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Quality care top priority at SNMH

Quality, a word used almost habitually in businesses and marketing, means something quite different when used in a hospital setting. How do you define it, achieve it, measure it, reproduce it, and improve it? Those are questions taken very seriously by a lot of people.

At Dignity Health Sierra Nevada Memorial Hospital (SNMH), quality represents a team of individuals monitoring hundreds if not thousands of metrics on a daily, weekly, monthly and ongoing basis. There is a standing board committee that examines quality at every level of service, both by the pinch and by the peck. And the Quality Department focuses on fine-tuning processes, outcomes and measurements on a daily basis. But in the end, quality is the job of everyone at the hospital.

At its simplest level, Angela Sheehan, one of several performance excellence analysts at SNMH, explains, “In a hospital context, quality is doing the right thing, at the right time, in the right way to achieve the best possible care for the patient. It means getting the services you need when you need them, and in the appropriate manner.”



Because a hospital provides such a wide range of services, from taking blood samples in the lab to administering radiation therapy in the Cancer Center, setting bones in the Emergency Department, cleaning rooms and providing appropriate nutrition, all of these tasks eventually are examined, measured, and analyzed for possible improvement. Then they are assessed — sometimes daily — to make sure they’re carried out appropriately.

Sheehan noted the scientific element that is attached to quality programs.




“Clinical quality of care goes well beyond having a pleasant interaction between a physician and a patient. It is how we use evidence-based, proven methods of care to save lives and reduce the time that someone might need to stay in the hospital. We strive to exceed patient expectations while delivering the highest level of care in the safest way possible.”

The hospital’s community-based board of directors is intimately involved in this process, according to Michele White, who chairs the board’s Quality Committee.

“Quality is our No. 1 priority,” she declared. “We keep our eye on that ball 100 percent of the time to ensure that we are providing the best possible care we can for our patients and our community.”

To that end, the quality team is proud of many stand-out achievements. Earlier this year, SNMH was ranked by Healthgrades as among the top 5 percent of hospitals in the nation in its overall pulmonary care, and the top 10 percent in stroke treatment and women’s health services. This was in a comparison to 4,500 hospitals across the U.S. SNMH was also given five-star ratings for its ability to treat heart attack, stroke, pneumonia, and sepsis, along with a five-star rank for total knee replacement.

SNMH recently received a top score of “A” in the Leapfrog Hospital Safety Survey and its stroke program received Joint Commission Advanced Certification as a Primary Stroke Center.

Virtually everybody is watching the hospital perform, White said. In addition to Dignity Health quality standards, the hospital must also meet the quality parameters of federal and state regulators.

Standards include such things as the Emergency Room meeting a goal of 30 minutes from the time a patient arrives to when she sees a provider. Similar standards exist for the management of stroke, surgical site infections, and sepsis. All these things are measured and reviewed.

“When I’m in the community I brag about the team of people I look at each time I call my Quality Committee to order,” White said. “To a person, they are competent, caring, and committed — all superb.”

Dr. Brian Evans, vice president for medical affairs, concurred.

“It takes a team of outstanding professionals to maintain high standards of quality, and we’re fortunate to have such a team here,” he said. “Our quality department is dedicated to success, as are the medical committees that oversee these efforts. But it comes down to the people who work directly with patient care, and they do an outstanding job.”

Consistent quality care and high rankings are vital to the hospital’s ongoing accreditations, and even to things like recruiting new doctors to the community.

“Bright doctors won’t come to a mediocre hospital,” White said.

Patient feedback is also important to the hospital’s ongoing quality assessments, Sheehan said.

“We ask our patients and their families to fill out surveys and return them to us for feedback,” she explained. “Our administrative leaders regularly visit patient rooms to check in and ask about their visit. We want to know if patients find anything lacking, or what may have impressed them during their stay. We use the information to make improvements in our nursing units and other departments. We make sure our patients’ concerns are addressed.”

All physicians providing care for patients at SNMH are members of the medical staff and are independent practitioners, not employees of the hospital.


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