“Standard as Possible, Different as Necessary,” Is Ascension’s Approach to Quality Across Multistate System, Dr Cacchione Says

The drive toward quality metrics demands a certain amount of standardization, but that doesn’t mean individual hospitals across a multistate system must lose all their local flavor, said Joseph Cacchione, MD, FACC, executive vice president, Clinical & Network Services, who recently sat down for an interview with Chief Healthcare Executive™.

CHE: Your operations spanned 20 different states in very different diverse parts of the country What processes do you have to balance the need for quality standards across your whole system, while still being able to adapt to the local conditions in each market?

Cacchione: We tell people, we want to be as standard as possible, but as different as necessary. And, I will say that quality care is a rallying and a levelling, that we always fall on. [During COVID-19] We released almost 250 treatment guidelines on care delivery. And all of those treatment guidelines, as well as operational issues went through the [Executive Vice President and Chief Operating Officer], my partner, Craig Cordola, and me. We signed off on every one [and had teams working to get them to front-line staff]. When things would change, when the science would change, when the CDC would make new recommendations, we would push those out to the front line. So, the front-line staff didn't have to spend the time finding the new guideline, seeing what the new guideline was. If a new drug came out, when remdesivir came out, we push that out and created the documents to help [the staff], “Here's the how to give remdesivir here's what you need to do. Here's how you create an infusion clinic for this, for a COVID-sensitive infusion clinic.”

So, we leveraged our national quality infrastructure to help push those guidelines and help standardize care. … From the time that we started [to] the time that we got to the end of calendar year 2020, our mortality rates have evolved differently.