More than an award: What our top ranking means for your health
For the first time, U.S News & World Report included a New Jersey hospital among the nation's top 20, and I am so proud that it is the flagship of Hackensack Meridian Health: Hackensack University Medical Center.
How did we get here? It's a continuous effort to create a culture of quality, safety, transparency, and trust and to embrace analytics and advanced technology and, of course, focus relentlessly on our patients. Awards are great, but the real gift is saving more lives and enhancing the quality of those lives in the most fundamental ways. Last year alone, at Hackensack University Medical Center, 354 people who were not expected to live given severity of their illness are enjoying family, friends, and so much more. This is why we do what we do.
Here are a few lessons I've learned along the continuing journey to getting better.
1. Create a culture that focuses on safety and quality.
In more than 40 years of healthcare leadership, I have seen that the blame game does not work. The industry has shifted rightly to a non-punitive, just culture that encourages the reporting of errors and near-misses without fear of retribution. This approach resulted in a 95% reduction in commercial flight deaths, and it's making a measurable difference in healthcare, too.
Throughout our 18-hospital system, we have reduced preventable deaths, hospital-acquired infections, preventable readmissions, surgical complications, and falls. And our patient satisfaction scores at our flagship improved 23% during the last few years, greatly outperforming the national rate of improvement.
We also invest in the best teams, and that's paying off, too. We recruit top physicians and nurses and continue to monitor their performance throughout their tenure. Our teams focus care on the quadruple aim: improving the patient experience, improving population health, delivering more value, and enhancing the nurse and physician experience. Daily team huddles help staff report near misses, great successes, and everything in between, a key component in developing a high-reliability organization. It's important to note that we are already teaching this to the next generation of physicians at the Hackensack Meridian School of Medicine.
2. Create standardized processes and embrace evidence-based practices.
Don't underestimate the basics. One of the most notable achievements in patient safety was a simple and effective tool to reduce central-line associated bloodstream infections (CLABSIs), which can be deadly. A five-step checklist requires teams to cover the fundamentals, including proper hand hygiene and gloving. After 18 months, CLABSI rates decreased at Johns Hopkins by two-thirds and the processes are now used in hospitals throughout the country.
We are taking best practices and disseminating them across the entire network, a major advantage of an 18-hospital system. Here's an example that we developed during COVID at Hackensack University Medical Center and continue to use. The Joint Commission, which is responsible for evaluating U.S. healthcare organizations, reported that poor communication is a contributing factor in more than 60% of all hospital adverse events. We have multi-disciplinary rounding to ensure there is effective communication among clinicians. Each hospital floor has a leader, who is a hospitalist who coordinates care and pulls in everyone—pharmacists, physical therapists, etc.—to understand what's going on with the patient, who joins in the conversation along with a loved one.
3. Put people first.
We have all been patients. It's clear what patients want: confidence in their care team and the institution. At Hackensack Meridian Health, every part of the patient journey focuses on patient care, whether it's nursing or in groundbreaking construction. Nearly two-and-a-half years ago, we opened an $800 million 9-story surgical and intensive care tower at Hackensack University Medical Center with all private rooms, six daVinci robots, and an intraoperative MRI so patients can remain in the OR for imaging. In their private rooms, patients have a tablet to control lights, shades, and temperature and the option to order from an extensive menu.
We also make sure every patient has a care companion—a loved one who can stay 24/7 whom we provide with meals, parking passes, and a pull-out bed and who we include in every patient conversation with our staff. This is a great comfort to patients, enhances care, and is a real differentiator for our network.
Beyond having exceptional teams, we make sure we care for the caregivers. Hackensack Meridian was recognized this year as a Fortune 100 Best Places to Work among all companies, across all industries; 85 percent of our team members consider HMH a great place to work.
We are supporting our teams in myriad ways, including turning to AI and other technology to ease administrative burdens. We also provide generous financial support for team members to continue their education.
4. Leverage data and technology.
Timely data collection and analysis are at the core of good care. We created dashboards to act like GPS and put that data in the hands of the clinical teams at the bedside and during huddles. It's not only patient data that's available; the data also offers comparisons to national averages, further empowering teams. No one ever became a nurse or doctor to be average.
There's no question AI is having a transformative impact. It has the potential to improve care delivery on a scale we have never seen. Predictive analytics can help hospitals better focus on patients at high risk for various conditions or let executives know when they need to schedule more staff. When I think of all that we have achieved and where we are headed, I am reminded of the iconic football coach and legend Vince Lombardi who said: 'Perfection is not attainable; but if we chase perfection, we can catch excellence.'
Robert C. Garrett, FACHE, is the CEO of Hackensack Meridian Health, New Jersey's largest health network with 18 hospitals, more than 500 patient locations and the Hackensack Meridian School of Medicine.
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