December 24, 2009
A. Lashbrook, Texas Health Harris Methodist–Cleburne: A System Approach to Surgical Improvement, The Comonwealth Fund, December 2009.
Texas Health Harris Methodist–Cleburne is one of the top performers in the country on the surgical care process-of-care measures, often referred to as the "core" or Surgical Care Improvement Project (SCIP) measures. The measures, developed by the Hospital Quality Alliance and reported to the Centers for Medicare and Medicaid Services (CMS), relate to achievement of recommended treatment in four clinical areas: heart attack, heart failure, pneumonia, and surgical care. In addition to its high performance on surgical measures, Texas Health is performing in at least the top 15th percentile in these other areas.
This case study focuses on Texas Health's achievement in providing recommended treatment related to surgical care. The hospital has relied on concurrent review, changes to care processes, and preprinted order sets to improve. It also has benefited from being a part of a larger health system. After the SCIP measures here introduced in 2004, an interdisciplinary workgroup aimed to identify opportunities for improving the hospital’s performance on these measures.
This study was based on publicly available information and self-reported data provided by the case study institution(s). The aim of Commonwealth Fund–sponsored case studies of this type is to identify institutions that have achieved results indicating high performance in a particular area of interest, have undertaken innovations designed to reach higher performance, or exemplify attributes that can foster high performance. The studies are intended to enable other institutions to draw lessons from the studied institutions' experience that will be helpful in their own efforts to become high performers. Even the best-performing organizations may fall short in some areas or make mistakes—emphasizing the need for systematic approaches to improve quality and prevent harm to patients and staff. The Commonwealth Fund is not an accreditor of health care organizations or systems, and the inclusion of an institution in the Fund's case study series is not an endorsement by the Fund for receipt of health care from the institution.