Quality Advocacy Showcase

Quality Advocacy Showcase Illinois Hospitals: Meet hospital leaders from your district to learn about quality improvement initiatives that impact your constituents April 12, 2018 11 am 2 pm Illinois State Capitol 1 -Floor Rotunda st

Anderson Hospital, Maryville SENATE DISTRICT 56 HOUSE DISTRICT 112 PATIENT SAFETY Improving the quality of care of patients with acute chest pain We used lean strategies to improve the quality of care of emergency department (ED) patients with acute chest pain. Strategies include: Rapid Improvement Events Workflow mapping Multidisciplinary collaboration $478k PERSONNEL & EQUIPMENT Decreases morbidity and mortality Decreases emotional stress with early diagnosis $645k ED THROUGHPUT Promotes efficient and qualitative emergency care Launch date: April 21, 2016

Fairfield Memorial Hospital, Fairfield SENATE DISTRICT 55 HOUSE DISTRICT 109 PATIENT SAFETY Tailoring antimicrobial drug therapy to each patient Clinicians perform daily assessments of each patient s condition to identify: Bug-to-drug mismatches between antimicrobial therapy and microorganisms in the body Therapies not indicated by the patient s condition Therapies the patient completed $750 Opportunities to change a medication from intravenous to oral ANTIMICROBIAL TRAINING patient safety $36k COST OF MEDICATIONS Decreases patient length of stay Prevents antimicrobial resistance in the community Launch date: July 2016

OSF HealthCare St. Joseph Medical Center, Bloomington SENATE DISTRICT 44 HOUSE DISTRICT 88 PATIENT SAFETY Reducing and preventing hypoglycemic events in patients A multidisciplinary team implemented several interventions including: Checking the blood sugar of every admitted patient Providing dextrose via IV for patients who are unable to eat Discontinuing oral diabetes medications while patients are admitted $4.2k Consulting pharmacy staff, a diabetes educator and dietitian when low blood STAFF TRAINING sugar occurs $808k Decreases patient length of stay EVENTS PREVENTED Decreases risk of mortality Launch date: October 2015 patient comfort and outcomes

AMITA Health, Arlington Heights SENATE DISTRICT 27 HOUSE DISTRICT 54 PATIENT SAFETY Decreasing opioid use in the emergency department AMITA Health emergency departments partnered to remove hydromorphone (Dilaudid) as a first-line pain medication. We: Reduced amounts of stocked hydromorphone by 50% Educated teams and patients with treatment algorithms, educational notices and posters Moved to alternative methods of administering hydromorphone to $1k CAMPAIGN MATERIALS patients who need it $8.2k patient safety DECREASED DOSES Reduces risk for addiction Launch date: August 2017 patient outcomes

Paris Community Hospital, Paris SENATE DISTRICT 51 HOUSE DISTRICT 102 PATIENT SAFETY Improving staff response time to patient alarms We implemented a new program and system upgrade that allow for: Notifications to staff assigned to patient rooms A locator to identify staff-patient assignments Staff to set reminders to follow up or check on patients at certain time intervals $12k SOFTWARE UPGRADE patient safety $7.2k PER POST-FALL INJURY quality of care Increases patient satisfaction Launch date: October 2017

HSHS Holy Family Hospital, Greenville SENATE DISTRICT 54 HOUSE DISTRICT 107 PATIENT SAFETY Improving medication administration safety A multidisciplinary team implemented several interventions: Medication administration checklist Education to all staff administering medications Structured follow-up for medication variances Review of event within 24 hours Do Not Disturb mats and signs for Pyxis machines and computers $105 DO NOT DISTURB TOOLS on wheels $5k Ensures safe and accurate medication administration PER AVOIDED EVENT Reduces monitoring, testing and length of stay Launch date: August 2017 Reduces harm associated with adverse drug events

Saint Anthony Hospital, Chicago SENATE DISTRICT 11 HOUSE DISTRICT 21 PATIENT SAFETY Reducing patient falls with injury A multidisciplinary team reviews all falls monthly. The team also implemented: Falls bundle recommended by The Joint Commission Nurse-driven protocol Bed alarms Post-fall huddle and reporting at daily safety huddles Semi-annual hospital-wide falls reduction education day $3k TRAINING & SUPPLIES Reduces avoidable injuries related to falls $22k REDUCTION IN LOS Reduces patient length of stay (LOS) Increases patient satisfaction Launch date: January 2016

McDonough District Hospital, Macomb SENATE DISTRICT 47 HOUSE DISTRICT 93 PATIENT SAFETY Eliminating mislabeled specimens using The Final Check After training through IHA s Hospital Improvement Innovation Network, we implemented The Final Check toolkit: Adding a final check between lab and nursing by comparing the last 3 digits of the patient s medical record aloud with the specimen Utilizing just culture principles Creating a culture of safety, reporting, learning and transparency $1.5k EDUCATION & TRAINING patient safety $1.5m MALPRACTICE CLAIMS quality of care Increases patient satisfaction Launch date: October 2017

OSF HealthCare Saint Paul Medical Center, Mendota SENATE DISTRICT 38 HOUSE DISTRICT 76 PATIENT SAFETY Preventing falls and fall-related injuries in the inpatient setting We implemented the fall intervention playbook to reduce total falls through: Fall risk assessments every shift Hourly rounding Bed/chair alarms Non-skid slippers Fall prevention posters Fall score on care boards Patient education Visual cues, such as bell signs $800 FALL BUNDLE MATERIALS Real-time feedback Fall audits $21k INJURIES PREVENTED patient safety quality of care Launch date: December 2017 Reduces patient length of stay

Illini Community Hospital, P i t t s fi e l d SENATE DISTRICT 50 HOUSE DISTRICT 100 PATIENT SAFETY Enhancing patient safety, the care environment and quality of care We revised our quality management system and implemented: Root cause analysis of all patient/ environmental safety events Team engagement in process evaluation with failure modes and effect analysis Department measures targeting critical quality metrics Redesigned policy review process $4k TRAINING and standard work $101k patient safety FEWER SAFETY EVENTS process and patient care efficiency Launch date: July 2017 Increases transparency and accountability

AMITA Health Adventist Medical Center GlenOaks, Glendale Heights SENATE DISTRICT 23 HOUSE DISTRICT 46 PATIENT SAFETY Improving blood clot awareness, mobility and prevention Interventions by a multidisciplinary team include: Early mobility protocol Patient and family blood clot education sheet Simulation training Real-time feedback Ongoing education through smart phone and tablet app $2k TRAINING & HANDOUTS Team discussion and apparent cause analysis for healthcare-associated blood clots $24k REDUCTION IN VTE quality of life Reduces patient length of stay Launch date: November 2016 Increases knowledge of blood clots

AMITA Health Adventist Medical Center Hinsdale, Hinsdale SENATE DISTRICT 24 HOUSE DISTRICT 47 PATIENT SAFETY Preventing reportable ventilatorassociated events (VAEs) We review patient charts daily for ventilator settings that may fall into VAE criteria. In addition: Staff receives a daily update with all ventilator settings. We strategize on safely weaning patients to a setting below VAE designation. We share information with respiratory therapists, nurses and $15k STAFF TIME physicians. $100k patient safety NO PENALTIES Reduces patient ventilator days Launch date: April 2016 Reduces patient days in ICU

HSHS St. Anthony s Memorial Hospital, Effingham SENATE DISTRICT 54 HOUSE DISTRICT 107 PATIENT SAFETY Optimizing antimicrobial use and awareness A multidisciplinary committee collaborated to provide oversight and guidance on the proper use of antimicrobial medications through: Pharmacy-driven antibiotic timeout process Physician antibiotic management audits Review of broad-spectrum antibiotic therapy days $330k TRAINING & EQUIPMENT Review of Clostridium difficile cases Use of BioFire Film Array $1.5m OPTIMIZED ANTIBIOTICS patient safety quality of care Launch date: June 2015 Increases patient satisfaction

HSHS St. Mary s Hospital, Decatur SENATE DISTRICT 48 HOUSE DISTRICT 96 PATIENT SAFETY Reducing falls for high-risk patients Multidisciplinary teams implemented several interventions including: Purposeful hourly rounding Multidisciplinary rounding Addressing pain management needs Patient safety and environmental inspection Plan of care focused on patients needs $6.1k EDUCATION & TRAINING patient safety $241k FALL-RELATED INJURIES patient outcomes Reduces mortality Launch date: January 2016

Garfield Park Behavioral Hospital, Chicago SENATE DISTRICT 5 HOUSE DISTRICT 10 PATIENT SAFETY Reducing the number of and time spent on restrictive interventions A multidisciplinary team implemented: Training focused on imminent risk, deescalation and early warning signs Individualized clinical conference plans Data analysis and trending Program modification Sensory items and a sensory room Sharing of data weekly Inclusion of unit staff in $115k SALARY & TRAINING decision making patient safety $570k STAFF TIME & FEES Reduces risk of injury and re-traumatization Launch date: January 2017 patient outcomes

Northwestern Memorial HealthCare, Chicago SENATE DISTRICT 13 HOUSE DISTRICT 26 PATIENT SAFETY Reducing fluoroquinolone prescribing rates in ambulatory care We improved appropriate prescribing of fluoroquinolones for acute sinusitis, acute bronchitis and uncomplicated urinary tract infection by: Establishing an antibiotic stewardship committee Adding physician-facing alerts in electronic health record Developing patient education material for display $4k STAFF TIME Creating alternative treatment options $32k Maximizes the benefit of antibiotic treatment ADVERSE DRUG EVENTS Minimizes harm to individuals and communities Launch date: September 2016 Reduces microbial resistance

Presence Saints Mary and Elizabeth Medical Center, Chicago SENATE DISTRICT 2 HOUSE DISTRICT 4 PATIENT SAFETY Improving nutrition care of the malnourished inpatient population We implemented the following interventions: Nursing-driven malnutrition risk screening tool for all admissions Standardized dietitian screening and assessment practices for malnourished patients Order-writing privileges for dietitians $50k Enhanced provider communication and documentation of malnutrition STAFF EDUCATION patient understanding of malnutrition $70k LENGTH OF STAY quality of care Launch date: August 2016 Increases patient satisfaction

Norwegian American Hospital, Chicago SENATE DISTRICT 2 HOUSE DISTRICT 4 PATIENT SAFETY Eliminating the development of heel pressure ulcers Using evidence-based practices, our wound nurse executed a plan to eliminate heel pressure ulcers through: Preventive screening Risk assessments based on physical capabilities Patient history Prophylactic use of pressure $19k offloading boots Cost-benefit analysis of boots PRESSURE ULCER BOOTS compared with clinical attributes $2.2m patient safety ULCERS PREVENTED quality of care Launch date: March 2016 Increases patient satisfaction

Edward Hospital, Naperville SENATE DISTRICT 21 HOUSE DISTRICT 41 PATIENT SAFETY Improving outcomes of our sepsis patients We adopted a multifaceted approach to foster improvement: Revised sepsis order set including fluid calculator and antibiotic decision support Piloted use of screening tool in adult medicine unit Implemented best-practice alert in electronic medical record Educated healthcare team on sepsis $20k STAFF TIME identification and management $2m patient safety LENGTH OF STAY quality of care Launch date: July 2015 Reduces patient costs

Advocate BroMenn Medical Center, Normal SENATE DISTRICT 53 HOUSE DISTRICT 105 PATIENT SAFETY Reducing the risk of blood transfusion complications We adopted several interventions to improve patient safety by decreasing blood transfusion utilization: Single-unit transfusion guidelines Standardization of blood transfusion orders Massive transfusion protocol Maternal hemorrhage protocol Guidelines for release of blood that is not cross-matched $4.8k (2017) STAFF TIME & EDUCATION Transfusion case review patient safety $7.1m (2017) HEALTHCARE COSTS Reduces patient costs Launch date: January 2015 Increases blood product available in the community

Red Bud Regional Hospital, Red Bud SENATE DISTRICT 58 HOUSE DISTRICT 116 PATIENT SAFETY Reducing serious safety events We implemented multiple interventions: Adopting a high-reliability culture Educating staff on transparent event reporting Establishing interdisciplinary rounding Forming a falls committee Including safety moments at the start of every meeting Joining a Patient Safety Organization $5k SAFETY INITIATIVES Reassessing methodology for event report investigations $320k FEWER EVENTS patient safety quality of care Launch date: January 2016 Increases patient satisfaction

Presence Holy Family Medical Center, Des Plaines SENATE DISTRICT 28 HOUSE DISTRICT 55 PATIENT SAFETY Reducing falls with injury through post-fall huddles A multidisciplinary team implemented interventions to assess, improve, maintain and eliminate variation through: Identification of high-risk factors on admission Early assessment and documentation Proper use of equipment Use of low beds Best practices in patient-family engagement on equipment use Post-fall huddles Ongoing analysis $70k STAFF TRAINING $318k FEWER FALL INJURIES patient safety Increases patient and family engagement Launch date: October 2016 Increases patient satisfaction

OSF HealthCare Saint James John W. Albrecht Medical Center, Pontiac SENATE DISTRICT 53 HOUSE DISTRICT 106 PATIENT SAFETY Decreasing episiotomy rates system-wide A collaborative group of physicians and nurses applied evidence-based medicine to implement and facilitate the following: Collaborative meetings, phone calls and emails Data presentation and transparency Feedback loops and accountability Cultural change Optimization of electronic medical record for accurate documentation $10k STAFF MEETING TIME Decreases perineal injury $0 N/A Decreases recovery post-delivery Decreases delivery costs Launch date: January 2015

Advocate Good Shepherd Hospital, Barrington SENATE DISTRICT 26 HOUSE DISTRICT 52 PATIENT SAFETY Becoming a high-reliability organization A hospital-wide multidisciplinary approach reduced serious safety events with: Training on leadership, safety culture and process improvement High-reliability units with specially trained safety coaches Peer coaching and performance improvement activities to hardwire safety behaviors and tools $83k TRAINING COSTS Safety principles and tactics in simulation lab $1.8m SAFETY IMPROVEMENTS Reduces serious harm Reduces patient length of stay Launch date: January 2015 Reduces mortality

Hospital Sisters Health System (HSHS), Springfield SENATE DISTRICT 48 HOUSE DISTRICT 96 PATIENT SAFETY Improving acute stroke care We established the HSHS Neurology and Telestroke Program system-wide to: Implement best-practice protocols and procedures Provide tpa to eligible patients as soon as possible after arrival in functional recovery of stroke patients emergency department Reduce average time to begin treatment by 50% from 70 to awareness of benefits of acute stroke care 35 minutes Implements best practices in acute stroke care Launch date: January 2015

Gateway Regional Medical Center, Granite City SENATE DISTRICT 57 HOUSE DISTRICT 113 CARE COORDINATION Improving outcomes for patients with total joint replacements An orthopedic nurse navigator is in charge of communication and care coordination with the multidisciplinary team involved in total joint replacements. The nurse navigator also educates patients and families on the surgery and recovery. Our goals: Decrease patient length of stay (LOS) Increase mobility Decrease recovery times $75k ORTHO NURSE NAVIGATOR Decrease opioid use $2m Ensures comprehensive care close to home REDUCTION IN LOS Provides continuing education and ongoing support Launch date: May 2016 Increases patient satisfaction

OSF HealthCare Saint Francis Medical Center, Peoria SENATE DISTRICT 46 HOUSE DISTRICT 92 CARE COORDINATION Reducing 30-day readmissions & mortality for heart failure patients We implemented a nurse-driven transitional care program to improve care coordination for patients admitted with heart failure. Patients receive: Follow-up phone call within 2 days and office visit within 5 days Additional outpatient follow-up as needed from 30 days up to 90 days Access to a dedicated call line staffed by the HF-TCS team 24/7 $2.3m STAFF, LABS & EQUIPMENT 74% decline in 30-day mortality $169k 38 READMISSIONS Increases individualized care Increases hospital-tohome support Launch date: September 2016

Touchette Regional Hospital, Centreville SENATE DISTRICT 57 HOUSE DISTRICT 114 CARE COORDINATION Reducing EKG testing time for ED patients with chest pain Emergency department (ED) staff identified delays in testing and equipment needing repair. Staff then: Defined chest pain and reviewed protocol Educated ED and admitting staff on protocol Trained triage staff to obtain EKGs $7k Provided remedial education to individuals consistently non-compliant STAFF TIME & AUDIT Shared learnings in meetings and a newsletter 16 MINUTES SAVED Provides early diagnosis and treatment Increases opportunities for patient education Launch date: January 2017 Expedites transportation to tertiary care

Graham Hospital, Canton SENATE DISTRICT 46 HOUSE DISTRICT 91 CARE COORDINATION Improving turn-around time from troponin testing to result Our laboratory team collaborated to identity ways to improve the turn-around time from draw to result for troponin testing, an indicator of heart damage in patients. Our strategy includes: Staff engagement and education Elimination of technical variables Streamlining of sample procurement $3.1k Shortens time to diagnosis quality of care PROCESS DESIGN & TRAINING $6.3k FEWER DRAWS PER YEAR patient safety Launch date: July 2017

Ann & Robert H. Lurie Children s Hospital of Chicago, Chicago SENATE DISTRICT 13 HOUSE DISTRICT 26 CARE COORDINATION Improving pediatric patient coping across the continuum of care A multidisciplinary team created an embedded plan in the electronic medical record to communicate patient care preferences across encounters. The team created and implemented training on non-pharmacologic interventions to support staff understanding and utilization of coping preferences such as positions of comfort and guided imagery. $20k STAFF TIME patient/family engagement and partnership $131k FOR PACU PATIENTS Increases coping behaviors and decreases anxiety Creates long-term health-seeking behaviors Launch date: June 2016

OSF HealthCare Saint Elizabeth Medical Center, Ottawa SENATE DISTRICT 38 HOUSE DISTRICT 76 CARE COORDINATION Reducing 30-day all-cause readmissions To reduce our readmission rate, we implemented the following: Follow-up appointments 3-5 days after discharge scheduled during the hospital stay Interdisciplinary bedside rounding 5 days a week for high-risk patients identified through an electronic screening process $10k STAFF TIME Identifies a clear plan for discharge $652k FEWER READMISSIONS access to care post-discharge quality of life Launch date: October 2015

Sarah D. Culbertson Memorial Hospital, Rushville SENATE DISTRICT 47 HOUSE DISTRICT 93 CARE COORDINATION Reducing 30-day readmissions for high-risk patients We implemented a multistep approach including: Personalized care binders for patients Discharge patient care coordinator Magnets identifying care transitions Care coordination with outpatient clinic Discharge callbacks $40.34 BINDERS & MAGNETS Eases patient transition from inpatient to outpatient $88k REDUCED READMISSIONS Increases educational opportunities discharge education and timely follow-up Launch date: December 2016

Jersey Community Hospital, Jerseyville SENATE DISTRICT 50 HOUSE DISTRICT 100 CARE COORDINATION Reducing 30-day readmissions for all-cause, high-risk patients We enhanced care coordination to identify potential needs and concerns of patients and to provide a follow-up appointment with their primary care provider prior to discharge. The care team includes: Hospitalist Case Management Pharmacy Physical Therapy $90k STAFF SALARY Dietary Nursing $190k REDUCED READMISSIONS post-discharge care of patients Increases medication compliance Launch date: January 2016 Reduces patient costs

Memorial Medical Center, Springfield SENATE DISTRICT 48 HOUSE DISTRICT 96 CARE COORDINATION Reducing length of stay with an expedited therapy consultation Using Six Sigma methodology, our rehabilitation services staff improved communication, triage and scheduling of physical therapy staff to ensure patient consultations occur on the day of surgery in over 95% of scheduled procedures. $12.5k PROJECT TEAM Increases postsurgical mobility Reduces patient length of stay $1.1m Reduces patient costs LENGTH OF STAY Launch date: February 2017

Memorial Medical Center Comprehensive Stroke Center, Springfield SENATE DISTRICT 48 HOUSE DISTRICT 96 CARE COORDINATION Improving care for stroke patients across central Illinois Memorial Health System has achieved Comprehensive Stroke Center designation through projects that lead to better patient outcomes: Coordinating with other hospitals in the region Coordinating with EMS Streamlining and enhancing emergency department treatment Training with advanced simulation $194k STAFFING & TRAINING techniques $1.1m access to care 23% patient growth VARIABLE CARE COST Reduces patient length of stay Launch date: March 2015 patient outcomes

Centegra Hospital McHenry, McHenry SENATE DISTRICT 32 HOUSE DISTRICT 64 CARE COORDINATION Reducing unnecessary hospitalizations We engage patients and families facing serious illness to participate in timely, effective and sensitive goals-of-care conversations that are documented. We help translate these goals into patientcentered care plans and communicate the goals across sites of care. $15k ASSOCIATE TRAINING quality of care Reduces patient length of stay $827k PER MEDICARE PATIENT Increases patient satisfaction Launch date: October 2015

Presence Saint Joseph Hospital, Chicago SENATE DISTRICT 6 HOUSE DISTRICT 12 CARE COORDINATION Reducing 30-day readmissions for high-risk patients A multidisciplinary team implemented interventions including: Multidisciplinary care coordination rounds with patients and families Use of LACE readmission predictive index Comprehensive medication reconciliation at discharge $250 Targeted patient and family education Follow-up phone calls after discharge STAFF TIME communication with patient and family $128k FEWER READMISSIONS patient understanding of chronic conditions Launch date: January 2017 Enhances discharge plan

Advocate Physician Partners, Rolling Meadows SENATE DISTRICT 28 HOUSE DISTRICT 55 CARE COORDINATION Redesigning PCP practices around patient-centered care Advocate s Patient-Centered Medical Home Clinical Transformation Program emphasizes a team-based approach using continual process improvement and nationally recognized care redesign elements to: Coordinate care between providers Enhance the patient experience Create efficiency within primary care physician (PCP) practices $1.3m STAFF TIME patient safety $10.1m CARE COORDINATION quality of care Increases patient satisfaction Launch date: February 2016

Rush Copley Medical Center, Aurora SENATE DISTRICT 42 HOUSE DISTRICT 84 CARE COORDINATION Reducing emergency department utilization for chronic pain issues Emergency department (ED) care managers collaborated with medical providers to develop individualized care plans that include: Patients receiving their plan in writing Plan followed during each ED visit Referral to primary care provider Education on the use of opioids Referrals to community providers $55k STAFF TIME Provides the right care in the right place $1.4m REDUCED VISITS 78% ED availability for true need Launch date: January 2015 Reduces cost of EMS services in the community

OSF HealthCare St. Mary Medical Center, Galesburg SENATE DISTRICT 37 HOUSE DISTRICT 74 CARE COORDINATION Reducing 30-day readmissions through a cross-continuum team A cross-continuum team uses root cause analyses and collaborates with home health and nursing homes. The team also implemented: Predictive modeling for high-risk patients Interdisciplinary rounds Care management referrals Discharge summary and appointment $2.8k within 5 days STAFF HOURS Follow-up phone call 24 hours postdischarge Medication reconciliation $784k HEALTHCARE COSTS access to care care continuity and management Launch date: January 2015 Reduces patient costs

Presence Saint Joseph Hospital, Elgin SENATE DISTRICT 33 HOUSE DISTRICT 65 CARE COORDINATION Reducing sepsis mortality through early recognition and treatment Our Care Team reduced the tele-icu sepsis mortality rate from 18% to 2% in 2017 by applying a standardized approach to care for patients with sepsis including: Utilizing evidence-based practices Enhancing nursing s role in early identification Initiating protocols $7.8k Providing medical management Enhancing communication among STEERING/TRAINING HOURS the team $130k communication between patient and care team 7 LIVES SAVED IN Q4 Reduces the need for invasive care Launch date: August 2017 quality of care

Advocate HealthCare, Downers Grove SENATE DISTRICT 24 HOUSE DISTRICT 47 CARE COORDINATION Supporting patients at high risk for readmission after discharge We used an automated readmission risk tool and several interventions to provide supportive transition management: Partnering with inpatient care managers Providing medication reconciliation within 72 hours Ensuring post-hospital visits are scheduled $700k Completing hand-offs to primary care physicians CASE MANAGER SALARIES Having weekly patient contact for 30 days $1.1m FEWER READMISSIONS quality of care Enhances patient experience Launch date: January 2017 Reduces patient costs

OSF HealthCare Ambulatory Clinical Practice, Peoria SENATE DISTRICT 46 HOUSE DISTRICT 92 CARE COORDINATION Increasing access to care through Medicare nurse visits Our ambulatory nurses work to the full scope of their licensure to utilize standing orders and provide chronic disease education. Benefits of their enhanced role include: Increased access to care Reduced care gaps and cost of care Improved professional satisfaction $150k Increased number of patients served Improved antibiotic stewardship NURSE TRAINING access to care $785k 7,626 MORE VISITS patientcentered care quality of care Launch date: June 2016

Memorial Health System, Springfield SENATE DISTRICT 48 HOUSE DISTRICT 96 CARE COORDINATION Engaging patients and families in their care We formed a Patient Experience Advisory Committee (PEAC) to work with Memorial leaders and staff on a variety of improvement initiatives: Discharge instructions Discharge lounge Food services Medication notes Brochures on preventing falls and central line-associated bloodstream $0 GRANT FUNDING infections Wayfinding $51k BUILDING PROJECT patient and family engagement Builds collaboration with the communities we serve Launch date: August 2016 Lunch provided through a grant from Memorial Medical Center Foundation. Allows patient experiences to drive change

OSF HealthCare Performance Improvement, Peoria SENATE DISTRICT 46 HOUSE DISTRICT 92 CARE COORDINATION Improving patient access and quality of care We created Care Teams as a platform for driving population health through newly implemented medical group sites. Improvements include: Increased access with nurse clinic access to care Communication via daily huddles Patient engagement prior to appointment Plan-of-care compliance via post-visit follow-up quality of care patient satisfaction Time for specialty consultations Launch date: June 2016

Harrisburg Medical Center, Harrisburg SENATE DISTRICT 59 HOUSE DISTRICT 118 CARE COORDINATION Reducing behavioral health bed holds in the medical-surgical unit We implemented several interventions including: Education to behavioral health (BH) providers and staff, emergency department (ED) physicians, and hospitalist staff Addition of an intake coordinator to facilitate timely admission Coordination of ED and BH staff on patient transfers to another facility if $624k STAFF TIME timely admission not possible $600k access to mental health services FEWER PATIENT HOLDS quality of care Launch date: February 2015 Reduces patient costs

HSHS St. Joseph s Hospital, Highland SENATE DISTRICT 54 HOUSE DISTRICT 108 INFECTION PREVENTION Improving Clostridium difficile infection rates We used a nurse-driven SBAR protocol (Situation, Background, Assessment, Recommendation), which reduced C. difficle testing and rates by over 50% through: Increasing critical thinking Providing nurse autonomy Improving communication with providers $520 STAFF TIME Reduces patient harm $58k REDUCTION IN HAIs Reduces complications and patient length of stay Reduces likelihood of C. d i ffi c l e recurrence Launch date: January 2017

Passavant Area Hospital, Jacksonville SENATE DISTRICT 50 HOUSE DISTRICT 100 INFECTION PREVENTION Reducing healthcare-associated pneumonia among patients We implemented several interventions including: Healthcare provider education Routine aspiration risk assessment and oral care Product changes Recurrent auditing for process compliance We also revised hospital policies based on evidence-based practice and we $12.5k PROJECT TEAM MEETINGS updated the electronic medical record to reflect process enhancements. $480k 1 CASE PER MONTH Reduces inpatient length of stay Reduces cost of hospitalization Launch date: December 2016 Reduces mortality rate

Elmhurst Hospital, Elmhurst SENATE DISTRICT 24 HOUSE DISTRICT 47 INFECTION PREVENTION Reducing healthcare-associated Clostridium difficile infection rates We implemented several interventions including: Electronic medical record (EMR) alerts for timely testing of patients symptomatic on admission Nurse screening to identify symptomatic patients and test within 3 days of admission Enhanced documentation of patient stools in EMR $20k TRAINING & MEDICATION Care coordination among infection preventionists, nurses and physicians $117k REDUCED INFECTIONS patient safety quality of care Launch date: September 2017 Increases patient satisfaction

Advocate Condell Medical Center, Libertyville SENATE DISTRICT 26 HOUSE DISTRICT 51 INFECTION PREVENTION Reducing catheter-associated urinary tract infections (CAUTIs) We conducted staff competency assessments and skill validation for each bedside nurse. We also: Standardized products and eliminated variation Developed an incentive program for the greatest reduction in catheter days Perform daily assessments on continued need of a urinary catheter $12k STAFF EDUCATION Conduct a journal club focused on CAUTI prevention $7k PER CAUTI PREVENTED Reduces length of stay Reduces unnecessary tests and procedures Launch date: September 2016 Reduces ICU admissions and transfers

Little Company of Mary Hospital and Health Care Centers, Evergreen Park SENATE DISTRICT 18 HOUSE DISTRICT 36 INFECTION PREVENTION Reducing healthcare-associated Clostridium difficile infections A multidisciplinary team implemented: Antimicrobial stewardship Appropriate testing via pharmacy pager program Standardized personal protective equipment Hand hygiene education/monitoring Universal sporicidal disinfectant Mobile equipment checklist Oral vancomycin prophylaxis UV technology Reduced use of fluoroquinolone/ proton pump inhibitor $105k SUPPLIES & TRAINING $889k REDUCED INFECTIONS patient safety Reduces patient morbidity Launch date: January 2016 community health

AMITA Health Adventist Medical Center La Grange, La Grange SENATE DISTRICT 41 HOUSE DISTRICT 82 INFECTION PREVENTION Reducing central line-associated bloodstream infections (CLABSIs) We implemented several interventions: Daily nursing surveillance of central venous catheters for compliance with 11 elements of dressing integrity Hospital-developed electronic tool to collect actionable information Weekly compliance report to nursing leaders $26k Use of midline catheters over peripherally inserted central catheters STAFF TIME when possible $59k Reduces patient length of stay 5 FEWER CLABSIs/YEAR Reduces costs to patients Launch date: December 2016 Reduces mortality

HSHS St. John s Hospital, Springfield SENATE DISTRICT 48 HOUSE DISTRICT 92 INFECTION PREVENTION Reducing healthcare-associated Clostridium difficile infections Our infection prevention staff review and approve all specimens submitted for C. difficile. These reviews require test evaluation based on necessity and representation of actual C. difficile, including: Medical history Antibiotic use and use of other diarrhea-causing medications $0 C. difficile-related symptoms, testing history and frequency Decreases inappropriate antibiotic administration $739k 78 FEWER HAIs Decreases patient length of stay Launch date: November 2016 patient experience and care environment

AMITA Health Adventist Medical Center Bolingbrook, Bolingbrook SENATE DISTRICT 43 HOUSE DISTRICT 85 INFECTION PREVENTION Preventing ventilator-associated events (VAEs) Multidisciplinary teams implemented several interventions: Oral care every 2 hours with designated oral care kits Cuff pressure checks every 4 hours Tube position change daily at specific time Daily monitoring of positive endexpiratory pressure value Product change to subglottic endotracheal tube New nebulizer kits for every treatment $15k EQUIPMENT CHANGES $294k patient safety NO VAEs IN 2.5 YEARS Decreases patient complications and mortality Launch date: July 2015 Increases patient satisfaction

Advocate Sherman Hospital, Elgin SENATE DISTRICT 33 HOUSE DISTRICT 66 INFECTION PREVENTION Preventing healthcare-associated infections in critical care Nursing partnered with physicians to implement interventions to prevent central line and urinary catheter infections: Daily checklist to validate chlorhexidine bathing IV lines and dressings changed at prescribed intervals Nurse-driven protocol to remove urinary catheters sooner Second-level review to promote blood/ $2.4k STAFFING urine culture stewardship $52k patient safety REDUCED INFECTIONS Reduces healthcareassociated conditions Launch date: December 2016 patient outcomes

Abraham Lincoln Memorial Hospital, Lincoln SENATE DISTRICT 44 HOUSE DISTRICT 87 INFECTION PREVENTION Implementing an antibiotic stewardship program A pharmacist-led antibiotic stewardship program led to a 19% decrease in antibiotic days of therapy per patient through: Monitoring antibiotic usage patterns Clinical recommendations when rounding with physicians Patient and staff education on appropriate antibiotic use $6.2k PHARMACIST HOURS Optimizes antibiotic therapy for patients $20k ANTIBIOTIC Reduces side effects from antibiotic usage Reduces antibiotic resistance Launch date: October 2015

HSHS St. Francis Hospital, L i t c h fi e l d SENATE DISTRICT 48 HOUSE DISTRICT 95 INFECTION PREVENTION Eliminating healthcare-associated infections for 24 months Prevention is key to reducing healthcare-associated infections (HAIs). We went two years free of all HAIs by implementing: Early identification of at-risk patients Daily screening Audits to ensure processes are followed $10k EDUCATION & AUDITS Reduces patient length of stay $23k PER AVOIDED HAI Provides education on preventing HAIs patient outcomes Launch date: November 2015

Gibson Area Hospital & Health Services, Gibson City SENATE DISTRICT 53 HOUSE DISTRICT 106 INFECTION PREVENTION Reducing risk of catheter-associated urinary tract infections A multidisciplinary team applied evidence-based interventions: Education on catheter-associated urinary tract infections (CAUTIs) for providers and patients Insertion criteria added to order sets Appropriate use and duration of catheter Aseptic technique and insertion checklist $19.4k PROCESS IMPLEMENTATION Catheter maintenance Ongoing evaluation of prevention measures $756k CAUTI PREVENTION patient safety quality of care Launch date: January 2016 Reduces patient length of stay

NorthShore University HealthSystem, Evanston SENATE DISTRICT 9 HOUSE DISTRICT 18 INFECTION PREVENTION Reducing healthcare-associated Clostridium difficile infections We collect rectal screening swabs from all newly admitted patients with the following risk factors: Hospitalization within the past two months Prior positive C. difficile test Stay in a long-term care facility within the past six months $277k patient outcomes Educates family members to care for patients at home LAB TESTS & STAFF TIME $157k PREVENTED INFECTIONS Reduces mortality, disability and community spread Launch date: August 2017

Northwestern Medicine Delnor Hospital, Geneva SENATE DISTRICT 25 HOUSE DISTRICT 50 INFECTION PREVENTION Identifying and treating sepsis early to save lives Our multidisciplinary approach to early sepsis identification and treatment includes: Pre-hospital sepsis identification by EMS and skilled nursing facilities Education for hospital staff Sepsis alert and multidisciplinary team response Real-time feedback to clinicians $507k STAFF TIME & EDUCATION quality of care $8.5m 73 LIVES SAVED patient outcomes Decreases mortality Launch date: January 2015

OSF HealthCare Saint Anthony s Health Center, Alton SENATE DISTRICT 56 HOUSE DISTRICT 111 INFECTION PREVENTION Improving hand hygiene compliance to reduce Clostridium difficile Our Hand Hygiene Process Improvement Team implemented several interventions: Adding hand hygiene dispensers throughout the facility Holding a hand hygiene in-service for all clinicians Implementing the C. difficile playbook Increasing monthly hand hygiene observations Re-educating staff on room cleaning $3.7k STAFF TIME patient safety $9.6k FEWER C. DIFF CASES quality of life Increases patient satisfaction Launch date: January 2017

Northwestern Medicine Central DuPage Hospital, Winfield SENATE DISTRICT 21 HOUSE DISTRICT 42 INFECTION PREVENTION Decreasing Clostridium difficile with electronic decision support Through a hospital-system collaboration, we devised an algorithm to guide the order for C. difficile testing. Our goal was to decrease healthcare-associated C. difficile by ensuring appropriate testing criteria, which include: 3 observed watery stools within 24 hours Positive result within the past 30 days Negative result in the past 7 days $5k STAFF TIME Reduces unnecessary testing and associated stress $350k FEWER TESTS NEEDED Reduces patient costs Launch date: November 2016 quality of care

Swedish Covenant Hospital, Chicago SENATE DISTRICT 7 HOUSE DISTRICT 13 INFECTION PREVENTION Providing effective antibiotics for patients with penicillin allergy We used a multidisciplinary team approach to successfully implement a penicillin allergy algorithm that includes: Asking three essential questions regarding the allergy Documenting updated allergy profiles with descriptions Providing the most efficacious and safe antibiotics to treat infections $12k STAFF EDUCATION quality of care $720k HEALTHCARE COSTS Decreases antibiotic resistance patient outcomes Launch date: March 2015

Northwestern Memorial Hospital, Chicago SENATE DISTRICT 13 HOUSE DISTRICT 26 INFECTION PREVENTION Reducing healthcare-associated infections in the medical ICU We formed a multidisciplinary team for daily rounds and implemented several interventions: Discussions on device indication for Foley catheters and central lines with just-in-time coaching Daily email on devices remaining in place and removed Escalation for identified risks Monthly report of quality metrics and $19k STAFF TIME number of devices removed patient safety $107k FEWER INFECTIONS quality of care Launch date: January 2016 Reduces infection rate

Carle Foundation Hospital, Urbana SENATE DISTRICT 52 HOUSE DISTRICT 103 INFECTION PREVENTION Reducing Clostridium difficile infections A multidisciplinary team implemented a variety of interventions including: Reducing inappropriate testing Implementing early testing and identification Standardizing testing Adding sporicidal disinfectant with all daily and terminal cleans $75k NEW CLEANING PROCESS patient safety quality of care $251k FEWER INFECTIONS Reduces infections in the community Launch date: January 2016

Presence Health, Chicago SENATE DISTRICT 5 HOUSE DISTRICT 9 BEHAVIORAL HEALTH Using telehealth to improve behavioral health services in the ED We implemented a Remote Crisis Worker Telehealth initiative to provide real-time virtual behavioral health consults to patients in the emergency department (ED) from 6 p.m. 8 a.m. every day. These patients previously had to wait in the ED for a crisis worker after 8 a.m. $802 TRAINING & NEW MONITOR access to care patient safety $158k 2.45 FTES quality of care Launch date: September 26, 2017

Perry Memorial Hospital, Princeton SENATE DISTRICT 37 HOUSE DISTRICT 74 BEHAVIORAL HEALTH Improving access to mental health services Our Community Needs Assessment identified mental health access as a priority. In response, our emergency department (ED): Implemented technology to provide telehealth consults in the ED Provides 24/7 access to mental health providers Collaborates with UnityPoint Health on proper placement of ED patients $18.5k CONSULTING & HARDWARE who need mental health services $86k access to mental health services REDUCED ED BOARDING Decreases patient length of stay in the ED Launch date: May 2017 quality of care

OSF HealthCare, Peoria SENATE DISTRICT 46 HOUSE DISTRICT 92 BEHAVIORAL HEALTH Addressing the lack of integrated behavioral health services We rolled out integrated behavioral health services to 20 sites and are expanding system-wide. For this initiative we hired a behavioral health provider who: Received advanced training in primary care behavioral health Joined care teams in select medical offices Uses brief interventions and therapeutic techniques to promote $192k 2018 Q1 SALARIES behavioral change $200k access to care ED DEFLECTIONS Increases patient satisfaction Launch date: August 2015 the mental health of our communities

Memorial Behavioral Health, Springfield SENATE DISTRICT 48 HOUSE DISTRICT 96 BEHAVIORAL HEALTH Improving access to appropriate behavioral health services Behavioral health staff are embedded in physician offices, schools, community settings and the adopted neighborhood. Sites expand each year through fees, grants and staff reallocation. Services are provided in settings familiar to patients. Screenings are integrated in the electronic health record (EHR) and workflows. $1m STAFF & EHR CHANGE 64% increase in community employment $1.5m FUNDING CHANGES 22% decrease in police calls to the neighborhood 8% increase in health coverage in the neighborhood Launch date: January 2015

OSF HealthCare Medical Group, Peoria SENATE DISTRICT 46 HOUSE DISTRICT 92 BEHAVIORAL HEALTH Improving access to psychiatry resources for primary care providers We use innovative methods to bring psychiatric expertise to primary care providers (PCPs): Asynchronous e-consults via electronic medical record for PCPs and specialists Synchronous live video case consults with medication management for providers $6.3k/m VIDEO & E-CONSULTS access to psychiatry care $5k LOW-COST ACCESS psychotropic medication management Aligns psychiatry with integrated behavioral health care Launch date: January 2016

Lincoln Prairie Behavioral Health Center, Springfield SENATE DISTRICT 50 HOUSE DISTRICT 99 BEHAVIORAL HEALTH Improving medication compliance among behavioral health patients We implemented the following steps to improve medication compliance resulting in better patient outcomes and increased time spent on direct patient care: Automating our medication administration record Providing patient education Ensuring proper doses $87k Monitoring medication effectiveness Enhancing clinical pharmacy decisions SOFTWARE & TRAINING patient safety $147k STAFF TIME quality of care Educates patients on proper medication usage Launch date: January 2018

Riveredge Hospital, Forest Park SENATE DISTRICT 4 HOUSE DISTRICT 7 BEHAVIORAL HEALTH Improving suicide care in the acute inpatient setting A multidisciplinary team implemented several interventions including: Designating AMSR leaders (Assessing and Managing Suicide Risk) Training the implementation team and all clinical staff Updating policies and procedures Developing new clinical forms Implementing bridge appointments, bridge groups and post-discharge $56k STAFF TRAINING HOURS wellness checks $857k communication with patients and families REDUCED READMISSIONS Reduces patient harm Launch date: October 2016 quality of care

Linden Oaks Behavioral Health, Naperville SENATE DISTRICT 21 HOUSE DISTRICT 41 BEHAVIORAL HEALTH Enhancing safety in the behavioral healthcare setting Interdisciplinary teams used integrated strategies including: Non-violent crisis intervention training Early identification and de-escalation of behaviors Team intervention Focus on injury reduction Decreased use of mechanical restraints $212k STAFF TRAINING Emphasis on violence risk screening Enhances patient choice $148k FEWER HARM EVENTS patient safety Launch date: January 2015 Increases patient and family satisfaction

Carle Hoopeston Regional Health Center, Hoopeston SENATE DISTRICT 53 HOUSE DISTRICT 106 POPULATION HEALTH Combating childhood obesity through a community wellness program We implemented a community wellness program through Drums Alive that combines physical fitness with the benefits of music and rhythm. Participants include children: With mental and physical challenges Who are gifted and talented Who are fit and healthy $7.2k With aggression issues EQUIPMENT & EDUCATION 530 children reached to date $19k PER CHILD SERVED Decreases risk for chronic conditions Encourages healthy lifestyle Launch date: April 2017

Warner Hospital and Health Services, Clinton SENATE DISTRICT 51 HOUSE DISTRICT 101 POPULATION HEALTH Reducing inappropriate usage of the emergency department We implemented interventions based on our Community Needs Assessment: Care coordination Interdisciplinary team Patient call-backs Collaboration with practitioners for consistent opioid management Collaboration with local health department for dental resources $11k CARE COORDINATION Walk-in clinic for improved access to care $13k quality of care REDUCED ED VISITS Addresses opioid overuse Launch date: January 2017 patient and family experience

Katherine Shaw Bethea Hospital, Dixon SENATE DISTRICT 45 HOUSE DISTRICT 90 POPULATION HEALTH Increasing influenza vaccination in the community We held drive-thru flu shot clinics in the community at convenient times and without charge to recipients. Clinics were held: Every Wednesday in October At three different times (morning, noon and afternoon/evening totaling 6 hours each day) In front of our hospital and administered to people in $11.6k VACCINES & SUPPLIES their vehicles $12k 673 individuals vaccinated FLU-RELATED COSTS 520 flu illnesses prevented Launch date: October 2017 23 flu-associated medical visits prevented

Northwest Community Healthcare, Arlington Heights SENATE DISTRICT 27 HOUSE DISTRICT 54 POPULATION HEALTH Reducing 30-day readmissions using machine learning and AI We implemented a sophisticated healthcare data analytics system that allows us to visualize healthcare operations and clinical data in new and innovative ways. Using machine learning and artificial intelligence (AI) tools, we can pre-emptively identify patients special needs and correct them to reduce readmissions. $10k DATA COLLECTION TIME Tailors care to the patient $4.5m quality of care REDUCED READMISSIONS Increases patient satisfaction Launch date: November 2017

La Rabida Children s Hospital, Chicago SENATE DISTRICT 13 HOUSE DISTRICT 25 POPULATION HEALTH Improving the quality of life of caregivers We found that the quality of life of caregivers of medically complex children improves over time with primary care from an interdisciplinary medical home team. The team provides: Specialized pediatric care Care coordination Nutrition support Developmental support Behavioral support $8.7k SALARY SUPPORT Social work and advocacy Family education $33k 444 families served HEALTHCARE SERVICES Provides supports to alleviate stresses Launch date: February 2017 quality of life to decrease caregiver burnout

HSHS Good Shepherd Hospital, Shelbyville SENATE DISTRICT 51 HOUSE DISTRICT 102 POPULATION HEALTH Engaging the community in health and wellness We use several approaches to enhance community health: Wellness program for employees and the community Community education and outreach Exercise classes Participation in or sponsorship of health fairs and community events $37k 200+ program participants STAFFING & SPACE $1.1m overall health and well-being FALLS PREVENTION Reduces falls Launch date: January 2015

Genesis Medical Center Aledo, Aledo SENATE DISTRICT 37 HOUSE DISTRICT 74 POPULATION HEALTH Reducing metabolic syndrome among patients Metabolic syndrome is a group of conditions that puts people at risk for heart disease and diabetes. A multidisciplinary team implemented a metabolic syndrome initiative among 345 patients consisting of: Initial biometric health screening Naturally Slim 10-week training program Mentorship program $137k STAFF & TRAINING PROGRAM Post-biometric health screening $432k 64% reduction in diabetes HEALTHCARE COSTS 41% reduction in metabolic syndrome Launch date: February 2015 17.8 lbs. average participant weight loss

University of Illinois Hospital & Health Sciences System, Chicago SENATE DISTRICT 5 HOUSE DISTRICT 9 POPULATION HEALTH Improving the health of chronically homeless patients UI Health s Better Health Through Housing program provides stability for the chronically homeless by moving individuals directly from hospital emergency departments into stable, supportive housing with intensive case management. Our healthcare-to-housing pilot demonstrated significant reductions in healthcare cost and utilization. $250k HOUSING individual health 22% quality of life HEALTHCARE SERVICES Addresses homelessness in the community Launch date: November 2015