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Case Study


St. Charles Hospital: Improving Surgical Care Through Best-Practice Literature and Order Sets

From 2004 to 2008, St. Charles Hospital achieved dramatic improvement on process-of-care, or "core," measures, particularly on those intended to reduce surgical complications. The core measures, developed by the Hospital Quality Alliance, relate to provision of recommended treatment in four clinical areas: heart attack, heart failure, pneumonia, and surgical care. Conversations with administrative and clinical staff indicate that St. Charles' achievements in surgical care can be attributed to a hospitalwide focus on quality improvement—spurred by involvement in the national Surgical Care Improvement Project—as well as to reliance on best-practice literature to get surgeons on board, use of preprinted order sets to standardize care processes, and a steady focus on tracking performance data and communicating results to physicians and other staff.

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.

Publication Details



S. Silow-Carroll and A. Lashbrook, St. Charles Hospital: Improving Surgical Care Through Best-Practice Literature and Order Sets, The Commonwealth Fund, September 2009.