The Vidant Health quality transformation.

Background: Vidant Health (VH), a private, not-for-profit health system in eastern North Carolina, began a systemwide quality transformation in 2006 after a serious blood event resulted in a patient's death.

Methods: Systemwide patient safety training served as the foundation of the transformation. Strategic planning of the quality work outlined a series of approaches that included board literacy in quality, an aggressive transparency policy, patient-family partnerships, and leader and physician engagement.

Results: The transformation of the system has resulted in an 85% reduction in serious safety events, a 62% reduction in health care-associated infections, 98% optimal care in the Centers for Medicare & Medicaid Services (CMS)/Joint Commission core measures, Hospital Consumer Assessment of Healthcare Providers and Systems performance in the top 20%, and more than 150 patient advisors partnering with leaders, physicians, and frontline staff. From the bedside to the boardroom the improvement in quality is evident across VH's nine hospitals, 70 physician practices, ambulatory surgery, and home health, hospice, and wellness services.

Conclusion: Strategic planning for quality set an ambitious agenda for VH's quality work and continues to drive action today. Engaging patients in quality work at all levels--as partners on performance improvement teams, in safety rounds, in quality improvement committee meetings, and in the boardroom--has been a deliberate strategy and a significant part of the quality transformation at VH. Additional requirements for public reporting, CMS's new payment reform, and the challenges inherent in the evolving health care industry at large make it imperative to maintain a focus on zero events of harm and exceptional patient experiences.