Stephen Jencks, M.D., director of quality coordination at the CMS, as well as two hospitals and a hospital group, are among seven winners of the 2004 Ernest A. Codman award for the use of outcomes measurement to achieve improvements in the quality and safety of healthcare, the Joint Commission on Accreditation of Healthcare Organizations announced Monday.
Codman, a Harvard Medical School graduate and surgeon, joined the medical staff of Massachusetts General Hospital in 1895 and proposed the "End Result Idea" -- revolutionary for its time -- saying patient outcomes should be the ultimate measure of quality of care.
JCAHO President Dennis O'Leary, M.D., in a press statement, said the winners were "truly the vanguard of raising the bar for health care quality."
Three months ago, Jencks, 63, a retired rear admiral and a member of the public health service for 33 years, was named as a civilian to be director of quality coordination at the CMS, where he pushes for consistency in quality improvement programs at Medicare, Medicaid, the federally contracted quality improvement organizations and the federal nursing home survey program.
Jencks said the award came for six previous years of work in which he was director of the quality improvement group at the CMS.
During that period, he said, the government healthcare agency dramatically increased the use of outcomes data to improve quality of care and pushed for transparency of results reporting. It also switched to an emphasis on cultural change to achieve quality improvement, "taking an entire system that was focused on kind of a bad-apple approach to quality and change it to a system focused on a notion that we were trying to improve the care of the public, rather than changing the behavior of a few docs."
In the years ahead, there will be no letup by the CMS on its quality-improvement drive, Jencks predicted.
"The agency is really doing an all-fronts effort," he said. "I think you'll see a growing emphasis on public data. You're seeing a growing number of pay for performance demonstrations and pilots. You'll only see more of those. The administration is clearly committed to them."
Jencks said the CMS also will focus on promoting specific, collaborations with providers, for example, improving immunization rates in nursing homes and reducing surgical complications.
The 301-bed Stamford (Conn.) Health System won for developing a protocol to monitor blood glucose levels in critically ill patients, after which mortality rates for these patients dropped 29% and length of stay decreased nearly 11%. The other hospital winner was the 686-bed Staten Island University Hospital in New York, which implemented a protocol for high-risk hip fracture patients, after which mortality rates decreased from 4.9% to 1%.
In the multiorganizational category, the winner was Novant Health, the seven-hospital, 1,978-bed group based in Winston-Salem/Charlotte, N.C. Its safety system for the administration of Warfarin resulted in a 38% reduction in adverse effects for inpatients and 51% reduction for outpatients.
Other categories and winners were:
The awards will be presented Thursday in Chicago at the JCAHO national conference on quality and patient safety.