Supported by a nationwide community of multispecialty clinicians and employees who stand united in their commitment to patient safety, Envision Healthcare is in the position to have a significant influence within the patient safety space. As the practice administering care to more than 35 million patients annually, Envision’s clinicians in multiple specialties have utilized this reach and implemented clinical best practices to address COVID—19, combat the opioid crisis and change outcomes in facilities nationwide. 

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In 2019, Physician Services Clinical Quality Department focused on expanding the occurrence reporting programs within each service line, a foundational step intended to strengthen the safety culture and support organizational learning. Anesthesia and Radiology had active occurrence reporting processes in place and Women’s and Children’s, Emergency Medicine and Hospital Medicine have been added. The department will continue to expand into the remaining specialties in early 2020.

When Stewart Coffman, M.D., MBA, FACEP, became Co-Chair of the Emergency Medicine National Clinical Quality Committee (CQC) for Envision Physician Services, he embraced the opportunity to unify Envision’s more than 16,000 emergency medicine (EM) providers working within a variety of different practice environments. Dr. Coffman and his Co-Chair, Keenan Bora, M.D., oversee approximately 60 physician and advanced practice providers (APP) volunteers across five unique EM quality subcommittees. The leaders conduct monthly CQC operating meetings to guide the work of the subcommittees and collaborate as a team. “If you look at the EM CQC deliverables in 2019 and what these subcommittees have accomplished, it’s pretty amazing and demonstrates our ability to impact patient safety,” Dr. Coffman said.

In 2019, Rebecca Parker, M.D., FACEP, led an Opioid Task Force of physician representatives from across all service lines to address the opioid crisis across the country. Representatives from every specialty participated, establishing subcommittees under their Quality Committees and developing guidelines for appropriate prescribing and use. As the focus continues, significant successes have been identified.

The Questcare Division of Envision’s American Operating Group provides care to over 600,000 ED patients a year and in 2019, successfully decreased opioid administration in their EDs by 30 percent. Other Envision facilities who used this approach also saw a similar decrease in opioid use, and now, the Alternatives to Opiates (ALTO) subcommittee is publishing disease-specific order sets to share the details of these best practices with all Envision site clinical leaders. “This program is an example of a system-wide approach in the ED, and it’s also happening in multiple places across Envision,” Dr. Coffman said.

Garnering similar results in the anesthesiology space, by the end of 2019, facilities that implemented Envision’s enhanced recovery after surgery (ERAS) program saw significant improvements in post-surgical outcomes and a comprehensive decrease in opioid exposure for patients nationwide. Joshua Bloomstone, M.D., M.Sc., FASA, Associate Medical Director of the Patient Safety Organization and anesthesiologist of over 25 years, commends the leadership of Jon Katz, Senior Vice President Anesthesia Operations, and Amy Metula, Vice President, Clinical Services Alliance/HCA National Group and Vice President, Quality Envision/HCA Joint Ventures, as their work has led to continuously improved results. “I am proud of this team for their steadfast dedication to enhancing perioperative outcomes.” Dr. Bloomstone said. “As seen in these results, our physicians are really driving change and positively impacting the communities we serve nationwide.”

Commending the great work being done in the ED and across other specialties, Dr. Coffman emphasizes the importance of these achievements. “We are working together to ensure safety across our entire company,” Dr. Coffman said. “We are looking to positively impact facilities, implement evidence-based policies and demonstrate real improvement in the care we provide our patients.”

Learn how Envision Healthcare’s Patient Safety Organization is setting new standards and AMSURG centers were among the pilot group of volunteers who participated in the first-ever Culture of Safety survey offered to ASCs through the links below.

Envision Healthcare Patient Safety News Story

AMSURG Patient Safety News Story