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Virginia Mason Medical Center (VMMC)

Virginia Mason Medical Center, based in Seattle, WA, experienced major financial challenges in 2000. The board, as part of organizational transformation efforts, was “willing to focus on and believe in the business case for quality” and helped senior leaders develop a one page strategic plan, a pyramid with the patient at the top. Prior to that the organization had too many priority areas and was not focused. Gary Kaplan, the CEO noted “if you are chasing 54 priorities you are not really chasing any of them adequately. So we’ve gotten much better at honing in and trying to triangulate … and putting our work on it, so we’ve got clear organizational quality and safety goals.”

The current board dashboard is presented in the form of a pyramid and contains three of four measures for each strategic area, including quality and patient safety. The Quality Committee of the board has a dashboard tracking 20 items, but what is reported to the board is condensed to 3 or 4 items. For example, safety goals relating to the overall goal “ensure the safety of our patients” include the following safety goals:

  • Zero avoidable deaths
  • Zero failures to follow specified critical safety policies
  • Critical results reporting: clinical hand off communication
  • 100% performance with clinical care bundles:
    • Acute myocardial infarction
    • Congestive heart failure; stroke; central line
    • Surgical site infection
  • Zero adverse drug events
  • Medication reconciliation targets
  • Zero avoidable falls