shattering their longstanding, value-based care plans.

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This might have been true for Danville, Pennsylvania-based Geisinger Health System and its ongoing effort to cut health care-associated pressure injuries and central line-associated bloodstream infections. Geisinger is a member of the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.

Teaming up with health care solutions company Medline Industries, Geisinger didn’t let the pandemic distract from its goals. Even in the pandemic’s first year, Geisinger cut hospital-acquired incidents by 30%.

The partnership accomplished this by leveraging data, identifying injuries during rounding, and using virtual technology to improve communication and training.

“This was all done with the motivation of shared risk and an emphasis on creating a culture focused on safety and quality improvement,” says a white paper (PDF) posted on the Medline website.

Geisinger and Medline formed an integrated partnership in 2018, creating an economic model similar to the value-based payment structure that hospitals use. It operates through three foundations: improving efficiency in the supply chain and logistics services, standardizing its formulary, and working toward better outcomes on quality of care.

Pressure injuries and bloodstream infections have been a key focus.

The partnership was in full swing when COVID-19 hit.

“We know how to respond to short-term disasters. We drill for that. But this is something nobody has drilled for,” said Donna Hahn, RN, the health system’s vice president of quality, safety and patient experience.

Geisinger underwent a significant cultural change as it adjusted to its new normal for health care.

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The health system streamlined its process for gathering, reviewing, and disseminating data, reorganizing 14 data points to optimize information sharing. Executive team reviews took place on supply usage and clinical outcomes, offering opportunities to solve any problems seen in the data.

Medline also created a mobile app that aligns leaders and staff, using agreed-upon metrics. The app supports Geisinger’s evidence-based clinical practice goals “while promoting trust and accountability, offering insight into performance across a health system down to the unit level,” says the white paper.

During rounds with nurses, Geisinger Chief Nurse Executive Janet Tomcavage, MSN, RN, noticed that many COVID-19 patients were developing unique pressure injuries on their shoulders, face, knees and toes.

Tomcavage worked with Medline clinical experts to alert nurses to the problem. Nurses were trained to address these injuries in real-time by repositioning pillows and applying pressure-relieving materials on shoulders and knees. Such timely interventions helped reduce all types of pressure injuries.

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Medline created live, virtual, one-on-one training sessions targeted units and personnel based on analyses of performance data. Geisinger took part in developing these 15-minute sessions taught by a Medline subject-matter expert.

Topics included admissions best practices, moisture-associated skin damage, medical device-related pressure injuries, deep-tissue injuries and anticipated wounds.

The partnership’s continued success in improving value and quality of care during COVID-19 relied on a mutual commitment and accountability at both the leadership and frontline staff levels.

“You have to have an ability to come together and commit to the success of each other,” said Terri Bickert, DNP, RN, Geisinger’s vice president of system nursing.

As a preferred provider of the AMA, Medline is here to support physician practices by offering significant savings on 300,000-plus medical, surgical and pharmaceutical supplies. Learn more about the AMA Medline Buying Program.