There’s a reason why people come from all over the world to receive care from Stanford Health Care
We are ranked 9th on U.S. News and World Report's 2017-18 Best Hospitals Honor Roll.
In the last fiscal year, Stanford Health Care provided outpatient care to 1.2 million patients , handled more than 26,000 in-patient admissions, and managed more than 70,000 emergency room visits. Additionally, we performed 371 solid organ transplants - more than one per day, and the success of our transplant program sets us apart:
- Of adult and pediatric centers that perform transplants, the average number of solid organ transplants in 2017 was 137.5
- There have only been three living donor heart transplants performed in the U.S. during the past decade. All were performed at Stanford: one in 2016 and two in 2017
- In 2017, there were only 29 heart-lung transplants in America, and nearly 25 percent of them were performed by Stanford Health Care. According to the Scientific Registry of Transplant Recipients’ most recent report, published in January 2018, Stanford Health Care's one-year patient survival outcomes is 100 percent for heart-lung transplantation
- Across the board, our one-year survival rates for multi-organ transplants, including heart multi-organ transplants, are above the national average
- Our kidney transplant program's one-year patient survival outcomes are at 100 percent over the last two years.
We Are Committed To:
Our focus is on your health and safety. Everything we do is geared toward that outcome.
Stanford Health Care is the only Level-1 Trauma Center between San Francisco and San Jose, and specializes in the treatment of rare, complex diseases and disorders including cancer treatment, organ transplantation, neurosciences, cardiovascular health, orthopedic surgery and other surgical services.
This means that Stanford Health Care is delivering lifesaving treatment to critically ill patients who are most in need of quality health care. These patients are more susceptible to contracting infections and are also more likely to enter the hospital with an infection. To ensure their safety and the safety of all of our patients, Stanford Health Care goes to extraordinary lengths to provide a safe, clean environment for patients and the staff who work in our hospitals and clinics.
We are proud of our people and dedicated to our patients. Stanford Health Care cares for you.
"When it comes to patient care and safety, Stanford Health Care is one of America’s best."
There are many different ways to measure quality.
Many reports cite outdated information that does not reflect current hospital performance data. Stanford Health Care partners with one of America’s leading health care performance improvement organizations, Vizient, to track its safety and quality measures. During the second half of 2018 Vizient ranked Stanford Health Care 14th of 95 in safety among the most complex/comprehensive academic medical centers (AMCs). The top 10 hospitals in U. S. News and World Report’s 2017 Honor Roll are also part of this ranking. See FAQs on Leapfrog and Vizient rankings
Stanford Health Care has achieved strong results reducing infection rates.
For example, the Clostridium difficile (C. diff) infection is caused by bacteria that can lead to serious complications. People who take antibiotics and also receive care in any medical setting are at greatest risk for this infection. Symptoms from C. diff infections often take a few days to develop. Patients are tested for C. diff. infections if they show signs of illness (diarrhea) while in the hospital. Stanford Health Care's Standard Infection Rate (SIR) at Stanford Health Care in March of 2018 is lower than that of comparable AMCs. C. diff rates have been consistently decreasing thanks to the work of Stanford Health Care infection prevention teams that have implemented programs to identify and prevent infections, ensure better hygiene monitoring and facilitate a more focused use of antibiotics. See FAQs on C. diff
Quality Initatives
There’s no one-size-fits all solution to infection prevention.
That is why Stanford Health Care has more than 120 unique safety and quality initiatives dedicated to keeping patients and hospital staff healthy. Here are a few examples of this initiatives:
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Stanford Health Care has a number of initiatives that have improved patient safety, clinical outcomes, and reduced hospital length of stay. Among them are:
Enhanced Recovery After Surgery (ERAS) initiatives are designed to improve patient care before and after surgery. A multidisciplinary team including surgeons, anesthesiologists, nurses, physical therapists, pharmacists, nutritionists, quality consultants, case managers, and information analysts create evidence-based pathways that cover the entire patient surgical experience. Stanford Health Care has created these surgical pathways in multiple areas, including cardiac, pancreatic, colorectal, spine, gynecologic, thoracic, and liver surgeries.
The goals of ERAS are to promote quick recovery and reduce the stress of surgery. This is done by improving pain management, reducing opiate use, getting patients moving around and eating more quickly after surgery, and preventing complications.
ERAS pathways have reduced patients’ hospital length of stay by up to 25 percent. Other notable results include:
- Reduction in patient readmissions
- Reduction in healthcare acquired conditions and hospital acquired infections
- Reduction in preventable complications following surgery such as blood clots and sepsis
- Reduction in waste and costs of care
This physician-led partnership between Stanford Health Care and Stanford University School of Medicine works to improve patient outcomes and reduce the length of patients’ hospital stays. This innovative program dedicates a portion of participating physicians’ time specifically to work toward improved patient outcomes.
One of the leading causes for hospital readmission is misuse of medications. In collaboration with the Stanford Health Care Patient Progression and Heart failure readmission reduction initiatives, the Transition of Care (TOC) Pharmacy Program was introduced to help combat this issue.
The program entails TOC pharmacists participating in daily TEAM CARE rounds and reconcile medications on admission and discharge. These pharmacists also address medication access issues or concerns with patients and provide in depth medication education upon discharge.
This program has demonstrated increased trust between patients and provider, encouraged a more tailored prescription regimen and instilled patient confidence in medicine management. In its trial run, hospital readmission for high-risk patients dropped 17 percent.
Across the country, mammograms have contributed to earlier detection of breast cancer. However, the accuracy of a mammogram decreases from approximately 85 percent to 66 percent when the breast is positioned incorrectly. Stanford Health Care introduced an initiative to improve mammographic positioning, including:
- Hosting in-service lectures from an American College of Radiology Mammographic Accreditation Program inspector
- Staff training and coaching on positioning
- Fostering communication between radiologists and technologists regarding positioning
- Developing a performance dashboard for care providers
As a result, positioning performance improved by 36 percent, contributing to earlier detection of breast cancer for our patients. Over the past three years, 91 percent of mammograms have met the American College of Radiology’s criteria for exemplary positioning.
When Head and Neck oncologists at Stanford Health Care saw that only 62 percent of their patients started their radiation therapy within the recommended window of six weeks or less after surgery, they convened a multidisciplinary team to tackle the problem and reduce preventable delays. Stanford Health Care identified three key factors that contribute to the delay in patients with oral cavity carcinoma, including delayed dental extractions, delayed consultations with radiation oncologists and inadequate communication with patients about their radiation therapy. To address these factors, Stanford Health Care implemented the following improvements:
- Ensured presurgical dental evaluations were completed, which avoided up to five weeks of delay
- Conducted radiation oncology consultation earlier in the patient’s treatment and allowed the consult team to schedule their follow-up visits proactively
- Engaged patients earlier in decisions about where they would like to receive radiation therapy
Seventy-three percent of patients who were treated using these quality improvements received radiation treatment within the six-week timeframe, up from Stanford Health Care’s initial 62 percent, and much higher than the national average of 44 percent.
There are more than 750,000 strokes in the United States every year. A stroke occurs when the blood supply to part of the brain is cut off by a blood clot. This results in lack of oxygen and nutrients to brain tissue which causes brain cell death. Two million brain cells die every minute during a stroke, increasing the risk of permanent brain damage, disability, or death. Over the past several years, Stanford Health Care’s Emergency Department, stroke, and neurology teams have implemented a number of innovative improvements to reduce the time from a stroke patient’s arrival to diagnosis and treatment.
The new approach relies on specially trained nurses to quickly recognize the signs and symptoms of stroke, and to independently activate a rapid stroke process to shorten diagnosis and treatment times.
Key elements of the department’s stroke response include:
- All Stanford Health Care emergency department nurses and physicians are trained on the National Institutes of Health Stroke Scale assessment. This is a detailed 15-point exam that looks at everything from vision, speech, coordination and movement
- Stroke patients arriving by ambulance are first in line and are brought directly to the CT scanner for a rapid diagnosis
- A stroke code team that includes a stroke neurologist, nurses trained in emergency and critical care, a CT technologist, a radiologist, and a pharmacist
- Treatment with IV medication (clot buster) is started immediately while the patient is still in the CT scanner
- Special CT software developed at Stanford Health Care, that helps identify stroke patients that could benefit from a clot-removal procedure, known as thrombectomy. This procedure has resulted in dramatic improvement in patients as long six to 24 hours after the onset of their symptoms, with nearly half of patients largely spared from significant consequences of their strokes
These improvement efforts have enabled the team to diagnose stroke in less than 10 minutes of arrival and offer treatment within 45 minutes for most patients. Recent treatment results show treatment times as fast as 17 minutes from the time the patient arrived to the emergency department, to the time the clot busting medication was given.
In 2017, the Stanford Health Care radiology department launched 52in52, an innovative improvement structure led by frontline staff, to identify and develop improvement projects in their environment. The goal of the initiative was to engage staff and complete 52 projects in 52 weeks to improve the patient experience and quality of care, as well as build Stanford Health Care’s financial strength.
To assist with implementing and completing the projects, frontline staff presented their projects to the department team weekly and received support from their coaches, department leadership and fellow staff members.
The team successfully completed 54 improvement projects that improved the patient experience, reduced supply costs and more efficiently allocated staff hours. In addition, employee engagement increased significantly.
Currently, the 52in52 initiative is being implemented in other departments and has become a critical step in enhancing improvement capability and developing a workforce that is empowered and ready to address all the elements necessary to increase value provided to our patients.
Delirium is a severe change in mental status that has been associated with mortality, long-term cognitive deficits, medical complications and frequent readmissions. It affects between 10 and 64 percent of hospitalized patients, yet it may be preventable 30-40 percent of the time.
Given the frequency of delirium, Stanford Health Care decided to act. From the onset, the goal was to reduce the incidence of delirium by 10 percent. To achieve that goal, a multidisciplinary team used performance improvement tools and methods, to: (a) whenever possible, prevent delirium; (b) when not possible to prevent, identify it early and; (c) when identified, treat it early and manage it safely.
In addition to extensive clinician education about delirium, the team implemented a screening tool that looked for signs of delirium in patients at every shift. A proactive patient screening for the risk of delirium was also developed, and standardized non-pharmacological measures and physician order sets were established for both prevention and management of patients with delirium.
As a result of implementing these new protocols, Stanford Health Care exceeded its goal of reducing the incidence of delirium by 10 percent. The team reconvenes every six months to reassess and, as appropriate, update the Delirium Prevention and Delirium Management Protocols.
Stanford Health Care’s Antimicrobial Stewardship program promotes the appropriate use of antibiotics to improve patient outcomes and decrease the unintended consequences of antimicrobial use, including C. difficile infections and the emergence of multi-drug resistant organisms, or “superbugs.”
Antimicrobial Stewardship initiatives within Stanford Health Care include:
- Using antibiotics only when necessary – Unnecessary antibiotic use exposes patients to risk and fosters the development of resistant bacteria. Stanford Health Care limits the use of selected antibiotics that should be reserved for the most difficult to treat infections. Since 2012, we have reduced our use of these selected antibiotics by 50%, ensuring that they are only used when needed
- Aerosolized ribavirin – Stanford Health Care examined its use of aerosolized ribavirin (AR), a very costly medicine sometimes used to treat respiratory virus infections in patients with severely compromised immune systems. After careful study revealed a lack of benefits of AR treatment, Stanford Health Care decreased its use of AR, eventually removing the treatment completely in January 2017, without adverse effects on patients or patient care
- Online education: Our program has developed several free online courses to train clinicians in the practice of antimicrobial stewardship
- Our programs initiatives extend beyond Stanford Health Care. In collaboration with the World Health Organization Regional Office for Europe, we developed a free online course to educate front-line clinicians worldwide in the optimal use of antibiotics. Released in January of 2018, this course has already enrolled more than 10,000 users from 100 countries.
More resources:
- Our website: http://med.stanford.edu/bugsanddrugs.html
- Online courses: https://med.stanford.edu/cme/learning-opportunities/antimicrobialstewardship.html
- WHO course: https://openwho.org/courses/AMR-competency
This is the “gold standard” for measuring excellence in nursing, and Stanford Health Care has earned this distinction since 2009. With our third consecutive Magnet Re-designation in 2016, our dedication to nursing excellence puts Stanford Health Care in the top two percent of American hospitals. 88% percent of Stanford Health Care’s nurses have a bachelor’s degree, well ahead of the Institute of Medicine’s 2020 goal of 80%. Additionally, Magnet facilities are required to have at least 50%t of their nurses certified in a specialty area – and 54% of Stanford Health Care nurses meet this standard. Other criteria for this recognition is based on demonstrated quality in:
- Culture of safety and quality
- Shared decision-making
- Autonomous nursing practice
- Interdisciplinary team work and collaboration
- Evidence-based practice
- Ethical nursing practice
- Professional growth and development, and competence
Stanford Health Care’s housekeeping (EVS) department has continued to strengthen its infection prevention initiatives. Stanford Health Care has more dedicated EVS staff than nearly all other AMCs in our peer group. Through an increased commitment to staffing, rigorous training and the adaptation of new technology, including Xenex machines that emit UV light that disinfect rooms, we are making a difference to ensure our employees and patients are safe.
To ensure intensive care unit patient rooms were being used efficiently, an interdisciplinary team worked collaboratively to refurbish the patient rooms and devise a process that streamlined room maintenance and deep cleaning services from as many as 14 days to as little as eight hours. This was accomplished through sequenced communications and handoffs across departments to maximize efficiency while ensuring room safety and cleanliness. As a result, quality has improved and patient care interruptions have been minimized. This sequenced approach is now being implemented across other Stanford Health Care interdepartmental initiatives.
No matter how well we perform, we can always do better.
Stanford Health Care includes patients as part of the Quality Patient Safety and Effectiveness Committee and the Patient Experience Action Team. The patient perspective is critical to our ability to focus on improvement and quality and deliver exceptional results. Our physicians and nurses place the highest trust in this feedback and make sure Stanford Health Care acts on it.
Patient voices aren’t limited to committee involvement. We want to ensure patients are involved in their treatment and making key decisions about their health and wellness. For example, in close collaboration with patients and families, Stanford Health Care created the Stanford Letter Project. The Stanford Letter Project uses a three tools that clinicians can use to best understand the values and goals of our patients so we can serve them better:
- The ‘What Matters Most’ letter, a simple tool available in eight different languages that empowers patients to write a letter to their doctors about their wishes and values. Research has shown that this approach really helps doctors better understand what matters most to patients, their wishes for future treatments, who they want making decisions on their behalf when they become too sick and are not able to make their own descisions anymore
- The ‘Who-Matters-Most’ letter, a simple tool that helps patients write a letter to their family acknowledging important people in their lives; remembering treasured moments; apologizing to those they may have hurt; forgiving those who hurt them; and saying “thank you,” “I love you” and “goodbye.” Using this template, patients can write a letter to friends and family in one of eight languages using an online form, an iPhone or Android App or a printable form
- The ‘I-Matter-Too’ letter: This tool allows patients to reflect on their personal values and life goals and identify important life milestones and experiences that they want to achieve before a certain age or like milestone
Stanford Health Care began offering the ‘What Matters Most’ letter as an option to all patients who requested an Advance Directive, a written statement that identifies a person’s wishes regarding medical treatment, with excellent patient response. Once completed, the ‘What Matters Most’ letter is placed within the patient’s chart for the physician to review and use to set or modify the goals of care. Our research has shown that patients find this approach to be easy to use. Their doctors find the letter to be very helpful in understanding what matters most to our patients.
The Stanford Letter Project won a national innovation award from the American Medical Association and has been featured in numerous national publications like The New York Times, PBS and Reuters.
We offer multiple ways for patients to share feedback and help us improve. That’s why patients trust Stanford Health Care:
- Over 80% of Stanford Health Care patients were likely to recommend us to their friends, based on a patient satisfaction survey required by the Centers for Medicare and Medicaid Services
- Stanford Health Care physician ratings are available online to help people find a physician that is right for them
- 98.4% of Stanford Health Care physician ratings have a score of 4.5 or higher (out of 5)
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