John and Mary E. Kirby Hospital - Monticello, Illinois

Summit Award Winner: Emergency Department

The John and Mary E. Kirby Hospital is a rural, not-for-profit community hospital located in Monticello, Illinois. The hospital has 16 inpatient beds, 8 Emergency Department beds, and 10,000 Emergency Department visits annually.

The main challenge at The John and Mary E. Kirby Hospital was to continue to strive for excellence in quality and patient satisfaction in spite of increasing census. Our battle was against complacency in our attitude towards delivering excellent care.

Using the C-A-R-E-S approach—Compassion, Empathy, Respect, Excellence, and Stewardship—we adopted a set of employee values and behavior standards. The initiative began with intensive training of leaders in how to model, evaluate, enforce, and hire employees to deliver care using the C-A-R-E-S values.

Inter-disciplinary critical care training was adopted. On an annual basis, medical, nursing, and EMS personnel were trained together in problem-based situations.

Monthly meetings were established using the following agenda format: Quality (performance improvement and national patient safety goals); People (training and hiring the best people to work in our Emergency Department); and Finance (added Bipap ventilation machine with the goal of reducing emergent rapid intubations, and to improve critical care revenue by training staff in billing and coding of critical care delivered). Medical staff, administration, nursing, and EMS personnel were represented at each meeting.

Two observation beds were added to allow for extended observation for low risk chest pain, dehydration, asthma, and other conditions requiring extended monitoring beyond the eight hour Emergency Department stay.