BEACON Improvement Advisors recommend to "AIM Big" when describing the steps to initiate a performance improvement (PI) project. El Camino Hospital has taken that advice to heart and defined the goal for their quality program to be in the top 5% of hospitals by 2012. El Camino's CMO, Dr. Eric Pifer, created an identity for the program, "APEX" (Analytics, Performance and Excellence). In 2008, El Camino Hospital celebrated the launch of APEX at an event with a group of 250 staff and physicians. The strategy behind APEX is to have multiple teams working together on performance improvement, developing strategies and measuring success.

Susan Bukunt, RN, MPA, CPHQ, Senior Director of Clinical Quality and Patient Safety, emphasized, "Putting patients first is necessary to make a hospital a quality organization."

El Camino Hospital has proven that a "Patients First" approach and the promoting of collaboration on multiple levels is working towards achieving their goal in many areas. Cardiologists formed a call team across a variety of groups in an effort to reduce Door to Balloon Time. A willingness to put aside the standard call structure in the ED and designate one physician to be on call for STEMI, reduced the response time by 30 minutes. The standard Door to Balloon Time is 92 minutes but El Camino's time has been as low as 60 minutes. The discharge process has been significantly changed after a need was recognized to improve the process. Physicians needed a means to easily provide discharge instructions containing all 5 components to patients. It took over a year to get past the barriers and the creation of 22 specialty discharge instructions to achieve the improvements.

Implementing bundles, changing systems and remaining consistent to sustain the success have all been part of the process of improving quality at El Camino.  By including follow-up with physicians on a day-to-day basis, 100% of all elements of the Congestive Heart Failure Bundles have been successfully implemented for two quarters at the hospital, proving how working together on multiple levels accelerates improvement.

Chris Hunter, RN, MPH, CPHQ, Manager Quality Improvement, Clinical Effectiveness at El Camino, supports the clinical PI teams and their data needs. She said, "We are all trying to solve the same problems." Christine and Susan agree, BEACON has provided an opportunity to learn from other hospitals and share experiences. By putting business aside, hospitals are able to see how they compare with other hospitals in their efforts to improve care and put patients first.

Joan Santana, RN, BSN, Clinical Outcome Nurse at El Camino, adds a little humor and fun goes a long way to sustaining change. Sometimes, the right doctor to call on might be Dr. Seuss. To see an example of Joan's creativity download Measures, Measures.

Download ‘Writing an effective AIM Statement'

This article appeared in the January 2010 Navigator Newsletter (download newsletter)