In just a few years, the United Hospital Center (UHC) rose from being one of the lower-performing U.S. hospitals on process-of-care measures to being one of the top performers. This case study focuses on UHC’s achievement in providing recommended treatment related to surgical care. UHC’s improvement can be attributed to hospital-wide strategies as well as policies and practices focused on the surgery department. Hospital-wide strategies include the creation of a subcommittee that reviews performance data and works across departments and disciplines to address performance gaps; careful data recording, assessment, and validation to gain the trust of physicians; engagement of the CEO, medical staff chairman, and medical staff; and communication of progress and challenges. Surgical care strategies include: emphasizing best-practice literature to bring surgeons on board; providing consistent data feedback, including to individual surgeons; using peer pressure when needed; and standardizing operating room procedures through standing orders, practice sets, and checklists.
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.