Dr. Stephanie Hall, chief medical officer of Keck Medical Center of USC, said Keck Hospital's greatest strength compared to other awardees is in treating niche cases. She said patients from other hospitals are often referred to Keck when their cases are highly complex and cannot be treated in most hospitals. (Jonathan Park / Daily Trojan)

Keck Hospital of USC received the 2024 Birnbaum, MD, Quality Leadership Performance award by Vizient, Inc. The award recognizes top performers among academic medical centers across the nation.

This is the second year Keck was ranked within the top 15 performers for accountability and quality. Keck previously ranked 11th out of 107 performers in 2022. Awardees are measured by their performance in six domains of quality patient care: mortality, efficiency, effectiveness, patient centeredness, safety and equity. Awardee performance is evaluated with the use of the Vizient Clinical Data Base, the Hospital Consumer Assessment of Healthcare Providers and Systems survey, and the Centers for Disease Control and Prevention National Healthcare Safety Network.

The Vizient Clinical Data Base measures hospital performance based on patient outcomes, usually revolving around statistics of mortality, complication and readmission rates, length of stay, and hospital-acquired conditions. The HCAHPS survey is a standardized, publicly reported survey instrument and data collection methodology for measuring patient perspectives on hospital care. The CDC's Safety Network is a healthcare-associated infection tracking system.

Dr. Stephanie Hall, chief medical officer of Keck Medical Center of USC, said the award helps Keck medical providers determine if they are meeting expectations for quality and safety.

"In order for us to understand how we were doing as an institution, [we need] to be able to measure our performance and outcomes in a data driven way," Hall said. "When an external organization recognizes you for the work that you do based on transparent data that is reproducible, it reinforces the fact that we are achieving [our] goals."

Hall said Vizient, Inc. evaluates monthly data Keck submits on its medical services to the national Vizient database and compares it to other academic institutions.

Dr. Ling Zheng, chief of clinical analytics for Keck Medical Center of USC, said the Vizient database evaluates all types of service lines -- or medical care specific to different patient cohorts -- for medical providers to understand the improvements needed for their respective specialties and patient populations.

"Our way of executing this finding is to make sure we actually slice and dice the data further so we provide the specialty-specific data to each individual service line so that they help our physicians and clinicians," Zheng said.

If the database detects variation outside of Keck's expected performance, the hospital typically creates a performance team. Hall said the team would adhere to a Plan-Do-Study-Act framework to address the specific performance variance, evaluate the outcome, determine what can be further improved and repeat until expected results are achieved.

A recorded instance of Keck being able to use the Vizient Database was when they reduced the average length of patient stay at their hospital back in 2022. Keck addressed issues on capacity management, patient flow, admissions, discharge planning, bed turnaround and bottlenecks to reduce patient stays in different service lines.

Hall said she believed Keck Hospital's greatest strength compared to other awardees is in treating niche cases. She said patients from other hospitals are often referred to Keck when their cases are highly complex and cannot be treated in most hospitals.

Keck Hospital had the highest case index in the Vizient database, Hall said. HCI refers to the complexity of cases, meaning Keck Hospital had the most specialty in addressing such cases.

Dr. Susan Gurley, professor of medicine and chair of the Department of Medicine at Keck School of Medicine, said such patient complexity affects Keck's work environment.

"The work environment at Keck is challenging in the sense that it's complex medical care being delivered to a variety of patients in a wide range of scenarios," Gurley said. "Our faculty and our hospital staff work very hard for excellent outcomes and high quality."

Keck's research facilities allow the hospital to advance their healthcare practices, Hall said. As a hub for research and innovation, Keck is able to adapt to novel therapies, procedures and general approaches toward medicine. She said these advances are important in adapting to complex cases in changing medical environments.

Gurley also attributed Keck's clinical quality to the effort put in by their faculty and staff. Hall said Keck's historically low nurse turnover rates reflect faculty members' commitment to their work.

"If you have a happy and engaged workforce, patients do better," Hall said. "It's been shown in literature that an engaged workforce has lower risk for complication [and] error."

The award recognizes the hard work and commitment of every member of the Keck community, Zheng said.