Advanced Illness and Conversation Project
Northwell Health continues to improve care and enhance clinical outcomes by engaging patients and their families in discussions about options for advanced care and treatment that are consistent with the patient’s values, beliefs and needs. As pioneer sponsors of the Conversation Project, a public engagement campaign with a goal of making sure that every person’s wishes for end-of-life care are expressed and respected, the health network is testing and spreading new and innovative ways to encourage conversations among patients, families and healthcare providers.
Antibiotic resistance is a major issue confronting healthcare providers and their patients. Changing antibiotic resistance patterns, rising antibiotic costs and the introduction of new antibiotics have made selecting optimal antibiotic regimens more difficult now than ever before. Furthermore, history has taught us that if we do not use antibiotics carefully, they will lose their efficacy. Misuse and overuse of antimicrobials is one of the world’s most pressing public health problems. Infectious organisms adapt to the antimicrobials designed to kill them, making the drugs ineffective. People infected with antimicrobial-resistant organisms are more likely to have longer, more expensive hospital stays, and may be more likely to die as a result of an infection. The mission of the antimicrobial stewardship program is to promote the appropriate use of antibiotics, through uniform policies, procedures, education and outcome measures.
Blood Avoidance Program
The Northwell Health Blood Avoidance program was established in response to the expressed need of community members for access to blood avoidance services. Objectives of the program are to:
- Establish system-wide best practice guidelines for blood avoidance
- Establish education for providers and support staff on blood avoidance and patient-specific care
- Establish a tertiary care Center of Excellence in Cardiothoracic (CT) Surgery, Orthopedics, and Obstetrics for the blood avoidance
- Create a cohesive and centralized system policy and informed consent for blood avoidance
Community Paramedicine Program
A new Community Paramedicine Program (CPP) offers an on-call system, twenty-four hours a day, seven days a week to patients who are living at home with advanced illness. The goal of this innovative partnership between the Northwell Health Advanced Illness Program (House Calls) and the Center for Emergency Medical Services is to ensure that frail, homebound patients with advanced illness have immediate access to care at any time of day or night to avoid unnecessary emergency department visits and hospitalizations.
Diabetes Community Screening and Education
Through community outreach, the diabetes screening program provides resources and support to individuals who are at high risk for diabetes. The mission of this program is to provide resources and support for the prevention and treatment of diabetes in our local communities. Goals are to increase access to care, offer diabetes screening and community-based diabetes education, and refer individuals to diabetes prevention programs and/or treatment in order to reduce the impact of diabetes as a public health concern.
Follow My Health
In 2014, Northwell Health launched a new patient portal/personal health record, called “Follow My Health.” Clinical information from a physician’s office and/or hospital electronic health record (EHR) is sent to the portal allowing patients to electronically access clinical information, such as medication lists, laboratory test results and discharge instructions from any computer, smartphone or tablet, twenty-four hours a day, seven days a week. The portal provides patients with educational materials and tools to facilitate communication with physicians and their staff about appointments and medication refills, among other things. The goal of “Follow My Health” is to engage patients in managing their care.
Healthcare-associated infections, such as catheter-associated urinary tract infections (CAUTIs), central line-associated bloodstream infections (CLABSI), clostridium difficile associated disease (CDAD), carbapenem-resistant enterobacteriaceae (CRE), methicillin-resistant staphylococcus aureus (MRSA) and surgical site infections (SSIs) may cause patient harm, increase morbidity and mortality, and prolong length of stay. In keeping with the national agenda to reduce healthcare-acquired conditions, Northwell Health has adopted evidence-based clinical practices including daily surveillance and real-time feedback to staff to reduce the incidence of healthcare-associated infections.
Patient Identification — Developing Highly Reliable Processes Across Settings
The Northwell Health Patient Identification initiative promotes awareness, education and implementation of best practices related to patient identification. There are currently 23 sites/service lines that are actively working on one or more high-risk patient identification initiatives. One example is correct patient identification during radiological testing and services. For its achievements in promoting patient safety through patient identification, Northwell Health was the recipient of the 2015 John Q. Sherman Award for Excellence in Patient Engagement and the 2015 National Patient Safety Foundation (NPSF) Stand Up for Patient Safety Management Award.
Pressure Ulcer Task Force
The Northwell Health Pressure Ulcer Task Force, chaired by a Certifed Wound Specialist Physician and a Wound Ostomy Continence Nurse has established a uniform standard of care for pressure ulcer prevention and treatment across the continuum. As a result of its achievements, Northwell Health was the recipient of the 2014 Hospital Association of New York State (HANYS) Pinnacle Award for Quality and Patient Safety for its network-wide approach to reducing healthcare-acquired pressure ulcers.
By launching a network-wide initiative to reduce sepsis mortality, Northwell Health has developed reliable processes, reduced variation in practice and implemented evidence-based best practices and protocols across 11 acute-care hospitals in all ED, inpatient, and pediatric settings. These achievements propelled Northwell Health into a leadership position, earning the health network the 2014 John M. Eisenberg Patient Safety and Quality Award. In collaboration with the Rory Staunton Foundation, Northwell Health is mobilizing a national movement to improve the early diagnosis and prevention of sepsis.
New York is the first state in the nation to mandate a series of protocols to diagnose and treat sepsis before it becomes fatal. The protocols which relied heavily on our health system’s best practices were named Rory’s Regulations for a 12-year-old boy, Rory Staunton, who died in a New York City hospital from an undiagnosed case of sepsis.
Northwell Health launched the New York area’s first hospital-based Helicopter Emergency Medical Service in 2014. The program, called SkyHealth, is a partnership with Yale-New Haven Health in Connecticut. Patients with both health networks experiencing life-threatening illnesses or trauma receive emergency medical care by helicopter and are quickly down to the most appropriate hospital.
North Shore University Hospital, the home of SkyHealth’s new helipad, is verified as a Level I Trauma Center by the American College of Surgeons (ACS) and is the first hospital in the downstate region to receive this designation. Southside Hospital is verified as a Level II Trauma Center and the Cohen Children's Medical Center is a Level I Pediatric Trauma Center (ACS).
Critical Care — Tele-Intensive Care Unit (eICU)®
To ensure constant and high-quality care in the intensive care units (ICUs), a new information technology (IT) system called the eICU is being deployed to remotely monitor critically ill patients 24/7. The eICU uses state of the art technology and audiovisual equipment, as well as a team of highly critical care physicians, nurses and other healthcare personnel to support patient care.
Behavioural Health — Emergency TelePsychiatry
The emergency TelePsychiatry program provides patients in emergency departments (EDs) with around-the-clock access to high-quality behavioral health assessment, stabilization and admission/referral as needed. Utilizing secure video conferencing technology, clinicians provide remote consultative and diagnostic services to patients and families in crisis ensuring high-quality care 24/7.