Innovations in Clinical Care
The Innovations in Clinical Care award is presented to the physician, nurse and/or team who demonstrates a visionary approach to problem solving and performance improvement.
Johns Hopkins Howard County Medical Center
Eric Schwartz, Co-medical Director of the Cardiac Catherization Lab
Peter Johnston, Co-medical Director of the Cardiac Catherization Lab
Johns Hopkins Howard County Medical Center has always been at the forefront of cardiac treatment. The hospital was involved in the early trials of stent placement in heart attacks back in the 1990s. However, for many years a life-saving procedure called cardiac catheterization was only allowed to be done on an emergency basis at Johns Hopkins Howard County Medical Center, while patients needing elective procedures (including patients having certain types of heart attacks) had to be transferred to The Johns Hopkins Hospital. In April 2020, just after the COVID pandemic began, Johns Hopkins Howard County Medical Center was approved to perform elective cardiac catheterization procedures. Not only were staff required to learn how to navigate COVID protocols, they also were managing a large increase in volume of patients needing the procedure. Through the hard work and dedication of the catheterization lab staff, with their physician leaders, the program has become one of the most successful at Johns Hopkins Howard County Medical Center and has been an example of how to expand a critical patient care program, in the middle of a deadly pandemic.
Johns Hopkins All Children’s Hospital
James Quintessenza, Heart Institute Co-Director and Chief of Cardiovascular Surgery
Ashish Shah, Heart Institute Director of Patient Safety and Quality
Led by cardiovascular surgeon James Quintessenza and cardiologist Ashish Shah, this interdisciplinary team of physicians and advanced practice providers uses the flight plan paradigm to develop a method for quick visualization of a cardiac surgical patient’s hospital course. This allows rapid and thorough investigation of any potential safety or quality concerns. The flight plan provides a clinical summary of each patient’s episodes of care, from surgical procedure to discharge, following the path from a high level of acuity down to discharge. Expected and unexpected clinical events are documented on the flight plan and reviewed in a weekly forum, with each care team providing detailed system and clinical concerns. The forum has enhanced interdisciplinary team collaboration, allowing quicker attention to areas of improvement and development of action items for smaller care teams to address sooner.
Johns Hopkins Bayview Medical Center
Johns Hopkins Bayview Medical Center’s stroke team, led by Elisabeth Marsh and nurse practitioners Erin Lawrence, CRNP, SCRN, and Dawn Merbach, CRNP, SCRN, offers a multidisciplinary approach to stroke care from the moment the patient arrives at the hospital. The team has implemented interventions such as optimizing the infrastructure to decrease door-to-treatment times for administration of intravenous tissue-type plasminogen activator and mechanical thrombectomy in the emergency department; streamlining hospitalization while providing comprehensive work-up and initiation of rehabilitation; and ensuring long-term follow-up in the Johns Hopkins Bayview stroke intervention clinic, where the focus is on improving post-stroke morbidity and patient-reported outcomes using cutting edge research. These innovations in clinical care have helped patients recover more fully from strokes and resulted in lower hospital readmission rates, shorter length of stay and fewer medication errors.
Johns Hopkins Community Physicians
Under Mattan Schuchman’s clinical leadership, Johns Hopkins Home-Based Medicine (JHOME) has expanded its regional footprint in the past two years since joining the Johns Hopkins Health System as a clinical delivery collaborative between Johns Hopkins Community Physicians and the Johns Hopkins Home Care Group. Its team-based and innovative home-based primary care model cares for a panel of more than 360 patients who are homebound and home limited, representing a 50% growth over the past two years. Combining the skillsets of geriatricians, nurse practitioners, nurses, care managers and clinical support staff members, the JHOME team works to ensure that all of its patients receive high quality, timely care in the home until end of life. JHOME is proud to far exceed national benchmarks for important outcomes for patients who are geriatric in areas such as advanced care planning and home end-of-life care. Additionally, the program continues to greatly reduce unnecessary end-of-life hospital and acute care. JHOME has prioritized Johns Hopkins Advantage MD patients, and has proved in a rigorous preliminary analysis to provide extremely high quality and cost-effective care, saving the health plan nearly four times more than the cost of the program in total health care spend. JHOME plans to expand further in the region to best serve Johns Hopkins Medicine’s patients, hospitals and health care plans.
The Johns Hopkins Hospital
Michael Streiff, Medical Director, Johns Hopkins Hospital Special Coagulation Laboratory
The JHM Venous Thromboembolism Collaborative
Led by Michael Streiff, the Johns Hopkins Medicine Venous Thromboembolism (VTE) Collaborative is a multidisciplinary team with wide ranging knowledge and experience in the prevention and management of VTE, which is the disease process that includes deep venous thrombosis (DVT) and pulmonary embolism (PE). Team members include patient safety and quality leaders, physicians, nurses, pharmacists, researchers, human factors engineers and health information technology experts. The mission of the VTE Collaborative, formed in 2004, is to develop and implement strategies to improve VTE prevention for patients who are hospitalized and deliver evidence based care by ensuring that patients are risk assessed, prescribed appropriate prophylaxis and administered the prophylaxis as prescribed. Achieving these goals can reduce the incidence of hospital-acquired VTE by 70%. The team has partnered with internal groups such as the Johns Hopkins Hospital patient and family advisory councils, and external organizations including the North American Thrombosis Forum (NATF), and the National Blood Clot Alliance, to engage with both patients and providers.
Sibley Memorial Hospital
The field of bariatric surgery has evolved dramatically over the past decade. Katherine Lamond and the multidisciplinary bariatric surgery team have helped advance many concepts in the care of patients having bariatric surgery — both regarding the procedure’s technical aspects and in postoperative care coordination. The team has elevated the culture of safety at Sibley Memorial Hospital and has raised overall care for bariatric patients to the highest possible level, including achieving successful accreditation in bariatric surgery from the American College of Surgeons.
Vicki Yfantis, M.S.N., Alyssa Kubischta (Selinger), Pharm.D., Sarojini Qasba, M.D., and the Perioperative Nasal Decolonization Team
The Perioperative Nasal Decolonization Team is a partnership between perioperative nursing, pharmacy and medical epidemiology committed to supporting providers in their infection prevention strategies. The team designed and implemented Suburban Hospital’s clinical trial for a nasal application of a nonantibiotic, alcohol-based antiseptic. These efforts yielded easier access, improved quality and better compliance for our patients requiring nasal decolonization prior to surgery. Other possible applications of this work are promising, including: the potential for cost savings around unnecessary isolation, personal protection equipment use and MRSA testing; the potential benefits of reducing unnecessary antibiotic exposure and use; as well as the potential advantages for expanding this intervention to prevent central line bloodstream infections and help other high-risk populations, such as critical care patients.
The team was able to develop and execute its plan within six months, and enhanced the patient experience through better access to care, supported the well-being of patients, pushed the boundaries of science and education through innovation, improved the quality of health care through performance improvement, aimed for precision through data-guided decision making, and worked like one organization through intention to share best practices.