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Helgerson: Maintaining standards amid growth

Legacy Salmon Creek Medical Center takes steps to ensure quality

The Columbian
Published: January 21, 2015, 4:00pm
2 Photos
The Columbian
Dr. Hoa Ly, center, and registered nurse Susan Frederick go over a checklist with cardiac patient Marilyn Wright, 64, of Vancouver at Legacy Salmon Creek Medical Center. Administrators and staff have worked together to maintain high-quality care in an era of unprecedented growth, says Bryce Helgerson, chief administrative officer.
The Columbian Dr. Hoa Ly, center, and registered nurse Susan Frederick go over a checklist with cardiac patient Marilyn Wright, 64, of Vancouver at Legacy Salmon Creek Medical Center. Administrators and staff have worked together to maintain high-quality care in an era of unprecedented growth, says Bryce Helgerson, chief administrative officer. Photo Gallery

Find more essays from each of the panelists at this year’s Economic Forecast Breakfast at www.columbian.com/economicforecast

Legacy Salmon Creek Medical Center has experience unprecedented growth for the past 18 months, hiring more than 200 new staff, increasing our annual number of baby deliveries from 2,200 to more than 3,000, and increasing our emergency room visits from 50,000 annually to more than 65,000 this past year.

Much of that growth is tied to our contract with Kaiser Permanente, which went into effect on Oct. 1, 2013. We are now the hospital of record for Kaiser’s 100,000 members in Clark County. A smaller part is tied to the Affordable Care Act, which has brought newly insured Clark County residents into the hospital. And we also know that more people are choosing Legacy for their health care needs.

This is all good news for us; it provides us an opportunity to pause and consider how this growth could shape our future. As we have moved into this time of change, our staff has made it clear that they didn’t want our high standards for quality and our great work culture diminished by the sudden growth. We have addressed these concerns in a number of ways that will help us continuously improve the quality of our care in 2015. These include:

Lean work principles: Lean management principles were originally born out of manufacturing, but have become the standard for high-quality health systems across the country. Key Lean concepts — make it visual, use data to manage change, standardize work processes and create capacity — help us seek continuous improvements, identifying specific goals. A recent rapid improvement process around room turnover times for discharges, for example, helped us save 23 hours of combined staff work time each day.

Checklists: Tied to standardized work, we have created checklists for clinicians around specific care areas, so we do the right thing every time for every patient. This eliminates risks of an error taking place or a step missed. Using this approach, we have reduced heart failure readmission rates at Legacy Salmon Creek by 36 percent since 2012.

Values in action: In addition to the standard Legacy Health new-employee orientation, Legacy Salmon Creek offers a quarterly Values in Action class. That class covers what we call our “Creek-ness,” the spirit of camaraderie and commitment to excellence here. This is an important introduction to our hospital and serves as an opportunity to showcase to our new team members our value of high-quality patient care and service. During our major hiring phase, we held VIA classes twice a month.

Daily safety huddle: More than a year ago, we introduced what we call the daily safety huddle to our routine. It’s a stand-up, 15-minute meeting held every weekday at 11 a.m. Hospital leadership and managers, representing all departments, report any rising concerns or other issues that have come up in the past 24 hours which may affect the next 24 hours of hospital operations. We also discuss any unusual or non-routine procedures that are being performed in the hospital on a given day. The huddle allows us to address concerns in real time, with everyone in the room together. It’s amazing to see all hands on deck ready to help each other solve any issue, small or large, to provide a safe environment for patient care.

For many years health care has struggled to provide a consistent experience for the patient, something in the industry known as the “culture of always.” At Legacy Salmon Creek we are intentionally focused on achieving that culture for anyone who may seek us for care.


Bryce Helgerson is chief administrative officer at Legacy Salmon Creek Medical Center.

Find more essays from each of the panelists at this year's Economic Forecast Breakfast at www.columbian.com/economicforecast

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