THA Bill Aston Award for Quality
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Bill Aston Award for Quality

The Texas Hospital Association Bill Aston Award for Quality honors hospitals’ measurable success in improving quality and patient outcomes through the sustained implementation of a national and/or state evidence-based patient care initiative.

Contact:
Ollie Jo Bozeman, 512/465-1007

2020 Award Winner
Dell Children's Medical Center – Austin

Scoliosis a relatively common spine condition in adolescents – roughly 3 million new cases are diagnosed in the United States each year. Most patients are diagnosed with idiopathic scoliosis, which presents in children between 10 to 12 years old. Only a small percentage of scoliosis cases need treatment, but patients need to have consistency in care if treatment is required.

Dell Children's Medical Center in Austin developed a swift recovery pathway for idiopathic scoliosis spinal fusions. Evidence supports the use of a rapid recovery pathway for spinal fusion surgery, including admission to the acute care floor, early mobilization, early transition from intravenous narcotics to oral pain management, and early initiation of a bowel regimen.

A multidisciplinary team of nurses, orthopedic spine surgeons, anesthesiologists, physician assistants, and other stakeholders began meeting monthly to develop a pathway to success using a Johns Hopkins Nursing model. So far, they have decreased length of stays, decreased intravenous opioid use and increased patient satisfaction.

Early figures also show significant financial improvement in the cost of care. The average total cost reduction is around $27,776 per case. Annualized, this creates an estimated total cost savings of $1,388,801 and a gross charge reduction of 13.72%.

photo of the Dell Children's Medical Center spine team virtual meeting over Zoom

By creating their rapid recovery pathway, Dell Children's has addressed the most common barriers to fully functional recoveries. Additionally, admissions of spinal fusion patients directly to the acute care floor has reduced costs and length of stay without compromising patient safety.


2020 Award Winner
Texas Health Resources – Arlington

According to the Centers for Disease Control and Prevention, sepsis has attributed nearly 270,000 deaths in the United States annually, with expenses approaching $20 billion per year. Because of sepsis' impact, Texas Health Resources adopted sepsis mortality as a key performance indicator to decrease mortality in 2016.

This goal brought everyone at THR to the table through a rigorous process that required system-wide engagement. Implementation of this goal heightened sepsis awareness and initiated meaningful conversations about sepsis care. By 2018, the KPI results were slipping. This regression challenged the team at THR to improve and create the Comprehensive Sepsis Workgroup.

The Comprehensive Sepsis Workgroup focuses on standardizing how THR cares for sepsis patients and consists of members from various disciplines, including quality, nursing, laboratory, pharmacy, physicians, clinical decision support and other stakeholders.

As a result of the Comprehensive Sepsis Workgroup, the outcome metric of sepsis-related mortality at THR decreased from 11.23% in 2015 to 7.07% in 2019, approaching the top-decile for the metric.

The Comprehensive Sepsis Workgroup at THR has affected change by supporting all sepsis-related items. The workgroup meets monthly to discuss best practices and review cases, both concurrently and retrospectively.

photo of Texas Health Resources team in Dallas, assembled in a labyrinth in a courtyard


2020 Award Winner
UT Health Tyler

In 2018, UT Health East Texas in Tyler launched a cultural transformation through the development and implementation of Mission Zero: Our Culture of Safety, where zero patient harm became their goal. UTHET's quality and patient safety team began by analyzing nearly 25,000 safety events from all facilities from 2016 through 2018. The analyses showed many approaches to patient safety system-wide and a need to standardize practices across all facilities.

With support from the board of trustees, physicians and administration, the QPS team began a journey toward a cultural shift that transformed the way UTHET ensures patient safety. They started with daily safety briefings at every facility. A "Good Catch Program" was added – where good catches are shared across the division in the newsletter – and caregivers are recognized for their diligence and focus on safety. The QPS team developed a Mission Zero Leadership Methods Booklet with an education program, and over 450 UTHET leaders were trained on Mission Zero leadership methods.

In January 2020, UTHET established a team of physicians and caregivers from across the organization who formally classify all safety events. This team's mission is to correctly classify safety events using the UTHET Safety Event Classification algorithm and Known Complications Test in a consistent, rigorous and strategic manner.

photo of the UTHET Mission Zero team

Mission Zero has helped UTHET improve patient quality, safety and outcomes by reducing the total number of hospital-associated conditions. With an 85% reduction in HACs in 2019, UTHET avoided a cost of about $1,371,891 and altogether eliminated the Centers for Medicaid and Medicare Services penalty by improving quality, safety and patient outcomes. UTHET has bolstered its commitment to patient safety and improved outcomes for the community they serve.

Across the state, THA-member hospitals are championing innovative quality and patient safety initiatives that are showing measurable success in improving quality and patient outcomes. In keeping with THA’s initiatives to promote quality and patient safety in Texas hospitals, THA established the Bill Aston Award for Quality in 2010. The award honors hospitals that have distinguished themselves through measurable success in improving quality and patient outcomes through the sustained implementation of a national and/or state evidence-based patient care initiative that involves physicians, hospital governing board members and staff.

The late W.W. “Bill” Aston was an exemplary leader who worked tirelessly to improve health care for the people in his community. He served on the Baylor University Medical Center board for 25 years and on the board of Baylor Health Care System from 2005 to 2010. In 2010, THA established the Bill Aston Award for Quality through an endowment from Baylor Health Care System.

“Mr. Aston was a strong advocate and champion for providing the highest level of safe, quality, compassionate care for all patients throughout the Baylor Health Care System,” said Joel Allison, president and CEO of Baylor Health Care System. “He will be remembered for his commitment to quality. He wanted nothing but the best. He always wanted excellence, and he constantly reminded us it’s about putting the patient first.”


Bill Aston

Hospitals or health care systems that are active institutional members of THA are eligible for this award. Nominated projects must demonstrate improved outcomes in patient care and be related to a national or state standard for improved patient care. Projects must demonstrate ongoing involvement by both physicians and trustees.

Selection Criteria
Applicants will be evaluated on the following criteria:

  1. A maximum of three Bill Aston awards may be awarded each year: one to an academic institution or large teaching hospital member; the second to a non-research, non-teaching member; and the third to a rural hospital member.
  2. The project/initiative submitted must demonstrate and document improved outcomes in patient care. Metrics might include reductions in specific infection rates or readmissions for specific diagnoses or increased compliance with specific protocols. Consideration will include the rate or delta of improvement.
  3. The project/initiative should be related to a national or state standard regarding improved patient care. Any clinic or nationally recognized issue, identification of an institutional problem or challenge, or team decision based on clinical factors or indicators is ideal.
  4. The project/initiative must have documented sustained effectiveness; a minimum of one year of improved performance/outcomes is required. The project/initiative must have been initiated in the last three years.
  5. Preference will be given to projects/initiatives that have been replicated and sustained within the entrant facility.
  6. The project/initiative must demonstrate the ongoing involvement of physicians.
  7. The project/initiative must demonstrate an ongoing role for the hospital governing board. For example, regular reports or educational activities related to the project for governing board members could demonstrate the board’s involvement.

Selection Process
The selection committee is composed of one member of the Texas Healthcare Trustees board, one member of the THA Board of Trustees, the THA president/CEO, one representative of the TMF Health Quality Institute, and one representative of the previous year’s winners. Hospitals represented on the selection committee are ineligible to receive the award during the member’s committee tenure. Hospital representatives serve one-year terms.

Presentation
The honorees will be featured in THA publications and recognized at the THA 2022 Annual Conference and Expo, Feb. 7-9.

Step 1. Complete the nomination form.

Step 2. Attach up to 15 pages of supporting documents, including a one-page summary and program description.

Step 3. Be sure all materials are completed and SUBMITTED by September 30, 2021.

Questions? Contact Ollie Jo Bozeman at obozeman@tha.org or 512/465-1007.

2020: Dell Children's Medical Center – Austin, Texas Health Resources – Arlington and UT Health Tyler

2019: Catholic Health Initiatives – Texas Division (Houston), Shannon Health System (San Angelo) and Houston Methodist The Woodlands Hospital (The Woodlands)

2018: Dell Children's Medical Center of Central Texas (Austin), Texas Health Harris Methodist Hospital Hurst-Euless-Bedford and Hill Country Memorial Hospital (Fredericksburg)

2017: Parkland Health & Hospital System (Dallas), Texas Scottish Rite Hospital for Children (Dallas) and Rankin County Hospital District

2016: Baylor Scott & White Medical Center - Carrollton

2015: Children's Health (Dallas), Doctors Hospital at Renaissance (Edinburg) and CHI St. Joseph Health Madison Hospital (Madisonville)

2014: JPS Health Network (Fort Worth) and Texas Health Resources (Arlington)

2013: St. David's Medical Center (Austin) and The University of Texas Medical Branch (Galveston)

2012: Methodist Health Care System of San Antonio and Medical Center of Lewisville

2011: Memorial Hermann Healthcare System (Houston) and South Texas Health System (Edinburg)

2010: The University of Texas MD Anderson Cancer Center (Houston)