Creating a center of excellence.

Area of Science:

• Healthcare Management
• Quality Improvement in Healthcare
• Patient Care Delivery Systems

Background:

• Establishing a hospital as a Center of Excellence requires demonstrating superior patient care, outcomes, and financial performance.
• St. Luke's Episcopal Hospital in Houston sought to differentiate itself through a structured quality improvement initiative.

Purpose of the Study:

• To outline St. Luke's Episcopal Hospital's three-pronged quality improvement approach.
• To provide a model for other institutions to adopt for achieving Center of Excellence designation.

Main Methods:

• Implementing service line management to coordinate staff and services for specific patient populations.
• Utilizing a case management model for individualized care planning, coordination, and cost-effective delivery.
• Employing outcomes management, including outcomes assessment, to track patient population experiences and drive changes.

Main Results:

• The integrated approach improved patient care, notably for cardiovascular patients.
• The hospital modified care methods based on outcomes assessment data.
• Participation in the Medicare Bypass Demonstration project in 1993 led to designation as a Medicare Participating Center of Excellence.

Conclusions:

• A multi-faceted quality improvement strategy combining service line management, case management, and outcomes management can establish a hospital as a Center of Excellence.
• Physician buy-in is crucial for implementing significant changes in care delivery.
• External validation, such as through Medicare projects, can further solidify a hospital's Center of Excellence status.