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Compirion Helps Baxter Regional Medical Center Achieve Patient Satisfaction Rankings in the Top 5th Percentile Nationally

MOUNTAIN HOME, Ark., May 5 /PRNewswire/ -- Baxter Regional Medical Center has recently reached the top fifth percentile ranking for patient satisfaction, in the National Database after a 6-month long improvement project in the Emergency Department. They have also reached number one in Arkansas, number one in Region Seven, and number one in Missouri. Compirion Healthcare Solutions, a hospital process improvement firm from Elm Grove, Wisconsin helped them get there.

Baxter Regional Medical Center prides itself on providing big city, state-of-the-art healthcare with a hometown touch. However, before the improvement project, its patient satisfaction ranking of 59% evidenced that it was struggling.

The most obvious problem seemed to be the long wait times. While the clinical performance was high, it was determined by hospital administration that the long wait times were just a symptom of other problems throughout the Emergency Department unrelated to quality of care. After several attempts to correct the situation, the ED staff was losing hope. Hospital leadership determined that outside help was needed. Compirion Healthcare Solutions based in Elm Grove, Wisconsin, was engaged to manage the improvement process.

According to hospital CEO, Ron Peterson, "Compirion was awarded the contract because they looked different from every other consulting group I had seen. They worked on site and they implemented the changes. They presented a total package for a lump sum (of money), with goals that were agreed upon beforehand...and they had the same goals we did."

Compirion sent a team to work on site, side by side with hospital staff. The first few weeks were spent in observation of the processes and procedures in the department. Compirion provided mentoring, leadership, coaching, and problem-solving facilitation while encouraging teamwork. They identified problems and helped set up pilot initiatives for testing solutions.

Dr. Pat Black, Emergency Department Medical Director commented, "Compirion made a significant contribution to the improvement project by showing us the value of observation and helping us set up a process to deal with problems. They did a fabulous job. They never dropped the ball or minced words. They showed us how to define the problems and the benefits of solving them instead of repeating the same problems over and over.

"One of the things Compirion's observation process revealed was the slow response from the teams on 'the floors' when they were needed in the Emergency Department. Our solution was to set up an ancillary team from lab and x-ray. We made it part of their responsibility to respond to needs in the Emergency Department in under 45 minutes.

"Another problem revealed through observation was that the Emergency Department physicians were complaining that nurses currently in triage were not up to the job. They were Fast Tracking the wrong people. As a result, jobs were reassigned putting the best nurses in triage, and Fast Track was eliminated. Next, we worked to redefine the Charge Nurse role making it more supervisory. In addition, Charge Nurses now coordinate with triage to get patients into beds."

Dr. Black added, "Charge Nurses want to be care nurses and disappear into rooms with patients. Without constant monitoring, we have a tendency to backslide. Our teams have to be in place at all times. Even so, we could use a little booster shot once a year."

Baxter's Michele Pierski commented, "As Director of the Cath Lab/ARU, I knew there was a problem with chest pain patient wait times and I had been trying to fix that for quite a while. Compirion supplied the 'oomph' that helped move things forward. When Compirion arrived, the first thing they did was get everyone in the Emergency Department on-board. The absence of a baseline for Core Measures was the first problem we uncovered relevant to wait times. They helped us determine one so we had something to measure against. Our Core Measures baseline for the first quarter was found to be 50%.

"Previously, the process for the initial handling of chest pain patients had been to call a physician from cardiology to the Emergency Department to perform an EKG. This burned up critical minutes. Now, a quick EKG is performed by an Emergency Department technician who has a printer nearby. The print is handed to the ED physician to read immediately."

Dr. Black added, "We have implemented a 'Code Stemi' where everyone is notified via overhead page. The team literally swarms on the patient. Chest pain patients are now prepped by the Emergency staff and it is the ED physician who determines whether a person goes to the Cath Lab or not."

Additionally, during peak times, a person from the Cath Lab is in the Emergency Department to expedite cardio patients. After implementing these changes, Door-to-EKG time compliance to the Core Measure rose to 78%.

"Our ambulances now have the ability to perform twelve-lead EKGs. These EKGs are sent directly from the ambulance to the ED. In this way we can have EKG results before the patient reaches the hospital, saving those critical minutes," said Pierski.

Other Core Measures initiatives for cardio patients were:

  • Aspirin on arrival added to the standard order sheet
  • Standardized procedures for Code Stemi
  • Development of Code Stemi packets containing all paperwork, Med Kits, and orders/protocol sheets
  • Realtime data sheets that flag issues immediately
  • Creation of a patient preparation board to educate ED staff on proper patient prep for cath procedures
  • EMS or ED physician initiation of Code Stemi call-in
  • Second IV started by EMS when feasible

Key Core Measures results over the term of the improvement project included:

  • ASA at arrival from 86% to 98%
  • Primary PCTA within 90 minutes from 56% to 91%
  • Blood culture prior to antibiotic for pneumonia patients from 90% to 100%
  • Antibiotic within 4 hours from 89% to 94%

Pierski added, "Their observation process proved to be a fabulous tool that I now use all the time. I used the tools Compirion supplied to move the whole house forward."

The results of the improvement project were:

  • Core Measures consistently above the 90th percentile
  • Door-to-admission time reduced from 4.41 hours to 2.3 hours
  • Door-to-discharge time for treated patients from 3.41 hours to 2.08 hours
  • Percentage of those who left without being seen (LWBS) from 6.8% down to 2%
  • Patient billable volume up 15%

At the conclusion of Compirion's engagement, Press Ganey patient satisfaction rankings were in the 85th percentile. Ten months after the end of the project, scores continue to climb and are consistently in the 95th percentile ranking, making Baxter Regional Medical Center number one in Arkansas, number one in Region Seven, and number one in Missouri. They are rated in the top 5% of the national database of 1053 hospitals.

According to CEO Peterson, "It is nice to know they were here. They were committed until the goals were achieved. They are very goal focused. Now there is more teamwork (at the hospital)."

Dr. Black concluded, "Our ED Physicians have reported that the improvement in patient satisfaction has made their jobs better. What the Compirion process taught us was respect for the patient and our coworkers. That is what it boils down to."

Compirion Healthcare Solutions, LLC is based in Elm Grove, Wisconsin. Compirion is a leader in healthcare consulting firms focusing on whole hospital process improvement. They work on site using a team approach and offer a money back guarantee that all goals are completed. Client hospitals show sustainable performance improvements in billable volume, patient satisfaction, core measures, length of stay, bed control, case management and staff retention. Their experience includes emergency room, surgical services, outpatient and inpatient nursing care improvement projects. They contract only for measurable outcomes to help achieve patient satisfaction, staff loyalty and a better bottom line.

For more information on Compirion's sustainable healthcare solutions call 1-866-661-4677, or visit

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SOURCE Compirion Healthcare Solutions, LLC
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