rmc above all else, commitment to excellence 2015

COMMITMENT TO EXCELLENCEAbove All Else

Mission

Above all else, we are committed to the care and improvement of

human life.

Vision Together, we will be the premier healthcare destination for all we serve.

Values • Integrity

• Compassion

• Always

• Respect

• Excellence

Table of ContentsQuality Care ...............................................................................2

Patients First ..............................................................................6

Cancer Care

Nursing Excellence

Rapid Response and Efficiency ..............................................12

Heart Care

Stroke Care

Pain Care

Perseverance and Innovation ................................................16

Transplant Care

Teamwork and Determination ...............................................20

Trauma Care

Emergency Medicine

Neonatal and Obstetrical Care

Reproductive Medicine

Health and Wellness ..............................................................26

Wellness at Work

Health Insurance

Accreditations and Honors ....................................................30

Facility Maps ...........................................................................32

On the cover: Joe A. Cates, MD, board-certified vascular surgeon, meets with a family member to share positive outcomes and describe the procedure that removed pancreatic cancer.

Dear Colleague,

Now is a time of swift and dramatic change in healthcare. The Affordable Care Act and the

push for more transparency for healthcare consumers, combined with the total transition to

digital space for secure medical record storage and sharing, have led us to become the masters

of change.

Yet we remain steadfast to our mission to guide our priorities:

“Above all else, we are committed to the care and improvement of human life.”

We deliver compassionate, high quality healthcare by focusing on the medical, spiritual

and mental needs of each patient and family. Achieving the best possible patient outcomes

while efficiently preserving healthcare dollars takes skill, in-depth planning and detailed

follow-through. Working together, our physicians and staff are continuously advancing

every one of our business pillars – clinical quality, patient experience, employee

engagement, growth and finance – to provide healthcare excellence and high performance

for our entire community.

We created this report to illuminate our recent achievements and share our commitment

to healthcare quality at Research Medical Center. Through a combination of patient stories,

important information and data illustrations, we invite you to join our journey as we set

our sights on becoming the best healthcare provider and healthcare employer in the

region. By working together with you, the leaders and healthcare decision-makers of this

community, we can further control costs, broaden access, enhance quality and encourage

healthy lifestyles.

Best regards,

Jackie DeSouza-Van Blaricum

President and CEO

Research Medical Center

1

Above All Else

At Research Medical Center, we take quality

performance very seriously. Working collaboratively

with executive and clinical leaders to progressively

improve patient care, our achievements are

transforming Research Medical Center into a top-

ranking U.S. hospital. To shed light on the levels

of care available within our halls, this Above All

Else Quality Report details our performance across

several centers of excellence. We are proud to share

this journey with our community as we continue to

pursue ever-higher levels of quality and service.

James A. Maliszewski, MD, board-certified internal medicine physician, and Shonté M. Hutson, RN discuss medication management at the bedside.

QUALITY CARE

3

David S. McKinsey, MD, Performance Improvement Committee Chair

Dr. David McKinsey (right) discusses quality improvements with Dr. Joel McKinsey (left) and Tien Nguyen, RN, 4West Charge

Nurse (center).

QUALITY CARE

Excellence in Quality CareHospital quality is measured in many different ways. Everyone, from

healthcare consumers to community and business leaders who make

decisions that drive healthcare choices, deserves to know the quality of

care available at any given hospital. Research Medical Center is deeply

committed to evidence-based healthcare that protects patient safety and

leads to high quality outcomes. Our recent awards and performance data

illustrate our journey of continuous quality improvement in overall hospital

metrics (Figures 1 and 2) and across service lines. We are making high

quality healthcare more accessible in Kansas City than ever before, and it

shows.

A national Top Hospital. Research Medical Center is the only hospital in

Kansas City to earn the prestigious 2014 Top Hospital award from The

Leapfrog Group. We are among an elite group of only 60 hospitals our size

to earn this highly competitive distinction nationwide. The Leapfrog Group

is a nonprofit coalition of employers and other large healthcare purchasers

who advocate for improvement in hospital care. As corporate advisors,

their work has been instrumental in determining what constitutes quality in

healthcare and establishing a common set of safety, quality, and resource

use standards to help purchasers make informed decisions about where to

spend healthcare dollars. By design, only a few hospitals in a given region

perform well enough to exceed these standards, and we are very proud to

be among them.

As a 2014 Top Hospital, Research Medical Center demonstrates exceptional

standards of care that lead to lower infection rates, higher survival rates for

high-risk procedures, decreased length of stay and fewer readmissions.

“A” grade in hospital safety. Through its well-known

Hospital Safety Score rating system, The Leapfrog Group

also awarded an “A” grade to Research Medical Center in

2014. To calculate our hospital’s patient safety grade, The Leapfrog Group

used multiple data sources that combine to illustrate how well we protect

1.6

1.4

1.2

1.0

0.8

0.6

0.4

0.2

0

Improving Overall Hospital OutcomesMortality and Complication Rates, Observed and Expected

2011 2012 2013 2014*

Figure 1Source: Research Medical Center, 2014. *Through September 2014

Better

In H

osp

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licat

ion

s

Research Medical Center Mortality Rates

Research Medical Center Complication Rates

Expected

1.09 1.15

0.75

1.151.07

0.78

4

1.6

1.4

1.2

1.0

0.8

0.6

0.4

0.2

0

Improving Care for Life-Threatening Conditions Overall Hospital Sepsis Mortality Rate, Observed and Expected

2011 2012 2013 2014*

Figure 2Source: Research Medical Center, 2014. *Through September 2014

Better

In H

osp

ital

Co

mp

licat

ion

s 1.51

0.97


Expected

0.82 0.820.64 0.64

Frederic L. Seligson, MD is board certified in cardiac and thoracic surgery and specializes in cardiothoracic procedures.

Jeffrey W. Cameron, MD is board certified in general and vascular surgery and specializes in complex vascular surgeries.

William M. Beary, MD specializes in endobronchial ultrasounds and electromagnetic navigation bronchoscopies (superDimension™).

5

Figure 3Source: Research Medical Center, 2013-2014.*Through September 2014

our inpatients from accidents, infections, injuries, and errors. Our “A”

grade represents extremely high performance in a rating system that is

quickly becoming the standard measure of patient safety in the U.S.

Top Performer on Key Quality Measures. Also in 2014, The Joint

Commission recognized Research Medical Center as a national Top

Performer on Key Quality Measures® for 2013 performance, marking our

second consecutive year receiving this distinction. The Top Performer

award demonstrates excellence in heart attack, heart failure, pneumonia

and surgical care (Figure 3). We are among only 1,224 hospitals across

the country to receive this most recent recognition from The Joint

Commission (the nation’s leading accreditor of healthcare organizations),

although nearly three times as many hospitals were eligible.

100%

80%

60%

40%

20%

0%Heart Attack

Heart Failure

SurgicalCare

Pneumonia

% o

f Pa

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Top Performer on Key Quality Measures

99.5% 98.4% 100% 99.2% 99.3%

Better

100%100% 100%

Research Medical Center 2013

Research Medical Center 2014

Above All Else

Megan Jones, 38, is fighting breast cancer under

the care of Stephanie Graff, MD. Familiar with Dr.

Graff through family and friends who have won

their own battles against cancer, Megan requested

a referral after diagnosis to begin chemotherapy at

Research Medical Center. “From day one, Dr. Graff

made me feel like a friend – someone she really

wants to help, not just a cancer case,” says Megan.

Her treatment is part of a clinical trial for people

who carry an inherited BRCA1 gene mutation that

elevates the risk for developing certain cancer types.Molly Lund, MS, CGC, board-certified genetic counselor, offers personalized and highly targeted care and prevention options to patients.

7

PATIENTS FIRST Cancer Care | Nursing Excellence

Megan Jones and Stephanie Graff, MD

Megan Jones (left) discusses her breast cancer with her oncologist, Stephanie Graff, MD. With board certification in internal

medicine, medical oncology and hematology, Dr. Graff specializes in breast cancer and actively leads a number of clinical trials to

ensure patients have access to the latest developments in cancer treatments.

Excellence in Cancer CareFor those in the fight against cancer, above all else, we believe in bringing

the latest treatments and technologies to Kansas City. From prevention

and early detection to advanced cancer therapies and comprehensive

oncology care services, Research Medical Center delivers excellence right

here, close to home and work for thousands of people in this community.

Network of excellence. In 2014, we were honored to become a cancer

treatment center of the Sarah Cannon Cancer Network of Excellence

(Figure 4). Sarah Cannon, in partnership with Hospital Corporation of

America (HCA), brings innovative minds together across 50 treatment

centers to transform care and personalize treatment for cancer patients

here and across the world. Through our Sarah Cannon partnership, we are

on the forefront of establishing molecular profiling for cancer patients

which will allow us to personalize cancer treatment to the genetic profile

of each patient’s particular cancer.

Quality outcomes. To accelerate improvements in survivorship, we

carefully manage changes in cancer care, treatment and surveillance

programs, and we continually measure our effectiveness against a range

of national quality standards. Some standards are nationally accepted

treatment guidelines proven to yield more favorable patient outcomes.

Others comprise indicators of quality, such as volumes, mortality and

complications. For example, we meet the National Quality Forum (NQF)

measures for post-breast cancer recommended therapies (Figure 5).

Our mortality rate for two high-risk surgeries – lung resections and

pancreatectomies – are lower than the national average (Figure 6)

across all hospitals accredited by the American College of Surgeons’

Commission on Cancer (CoC).

8

Figure 4Source: Research Medical Center, 2014.

Figure 5Source: Research Medical Center, 2011 (most recent publicly reported data); Cancer Quality Improvement Program (NQF 0219, 0559, 0220).

100%

98%

96%

94%

92%

90%

88%

86%

84%

82%Guidelines

for Radiation Therapy

Guidelines for Hormone

Therapy

Guidelines for Chemotherapy


Missouri

All CoC Programs

100% 100% 100%

94.4%

97.4%

93.0%

91.1% 91.5%

88.1%

% o

f Pa

tien

ts

Upholding Best Practices in Breast CancerCare Exceeds National Guidelines

PATIENTS FIRST

Better

Advanced cancer-fighting technologies. Research Medical Center offers

some of the most progressive cancer treatments in the region, including

neurosurgeons trained to use the area’s only Gamma Knife® treatment for

brain tumors (pictured on page 15), the only suite for high-dose rate (HDR)

image-guided brachytherapy and the MammoSite® Radiation Therapy

System. These technologies target cancer cells, limit the radiation exposure of

healthy tissue, and deliver faster treatment and recovery times.

Innovative clinical trials. Together with Sarah Cannon, Research Medical

Center brings more clinical research, more clinical trials and a broader range

of cancer care services to Kansas City. Having conducted more than 140

first-in-man clinical trials to date, Sarah Cannon is one of the largest

early-phase research programs worldwide. Research Medical Center is also

a partner in the National Cancer Institute Community Oncology Research

Program, which brings access to additional clinical research trials. These

partnerships make it possible for us to have trial opportunities in breast,

gynecological, prostate, gastrointestinal, lung, head and neck, brain, thoracic,

bone, skin, and blood cancers.

9

Verda J. Hicks, MD, board-certified OBGYN and gynecologic oncology physician, advances minimally invasive surgery using the daVinci® robotic surgical system.

Figure 6Source: Research Medical Center, 2009-2011; Cancer Quality Improvement Program (n=1,200).

Improving Cancer Care OutcomesMortality Rates Better Than National Averages

3.5%

3.0%

2.5%

2.0%

1.5%

1.0%

0.5%

0.0%Lung Resection Pancreatectomy


All CoC Programs

2.7% 2.7%

1.6%

3.3%

In H

osp

ital

Dea

ths

Better

Syed Faisal Jafri, MD, board-certified gastroenterologist, consults on a broad range of cancer cases.

Multidisciplinary specialists gather for a clinical case conference at our Liver and Pancreas Institute.

Genetic testing and counseling. Clinical leaders encourage early detection

of cancer risk factors. Research Medical Center offers predictive gene

testing to give patients and families insight into their risks of developing

cancer. Our four board-certified genetic counselors have 65 years

combined experience working with clinicians and patients to provide

personalized information about genetic influences, specific cancer risks,

and targeted screening and prevention options.

Liver and Pancreas Institute. Our Liver and Pancreas Institute (LPI) clinical

case conferences bring together a team of hepatologists, oncologists,

radiologists, surgeons, and other physicians to shorten the time between

diagnosis and treatment for our patients. Patients with even the most

complex cases receive a treatment plan the same day.

Prestigious accreditation. Research Medical Center is accredited by

the CoC as a Community Hospital Comprehensive Cancer Program.

The CoC recognizes cancer care programs that carry out the mission of

comprehensive, high quality and multidisciplinary care. Only facilities that

accession at least 500 newly diagnosed cancer cases each year, provide a

full range of diagnostic and treatment services, and participate in cancer-

related clinical trials are eligible for this accreditation. Through our CoC

accreditation, we have access to reporting tools for benchmarking and

improving outcomes.

Oncology nursing excellence. Research Medical Center exceeds CoC

recommendations for specialty nurse staffing. Half of our nurses treating

cancer patients have also attained the Oncology Nursing Certification,

which is a formal recognition of standards in skill and experience that

promote healthy outcomes.

Industry evidence suggests a strong emphasis on nursing and nurse

communication is central to all gains in patient experience. We are

proud to see nursing excellence reflected in our cancer center patient

satisfaction scores. In the area of communication – how well our oncology

nurses communicate with and listen to patients – we exceeded the

national average in 2014 (Figure 7), a testament to the “patients first”

philosophy we embrace across the organization.

10

PATIENTS FIRST

Figure 7Source: Research Medical Center, 2014; Hospital Consumer Assessment of Healthcare Providers and Systems: Percentage of patients who responded “always” related to satisfaction with communication with nurses.*Through September 2014

Strengthening the Patient ExperienceOncology Nurse Communication with Patients Improves, Exceeds National Average

100%

80%

60%

40%

20%

0%3Q2013 1Q2014 3Q2014*2Q20144Q2013

79%


National Average

% o

f Pa

tien

ts

77% 75% 76%84% 84%

Better

11

Excellence in Nursing Research shows positive work environments where nurses can flourish

have healthy downstream effects on quality of care and patient satisfaction.

Through the Pathway to Excellence® credentialing program, we have

implemented a series of evidence-based practice standards known to improve

nurse satisfaction, retention and recruitment. As we strengthen the 12

Pathway Practice Standards this year, our goal is to apply for the American

Nurses Credentialing Center’s Pathway designation in 2015.

Our commitment to pursuing this achievement mirrors our commitment to

true nursing excellence and recognition of the important contributions nurses

make to quality healthcare and the entire patient experience.

A 110-year legacy of developing nursing excellence. The Pathway to Excellence

credentialing program is relatively new, but our strengths in nursing are

anything but. In 2015, Research College of Nursing is celebrating its 110th

anniversary, having grown substantially since its inception in 1905 with

only five students, to more than 400 students today. Despite this growth in

enrollment, the nursing college maintains an 8:1 student-faculty ratio that

fosters rich academic and clinical discussions, and provides wide-ranging

opportunities for nursing student research. Leading the way for patient care

excellence despite nursing shortages, in 1991 the school became one of the

first in the country to offer an accelerated program. Throughout its 110-year

history, more than 4,000 professional nurses have graduated from Research

College of Nursing.

Positive work environments allow nurses to flourish at Research Medical Center.

Nurses at Sarah Cannon at Research Medical Center provide patient care excellence, which is reflected in our patient satisfaction scores.

When Lorraine Jones, 43, arrived at Research

Medical Center, she was clinging to life after

resuscitation from sudden cardiac death. The

cardiology team moved quickly to provide

advanced cardiac care, and despite the severity of

her condition, Lorraine survived. After two weeks in

the ICU, two surgeries and a total hospital stay of

23 days, she was strong enough to go home. “I was

nearly dead when they carried me in, but I walked

out,” Lorraine says. “That speaks volumes about the

life-saving care they provide.”

Willie E. Lawrence, Jr., MD, FAHA, FACC is board certified in cardiovascular disease and specializes in interventional cardiology.

13

Above All ElseRAPID RESPONSE AND EFFICIENCY

Lorraine Jones (left) with her mother Marjorie

Having witnessed the skill and devotion of the cardiac team firsthand, Marjorie says it often felt like Lorraine was getting special

treatment. Now, she says, “I understand it was nothing out of the ordinary – every patient gets that VIP treatment at Research

Medical Center.”

Heart Care | Stroke Care | Pain Care

Excellence in Heart CareCardiovascular disease is the number one killer of men and women in the

U.S. As an accredited Cycle IV Chest Pain Center with PCI (Heart Attack

Care), our highly skilled cardiologists provide round-the-clock, emergency

heart care that exceeds national guidelines. Rapid response and efficiency

in cardiac care are demonstrated through quality measures like door-

to-balloon time – that is, how long it takes to unblock an artery through

balloon angioplasty from the moment a patient enters the emergency

room doors. At just 56 minutes, our average time is currently well below

the national guideline of 90 minutes (Figure 8).

Timely and effective heart attack care. In 2014, Research Medical Center

excelled at all eight core measures for heart attack care. This represents

exceptional compliance with all treatment steps recommended by

the Centers for Medicare and Medicaid Services (CMS) for timely and

effective heart attack care.

Excellence in Stroke CareTime is critical when someone has a stroke, and Research Medical Center

is a local leader in prompt, effective, high quality stroke care. As the first

Certified Primary Stroke Center in the region, we provide interventional

stroke care with the most advanced and effective treatments available.

Our stroke care team includes physician specialists who perform clot

retrieval using the latest devices and technologies.

Quality outcomes. As one of Kansas City’s largest high acuity hospitals,

we treat more patients with very serious, life-threatening health issues

than most other area hospitals. Despite this fact, mortality rates for

neuroscience patients treated at Research Medical Center are much lower

than expected (Figure 9).

14

RAPID RESPONSE AND EFFICIENCY

90

80

70

60

50

40

30

20

10

02011 2012 2013 2014*

63

55.9 58 56

Exceeding Standards for Door-to-Balloon Times


National Guideline

currentaverage

562014

Figure 8Source: Research Medical Center, 2014; GWTG, American Heart Association. *Through September 2014

Min

ute

s

1.6

1.4

1.2

1.0

0.8

0.6

0.4

0.2

0

Improving Neuroscience Outcomes Mortality Rates Better Than Expected Levels

2010 2011 2012 2013 2014*

Figure 9Source: Research Medical Center, 2014; Neuroscience MS-DRGs per U.S. News & World Report Methodology; American Stroke Association. Expected levels are established based on the high severity of illness associated with neuroscience patients at Research Medical Center. *Through September 2014

Better

In-H

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90 90 90 90

1.431.24

0.620.78

Research Medical CenterNeuroscience Mortality Rates

Expected

0.87

Better

Iftekhar Ahmed, MD, board certified in neurology and psychiatry, is Medical Director of the Stroke Care Center and TIA Clinic at the hospital.

15

Board-certified neurosurgeons Jonathan D. Chilton, MD (left) and Geoffrey L. Blatt, MD (right) specialize in comprehensive neurosurgeries, including Gamma Knife radiosurgery (pictured above).

Award-winning speed and efficiency. As a regular recipient of GWTG-

Stroke Gold Plus with Target Honor Roll recognition, we consistently rise to

a higher standard of care for our stroke and transient ischemic attack (TIA)

patients (Figure 10). The American Heart Association’s current guidelines for

treatment include an intravenous (IV) t-PA procedure with a key measure

known as door-to-needle time. Lower door-to-needle times are associated

with decreased morbidity and mortality, and in 2014 Research Medical Center

met the national guideline of 60 minutes. In terms of functional recovery, the

majority of our stroke patients return home or continue onto rehabilitation

therapy after discharge.

Excellence in Pain CareThe Center for the Relief of Pain is a unique component of our comprehensive

Neuroscience Institute. Led by internationally recognized neurosurgeon

William Rosenberg, MD, the Center for the Relief of Pain manages complex

pain through advanced interventional techniques and integrative therapies.

The Center is dedicated to improving each patient’s quality of life through

evidence-based care and patient education.

Exceeding Expectations for Ischemic Stroke OutcomesMortality Rates Better Than Expected Levels

Figure 10Source: Research Medical Center, 2014; CMS ICD-9 codes; GWTG, American Heart Association and American Stroke Association.*Through September 2014

1.6

1.4

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0.8

0.6

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0.2

02010 2011 2012 2013 2014*

Better

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s 1.271.45

0.71 0.74

0.46

Research Medical CenterIschemic Stroke Mortality

Expected

When Willie McFail was diagnosed with kidney

failure, he found himself hooked up to dialysis

several hours a week. Knowing how hard it was,

his brother Charlie gave him a second chance

by becoming a living donor. Under the care

of transplant surgeon Daniel Murillo, MD and

transplant nephrologist Pranav Dalal, MD, Charlie

underwent a laparoscopic procedure to donate his

kidney to Willie at Research Medical Center last

May. When asked by a local news station what his

brother’s gift meant for him, Willie’s answer was

simple but powerful: “Life.” Pranav Dalal, MD, board-certified nephrologist (left) and Daniel Murillo, MD, board-certified surgeon (right) discuss patient outcomes at The Transplant Institute.

17

Above All ElsePERSEVERANCE AND INNOVATION

McFail Brothers, kidney recipient and donor

Willie McFail (right) shares a laugh with his younger brother and living kidney donor Charlie (left). The brothers are pictured here in

their hometown of Sedalia, Missouri, six months after the transplant that restored Willie’s quality of life and freed him from dialysis.

Transplant Care

Excellence in Transplant CareThe Transplant Institute at Research Medical Center serves the region with a

nationally recognized kidney transplant program, as well as one of the area’s

only simultaneous kidney/pancreas transplant programs. In its 30-year history,

the kidney and kidney/pancreas transplant teams have performed 1,368 organ

transplants (Figure 11). More than half of those transplants (740 to date)

have been performed since 2003 under the direction of Daniel Murillo, MD,

Medical Director. In 2014, the kidney transplant team performed a total of 62

transplants.

In 2012, The Transplant Institute earned the prestigious Medal of Honor for

Organ Donation from the U.S. Department of Health and Human Services for

exceeding national organ donation rates. Today, we transplant seven percent

more kidneys than expected based on the high acuity level of patients seen

here (Figure 12). Clinical evidence shows patients who receive transplantation

at higher volume hospitals like Research Medical Center are more likely to

have better outcomes.

Quality outcomes. By offering options for the rapidly growing number of

end-stage renal disease patients who require dialysis or transplantation for

survival, The Transplant Institute fills a serious role in the American healthcare

system. Multidisciplinary physicians and nephrologists work with transplant

recipients before, during and after surgery to assure high-quality outcomes

for patients. The Transplant Institute’s success in kidney transplants is

demonstrated by patient survival rates and graft survival rates, which exceed

national averages for one month and one year post-transplant (Figure 13).

18

PERSEVERANCE AND INNOVATION

30%

25%

20%

15%

10%

5%

0%

16%

24%

National ResearchMedicalCenter

Exceeding Expectations in Transplant VolumeKidney Transplant Rates Higher Than National Levels

Figure 12Source: Research Medical Center, 2013; Scientific Registry of Transplant Recipients. The percentage of kidney patients on the transplant waitlist who receive a transplant at Research Medical Center exceeds the national average among U.S. kidney transplant programs.

ExpectedBetter

% K

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Kidney Transplant Patient Volume

2011 2012 2013 2014*

Figure 11Source: Research Medical Center, 2014.*Through September 2014

# Pa

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Simultaneous Pancreas and Kidney TransplantsKidney Transplants

57

4

5551 52

5 34

Living donor program. Kidneys from living donors generally function longer

and are associated with higher success rates than kidneys from deceased

donors. The Transplant Institute offers an active living donor program, with

a laparoscopic procedure for recovering organs from living donors, and

Research Medical Center operates a dedicated transplant unit for post-

transplant care.

Kidney/pancreas program. With one of the few simultaneous kidney/pancreas

programs in the region, Research Medical Center specializes in care for

patients suffering from a variety of liver, pancreas or biliary tract diseases

or disorders. Our nationally recognized transplant program has earned

a reputation for excellent surgical skill, multidisciplinary care, advanced

research and outstanding patient success rates.

Expanding access in Kansas and Oklahoma. In 2014, Research Medical Center

partnered with Wesley Medical Center to fulfill a need for patient access to

pre- and post-transplant care in the large region surrounding Wichita. We have

also performed transplants on patients from Oklahoma.

19

Delivering Excellence in Transplant OutcomesGraft Survival and Patient Survival Rates Meet and Exceed National Averages

100%

95%

90%

99.24% 99.12%

1 month 1 year

98.23%98.29%

Figure 13Source: Research Medical Center, 2013; Scientific Registry of Transplant Recipients, July 2011 through December 2013 (most recent publicly reported data).

Better

% P

ost

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urv

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Gena Soto, RN, transplant nurse, educates a patient about transplant medications.

Physician specialists and transplant professionals meet regularly to discuss evidence-based care for each patient.

Length of Time Post-Transplant

Graft Survival Rate (Living Donor/Diseased Donor)

National Rate

Patient Survival Rate (Living Donor/Diseased Donor)

At 15 weeks pregnant, Aiden’s mother Amie was in

a car accident that caused massive head trauma,

broken bones and lacerated organs. LifeFlight

Eagle transported her to our Level I Trauma Center,

where physicians from 20 specialties worked

collaboratively to keep Amie and her unborn son

alive. The 4West nursing team provided attentive

care and life support for the next four months, and

despite the extreme severity of her condition, Amie

gave birth to Aiden at 33 weeks gestation. He spent

34 days in the NICU before starting his new life

outside the hospital as a healthy, happy baby boy. Nurses Ruth Woronick, RN (left), Pat Conley, RN (right) and Norma Bolling, RN (seated) discuss patient care on 4West.

21

Above All ElseTEAMWORK AND DETERMINATION

Aiden King and Scott Bjerke, MD

Aiden is pictured here at six months old with Scott Bjerke, MD, Medical Director of Trauma Services. As a board-certified surgeon

and fellowship-trained traumatologist, Dr. Bjerke led the coordinated effort that crossed multiple specialties and disciplines to save

Amie and baby Aiden after a devastating car accident.

Trauma Care | Emergency Medicine | Neonatal and Obstetrical Care |

Reproductive Medicine

Excellence in Trauma Care According to the Centers for Disease Control and Prevention, three out of

every four deaths among young people are the result of injuries and violence.

Since 2011, Research Medical Center has been offering the highest level of

comprehensive trauma care as a Level I Trauma Center for acutely injured

patients in our region. Our comprehensive center of excellence for burn care –

the Grossman Burn Center, opened in 2013.

As a Level I Trauma Center, Research Medical Center provides

24-hour total care for every aspect of injury, from prevention through

rehabilitation. Under the direction of Scott Bjerke, MD, fellowship-trained

traumatologist, we admit more than 1,000 patients with severe injuries per

year (Figure 14). Approximately 20 percent of our trauma patients come from

rural areas, arriving by helicopter or emergency ground transport.

Quality outcomes. Determination and teamwork drive a multidisciplinary

team of in-house critical care and trauma-trained, board-certified surgeons

who provide critical care within 15 minutes of arrival. Together with critical

care nurses, support staff and specialists in critical care, orthopedic surgery,

neurosurgery, anesthesiology, emergency medicine, radiology, and internal

medicine, the trauma team works tirelessly to improve survival rates and

lower costs associated with medical care and work loss. Based on the number

of patients in the trauma registry and their acuity, it is expected Research

Medical Center would have a complication rate of 4.4 percent. However,

our actual complication rate is only 3.8 percent and our mortality rate is 5.0

percent, both below expected levels (Figure 15).

22

TEAMWORK AND DETERMINATION

Figure 14Source: Research Medical Center, 2014. Activations are defined as severely injured patients for whom the trauma team are activated; total patients include activations plus patient consults required regardless of activation. *Through September 2014

Caring for More Trauma PatientsVolume Continues to Grow

1400

1200

1000

800

600

400

200

02012 2013 2014*

Activations

Total Patients

672765

1070

736

11691065

# o

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8.0%

7.0%

6.0%

5.0%

4.0%

3.0%

2.0%

1.0%

0.0%

4.4%

Mortality Medical Complications

Improving Trauma Care OutcomesMortality and Complication Rates Better Than Expected Levels

Figure 15Source: Research Medical Center, 2013; Diagnosis codes for major medical complications for trauma, injury and poisoning. Expected levels are based on the high severity of illness associated with trauma patients at Research Medical Center.


Expected

5.0%

3.8%

5.1%

Better

% o

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tien

ts

Excellence in Emergency Care Every second matters in an emergency – that’s why Research Medical Center

offers round-the-clock emergency care. Board-certified physicians, critical care

nurses, and support staff ensure that emergency patients are triaged at arrival

and seen by a qualified medical professional in priority order. On average, our

emergency department sees more than 63,000 patients each year at our main

hospital and Brookside campuses.

Increased access to emergency care. To ensure timely, convenient emergency

care, we actively measure and manage patient wait times, which are well

below national averages (Figure 16). Because efficient emergency care

translates to more optimal outcomes, we have implemented continuous

quality improvement initiatives to maintain low wait times. As a result, we

have significantly reduced the number of patients who leave our emergency

department without being seen. At our main hospital campus, this rate has

fallen from 4.4 percent in January 2013 to just 0.1 percent today – below the

national average of two percent.

Megan L. Garcia, MD, board-certified surgeon, treats patients at the Grossman Burn Center, a specialized center for comprehensive acute and reconstructive burn care.

On average, LifeFlight Eagle transports more than 225 patients annually to Research Medical Center.

23

30

25

20

15

10

5

0Jan Feb Mar Apr May Jun Jul Aug Sep

Providing Timely Emergency CarePatients Receive Care Faster as Arrival-to-Greet Time Improves

Figure 16Source: Research Medical Center, 2014; Hospital Compare, CMS.*Through September 2014

Min

ute

s

Teamwork drives low wait times in emergency care. Left to right: Cassandra Montoya, PA-C, Jason W. Eppler, MD and Robyn Miller, Director of Emergency Services.

BetterResearch Medical CenterBrookside CampusNational Average (24 min)Top 5th Percentile (12 min)

7.59 8.23 8.32 8.88 7.889.48

7.8 7.7 8.65

29.7

22.521.1

18.5 19.9

23.8

11.64

16.612.65

Excellence in Neonatal CareThe availability of neonatal intensive care has improved outcomes for

high-risk infants like Aiden King, who are born either preterm or with

serious medical or surgical conditions. Our 19-bed, Level III Neonatal

Intensive Care Unit (NICU) provides subspecialty care for the tiniest, most

vulnerable patient population: critically ill newborn infants.

Our Level III NICU cares for infants born as early as 23 weeks (four

months premature) through full term. The nursery is staffed with

highly specialized neonatologists, neonatal nurse practitioners, nurses,

respiratory therapists, lactation consultants and social workers. Advanced

equipment supports newborns with respiratory difficulties or other high-

risk complications (Figure 17).

Neonatal quality outcomes. Research Medical Center has made

measurable improvements in the quality and cost of neonatal intensive

care. Following a multidisciplinary collaborative quality improvement

model, our neonatal team eliminated central line-associated bloodstream

infections (CLABSI) in the NICU. CLABSI is a high-cost adverse event and

significant contributor to neonatal mortality because these patients have

immature immune systems.

Excellence in Obstetric CareCesarean sections and early elective deliveries come with added health

risks for mothers and babies. Our care teams in obstetrics have improved

quality, safety and performance by implementing evidence-based

practices to assure low C-section rates. With the national C-section rate

remaining above 30 percent, we consistently perform below national

averages on C-sections for first-time pregnancies (primary C-section rate),

as well as total pregnancies (Figure 18). Research Medical Center was

honored in 2014 by March of Dimes for decreasing early elective deliveries

to zero as of August 2014 (Figure 19).

24

TEAMWORK AND DETERMINATION

Neonatologists, neonatal nurse practitioners

Specialized nurses, respiratory therapists

Radiology and lab technicians

Portable X-ray machine

Blood gas analyzer

Sustained life support

Full range of respiratory support

Access to full range of pediatric medical and surgical subspecialists

Advanced imaging capabilities

Comprehensive care for all critically ill infants born at any gestational age or birth weight

Highly Specialized Level III NICU

Figure 17Source: American Academy of Pediatrics, 2012.

Figure 18Source: Research Medical Center, 2014; Agency for Healthcare Research and Quality national average for inpatient quality indicators #33 and #21. *Through September 2014

Obstetric OutcomesC-Section Rates Better Than National Averages

2014*

2013

2012

2011

2010

35%30%25%20%15%10%5%0%

30%

20.93%

19.2%

17.8%

17.6%

16.8%

Research Medical CenterPrimary C-Section Rate

Research Medical CenterTotal C-Section Rate

NationalAverage

10%

9%

9%

8%

10.58%

17.96%

Better

Excellence in Reproductive Medicine From saving lives to giving life, we are committed to our philosophy of

touching lives with hope, healing, comfort and care. We complement cutting-

edge diagnostic and treatment technology with highly specialized and skilled

physicians who translate research and evidence-based best practices into

advanced life-giving techniques.

Women seeking in vitro fertilization (IVF) choose Research Medical Center for

our success rates, a measure known as clinical pregnancy rates (CPR). Our

affiliated women’s care practice, Midwest Women’s Healthcare Specialists,

outperforms IVF centers both locally and nationally with a 65.2 percent CPR

for women under 35. By comparison, the national CPR rate in 2012 was only

47 percent.

Board-certified OBGYN physician Gregory C. Starks, MD, a renowned specialist with more than 30 years’ experience, leads our Fertility and Family Planning program.

Neonatal nurse practitioners and nurses provide subspecialty care in our Level III NICU.

25

20%

15%

10%

5%

0%

17.0%Research Medical Center

National Average

Figure 19Source: Research Medical Center, 2014; The Leapfrog Group (most recently publicly reported data).

14.0%

11.2%

4.6%

2.4%0% 0% 0%

4%

2010 2011 2012 2013

Optimal Obstetric OutcomesEarly Elective Deliveries Remain Low

Better

% o

f Pa

tien

ts

To succeed in our continuous journey of healthcare

excellence, we firmly believe in exchanging ideas

and input with our local community leaders. As part

of this commitment, we held our first Community

Advisory Board meeting last November. At the

inaugural session, Jackie DeSouza-Van Blaricum,

President and CEO, shared our goals and

achievements in health and wellness with Kansas

City business leaders, while hospital executives and

physicians spoke about our bold quest to be the

best healthcare provider and healthcare employer

in the region. At a recent Town Hall meeting, Jackie DeSouza-Van Blaricum shares patient satisfaction reports with the patient transportation team.

27

Above All ElseHEALTH AND WELLNESS

Jackie DeSouza-Van Blaricum and Ted McKnight

Jackie DeSouza-Van Blaricum and Ted McKnight, a broker at CBIZ, Inc., share ideas for building healthier workplaces at a recent

Community Advisory Board meeting. Discussions spanned topics such as advances in cancer care and research, health and

wellness, and health insurance.

Wellness at Work | Health Insurance

Workplace HealthWith employee healthcare costs continuing to rise, employers turn to

Research Medical Center for resources that improve employee health and

stem costs associated with absenteeism and reduced productivity. For

many employers, the biggest obstacle to achieving a healthier workforce

is employee engagement, so our workplace health programs include

targeted engagement strategies to generate interest and participation that

brings results.

Wellness at Work. Through our Wellness at Work program, Research

Medical Center works with local employers to create a healthier Kansas

City. Our Wellness at Work program includes programs and tools to

encourage and support employees as they pursue healthier lifestyles. Our

goal is to equip employers with the means to help improve employee

health, which in turn leads to lower healthcare costs for the firm and

the employees.

Through the following program components, Wellness at Work directly

addresses employers’ health-related goals in the workplace by offering

the following:

• Online and risk-based screenings that may identify employee health

risks early

• Timely access to primary care physicians and other providers for annual

wellness visits and urgent healthcare needs

• Targeted engagement strategies that increase employee involvement

• Targeted education and interventions that encourage accountability

and impact poor employee health habits

• Best-in-class health solutions delivered in partnership with health plans,

employee benefit brokers and/or local community resources

Many organizations in Kansas City use our education and wellness

initiatives to help employees learn how to reduce health risks before

chronic or major conditions develop. Other employers offer our health

and wellness educational services to their employees in the workplace.

Available onsite as health education and online as wellness screenings,

tools are readily available for employers and individuals to influence

healthier lifestyle changes such as quitting smoking, losing weight,

increasing fitness levels, or managing diabetes and other chronic

diseases.

Because our vision for Research Medical Center includes initiatives that

address the needs of our people, we offer our own employee wellness

28

HEALTH AND WELLNESS

Lifestyle management

weight

nutrition

stress management

smoking cessation

Disease management

targeted health intervention for chronic diseases such as coronary artery disease, hypertension and diabetes

Sports management

sports injury prevention

injury treatment

Employee and work place health

post-offer and pre-employment screenings

return to work services

healthcare experts to address prevention to intervention

across a range of conditions

Workplace Health Programs

Stephen C. Salanski, MD, Program Director of the Research Family Medicine Residency, trains 2014 resident Suzanne Ozborn, MD.

Research Medical Center’s health and wellness programs extend from workplace to community.

29

programs. Studies show a positive correlation between employee wellness

and the organization’s reputation, overall performance and cost of care – three

factors that can also have a direct or indirect impact on patient satisfaction.

By promoting and supporting healthier lifestyles among the people who work

at our healthcare campuses, we aim to improve satisfaction levels of our

employees and patients alike.

Founded on evidence-based principles, Wellness at Work influences positive

health behaviors for participating Kansas City-area employers. Financial

return for employers comes from helping high-risk employees increase their

health awareness and accountability through relevant and accessible health

education, seminars and coaching, and keeping healthy employees fit

and active. We also encourage employers to educate their staff about the

importance of annual wellness visits with a primary care physician and other

recommended healthcare providers.

Health insurance premium reduction programs. At Research Medical Center,

we have implemented a health insurance premium reduction program to

reward our employees for meeting wellness goals. Such financial incentives

are encouraged by the Affordable Care Act (ACA). ACA supports participatory

workplace wellness programs, such as fitness center reimbursements for

positive participation in health seminars, risk assessments and other wellness-

related activities. Some employers offer non-discriminatory, health-contingent

wellness programs tied directly to individual performance to specific health

goals.

30

ACCREDITATIONS AND HONORS

TARGET: HF HONOR ROLL

2014 Top HospitalResearch Medical Center is the only hospital in Kansas City to earn the prestigious Top Hospital distinction from The Leapfrog Group in 2014. Nationwide, only 94 hospitals achieved this honor, and among them, only 60 were similar in size to Research Medical Center.

Top Performer on Key Quality Measures® 2013, 2012For the past two years, Research Medical Center has earned national recognition as a Top Performer on Key Quality Measures by The Joint Commission. Our Top Performer awards, which are based on 2013 and 2012 hospital performance data, represent our exemplary care for heart attack, heart failure, pneumonia and surgical patients.

“A” Grade Hospital Safety Score, 2014The Leapfrog Group evaluates hospital data to assign a letter grade rating that represents how well each hospital protects patients from accidents, infections, injuries, and errors. Research Medical Center proudly achieved a top “A” grade rating in 2014.

2014 Get With The Guidelines® Heart Failure – Gold Plus Honor RollFor the second year in a row, the American Heart Association has recognized Research Medical Center for exceptional heart failure care. This award confirms our consistent adherence to GWTG performance achievement indicators and quality measures.

2014 Get With The Guidelines® Stroke – Gold Plus with Target Honor Roll2014 marked the second consecutive year that Research Medical Center was recognized by The American Stroke Association for exceptional stroke care. This award confirms our consistent adherence to GWTG performance achievement indicators and quality measures.

2014 Mission: Lifeline® – BronzeResearch Medical Center received the Mission: Lifeline award from The American Heart Association for demonstrating consistent adherence to all performance achievement indicators and quality measures to improve the quality care for ST-elevation myocardial infarction (STEMI) patients.

Awards & Honors

2014 Leader in LGBT Healthcare EqualityResearch Medical Center earned top marks from the Human Rights Campaign (HRC) Foundation for our commitment to equal care for lesbian, gay, bisexual and transgender (LGBT) patients. We are among just 426 hospitals nationwide to receive distinction as a Leader in LGBT Healthcare Equality in 2014, which is based on findings from HRC’s annual Healthcare Equality Index.

2014 March of Dimes RecognitionFor decreasing early elective deliveries (EEDs) to zero in 2014, Research Medical Center was honored by the March of Dimes as part of their Healthy Babies are Worth the Wait® (HBWW) initiative. The goal of HBWW is to give babies a stronger start in life by encouraging the prevention of EEDs, or non-medically necessary deliveries before 39 weeks gestation.

2013 ACTION Registry® – GWTG™ Platinum Performance AchievementResearch Medical Center consistently followed treatment guidelines set forth in the ACTION Registry–GWTG Premier for eight consecutive quarters and met a performance standard of 90 percent for specific performance standards.

2012 HHS Organ Donation Silver Medal of HonorThe U.S. Department of Health and Human Services awarded the Silver Medal of Honor to Research Medical Center for achieving at least a 75 percent organ donation rate from eligible donor families in a consecutive 12-month period.

2013 UDSMR Top Performer AwardFor excellence in acute rehabilitation services, Research Medical Center earned the Top Performer Award from Uniform Data Systems for Medical Rehabilitation (UDSMR). This achievement is based on 2013 performance data that placed us in the 92nd percentile among nearly 800 qualifying facilities nationwide.

31

Hospital AccreditationResearch Medical Center earned The Joint Commission’s Gold Seal of Approval® for accreditation by our continuous dedication to compliance with The Joint Commission’s state-of-the-art standards for healthcare quality and safety in hospitals.

Advanced Certification in Heart FailureResearch Medical Center received advanced certification from The Joint Commission for demonstrating that we meet the requirements for Disease-Specific Care Certification, plus additional, clinically specific requirements and expectations.

Chest Pain Center Accreditation with PCIThe Accredited Chest Pain Center at Research Medical Center earned accreditation from The Society of Cardiovascular Patient Care by demonstrating our expertise and commitment to quality patient care in multiple key areas.

Certified Cardiac Rehabilitation ProgramThe American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) certifies our cardiovascular and pulmonary rehabilitation program offers the most advanced practices available and provides the appropriate and effective early outpatient care of patients with cardiac or pulmonary issues.

Advanced Certification in Stroke (Primary Stroke Center)Research Medical Center received an advanced certification from The Joint Commission for our programs that meet the requirements for Disease-Specific Care Certification, plus additional, clinically-specific requirements and expectations.

Vascular Testing AccreditationResearch Medical Center received a “seal of approval” by medical experts in the field of Vascular Testing for our accreditation by The Intersocietal Accreditation Commission.

Level I Trauma Center in MissouriResearch Medical Center earned Level I Trauma Center status, the highest designation available, from The Missouri Department of Health and Senior Services for our 24-hour in-house coverage by general surgeons, and prompt availability of care in specialties such as orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology, internal medicine, and critical care.

Accreditations & Certifications

National Accreditation Program for Breast Centers (NAPBC)National Accreditation Program for Breast Centers (NAPBC), the gold standard for breast center accreditation, recognizes Research Medical Center for our commit to providing the best possible comprehensive care to patients with diseases of the breast.

Breast Imaging Center of ExcellenceOur Breast Imaging Center of Excellence designation recognizes that we have earned accreditation in mammography, stereotactic breast biopsy, and breast ultrasound (including ultrasound-guided breast biopsy).

Mammography AccreditationThe gold seal of accreditation from the American College of Radiology (ACR) represents the highest level of image quality and patient safety. Following peer-review evaluations by board-certified physicians and medical physicists, Research Medical Center earned the ACR gold seal of accreditation for mammography.

Computed Tomography AccreditationFor meeting ACR Practice Guidelines and Technical Standards as demonstrated in a peer-review evaluation, ACR awarded the gold seal of accreditation to Research Medical Center for computed tomography.

MRI AccreditationFor meeting ACR Practice Guidelines and Technical Standards as demonstrated in a peer-review evaluation, ACR awarded the gold seal of accreditation to Research Medical Center for Magnetic Resonance Imaging (MRI).

Ultrasound AccreditationFor meeting ACR Practice Guidelines and Technical Standards as demonstrated in a peer-review evaluation, ACR awarded the gold seal of accreditation to Research Medical Center for ultrasound imaging.

Nuclear Medicine AccreditationFor meeting ACR Practice Guidelines and Technical Standards as demonstrated in a peer-review evaluation, ACR awarded the gold seal of accreditation to Research Medical Center for nuclear medicine.

•

•

32

Research Medical Center2316 E. Meyer Blvd Kansas City, MO 64132Phone: (816) 276-4000

Research Brookside Campus 6601 Rockhill Road Kansas City, MO 64131Phone: (816) 276-7000

Research Psychiatric Center2323 E. 63rd StreetKansas City, MO 64130Phone: (816) 444-8161

RESEARCH MEDICAL CENTER FACILITIES

33

METHODS AND FOOTNOTES

Executive Team

Jackie DeSouza-Van Blaricum, Chief Executive Officer

Lisa St. Aubyn, Chief Executive Officer, Research Psychiatric Center

James Bower, MD, Chief Medical Officer

Paige Baker, RN, MSN, Chief Nursing Officer

John Krajicek, Chief Financial Officer

Eric Becker, Chief Operating Officer

Methodology

Research Medical Center collects internal, patient-level data based

on the Centers for Medicare & Medicaid Services Diagnostic Related

Group (MS-DRG) classification system and International Classification

of Diseases (ICD) codes. Detailed data indicate the volume of Medicare

patient discharges, mortality, lengths of stay, charges and costs, as well

as the associated severity code for each DRG.

Standards and Data Sources

Data are compared to state and national averages for the most recent

publicly reported period. Where possible, Research Medical Center has

reported 2014 data through the third fiscal quarter (September 2014).

Publicly reported standards and data sources include:

Agency for Healthcare Research and Quality

www.ahrq.gov

American College of Surgeons Trauma Quality Improvement Program (TQIP®)

www.facs.org/quality-programs/trauma/tqip

American Heart Association/American Stroke AssociationGet With The Guidelines®

www.heart.org

Core Outcome Measures in Effectiveness Trials (COMET) Initiative

www.comet-initiative.org

Hospital Compare

www.medicare.gov/hospitalcompare

Hospital Consumer Assessment of Healthcare Providers and Systems

www.hcahpsonline.org/home.aspx

Scientific Registry of Transplant Recipients (SRTR)

www.srtr.org

The Advisory Board Company: Crimson Continuum of Care

www.advisory.com/technology/crimson-continuum-of-care

The Leapfrog Group

www.leapfroggroup.org

Acknowledgments

Above All Else Quality Report is published by Research Medical Center.

Project Leaders: Corrine Everson, Vice President of Marketing, and

Megan Fischer, Vice President of Quality Improvement

Photography: Mark McDonald

TARGET: HF HONOR ROLL

Top Hospital, The Leapfrog Group, 2014

Mission: Lifeline® – Bronze, 2014

Top Performer on Key Quality Measures®

2013, 2012

Leader in LGBT Healthcare Equality, 2014

“A” Grade Hospital Safety Score,The Leapfrog Group, 2014

ACTION Registry® – GWTG™ Platinum, 2013

Get With The Guidelines® Heart Failure – Gold Plus Honor Roll, 2014

HHS Organ Donation Silver Medal of Honor, 2012

Get With The Guidelines® Stroke – Gold Plus with Target Honor Roll, 2014

UDSMR Top Performer Award, 2013

2316 E. Meyer Blvd

Kansas City, MO 64132

(816) 276-4000

ResearchMedicalCenter.com

©2015 Research Medical Center