Clinical leaders must be effective in an ever-changing environment and successfully drive improvements in clinical practice. Several presentations on clinical leadership at VITAL2018, our annual meeting, highlighted key insights for clinical leaders at essential hospitals.

1. Collect meaningful data to improve quality of care.

Leaders at UF Health Jacksonville presented a debrief tool developed to help clinicians determine the root causes of health care–associated infections and use real-time data and feedback to reduce catheter-associated urinary tract infections (CAUTIs) and central line–associated bloodstream infections (CLABSIs). The health system created an electronic report and reviewed infections as a team to educate staff and improve reporting, resulting in a 69 percent decrease in CAUTIs and a 62 percent decrease in CLABSIs.

In a separate presentation, clinical leaders from the University of Alabama at Birmingham (UAB Health System) discussed a unique tool they developed to screen for sepsis. The tool was designed to reduce alert failure for clinicians by focusing on four key screening questions. Through this effort, UAB increased its screening compliance to 81 percent in acute care and 95 percent in the intensive care unit.

2. Intentionally engage staff to drive improvements and implement changes.

Carmen Wah Liang discussed efforts to enact change over three years at the Adult Urgent Care Center at Zuckerberg San Francisco General Hospital and Trauma Center.

A performance improvement team observed daily processes and offered consultation on how to improve clinical operations. In addition, clinical leaders held a staff-only workshop and implemented a staff satisfaction survey, which found that communication, accountability, and environmental support were most important to the organization. Throughout this process, clinical leaders learned the importance of linking mission, staff priorities, and data when implementing change.

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Carmen Wah Liang from essential hospital Zuckerberg San Francisco General talks change management at VITAL2018 mini-session. They used it to develop workforce and improve clinical operations.

3. Build community partnerships to help provide whole-person care.

Clinical leaders from Christiana Care Health System presented on the implementation of an opioid withdrawal clinical pathway, developed to help screen, identify, and treat admitted patients for opioid withdrawal. The pathway included partnerships with community clinics to aid patients receive in long-term care and recovery assistance. Because of this partnership, 40 percent of patients experiencing opioid withdrawal engaged in ongoing care in the community after discharge.

A partnership between clinical leaders at Harborview Medical Center and local skilled nursing facilities helps to transition complex patients to a clinically appropriate setting. An interdisciplinary bed readiness team established weekly check-ins about these patients and created a report specifically for transfers to skilled nursing facilities. The report includes information on immunizations and follow-up appointments, as well as qualitative notes on behavioral issues. Through this partnership, Harborview avoided 9,000 bed days and more than $6 million in costs.

Don’t miss valuable insights like these and many others next year, at VITAL2019, June 19-21, in Miami. Our call for presentation and poster proposals opens Oct. 1.