HMI’s Elizabeth Brown and John Helfrick reviewed patient information management with SRMCRI staff.

HMI and Sri Ramachandra measure progress of quality improvement initiative

Sri Ramachandra Medical College & Research Institute (SRMCRI) welcomed a team from HMI in September to conduct a survey of the institution’s affiliated medical center in order to further the partners’ collaborative efforts to enhance health care quality and patient safety. The Chennai, India institution has set its sights on accreditation by Joint Commission International (JCI) for the Sri Ramachandra Medical Centre, a 1,050-bed teaching hospital.

The team from HMI included Harvey Makadon, MD, HMI vice president of global programs; Elizabeth Brown, RN, MSN, MBA, director of clinical service; John Helfrick, DDS, MS, FACD, FICD, senior consultant at HMI; and Kenneth Sands, MD, MPH, director of  health care quality at Beth Israel Deaconess Medical Center.

The HMI team met with SRMCRI leadership, including committee chairs and department chairpersons, and completed a comprehensive tour of the hospital facilities, including nursing wards, laboratories, emergency care units, and medical record and IT departments. Makadon said one of their goals was to look at all aspects of hospital operations and the environment and provide the administrative leaders at Sri Ramachandra Medical Centre with practical suggestions in areas needing improvement. The team noted the enthusiasm among the hospital staff, saying it was clear that the hospital was succeeding in one of its most important objectives: to create a culture of quality that is a critical precursor for improvement.

The HMI team met with SRMCRI leadership and completed a comprehensive tour of the hospital facilities.

“SRMCRI’s leadership and that of the Chancellor’s has been extremely important in getting this effort started,” said Makadon. “The process of spreading and prioritizing change in an organization the size of SRMCRI is enormous, and a great deal of progress has been made in this regard.”

Rahda Venkataachalam, chief executive director of the hospital, said, “Every person in the organization is responsible for patient care quality and safety. The commitment to quality begins by recognizing and reporting incidents or ‘near misses’ that are indicators of lapse in quality or safety.” She added that the hospital has set up a secure, confidential quality hotline to encourage members of the organization to report incidents.

Sands, in discussions with the hospital’s leadership, encouraged them to formally develop a Department of Quality and Patient Safety to oversee quality and patient safety. He presented examples of quality and safety efforts at BIDMC in Boston, highlighting the importance of a quality management plan in the institution’s organizational philosophy, structure, and strategic planning. Sands also emphasized the need for collaboration among clinical chiefs and cross-disciplinary discussions, especially with its nursing staff, and stressed the value of putting in place a robust credentialing and privileging process for physicians and nurses.

The hospital’s efforts have been bolstered by the increased involvement and collaboration of nurses throughout the organization. To encourage further progress in this area, Brown suggested the development of a pilot initiative in nurse training within a specific clinical area, such as pediatrics, to develop competency goals for both improvement in patient outcomes and overall objectives of the nursing team to increase retention of the staff.

As 2006 comes to a close, HMI and Sri Ramachandra will continue to work on implementing the infrastructure, roles, and procedures to maintain the momentum of the quality improvement program. The partners are also looking ahead to July 2007, when they will commemorate the tenth anniversary of the alliance.

HMI's Elizabeth Brown facilitated workshops with SMRCRI nursing staff to develop competency goals.

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