PARK RIDGE, ILL – Executives at Advocate Lutheran General Hospital, a 645-bed tertiary, academic and research hospital in a northern suburb of Chicago, say there are five elements critical to the hospital's clinical integration program. The hospital has been developing its program over 10 years.

“Clinical integration is really leading us down the path of evolving into a highly reliable organization that develops the right care model to get the best possible outcomes,” said Michael McKenna, MD, vice president of medical management at Advocate Lutheran General Hospital.

McKenna identified five vital elements to the program:

1. The American Nurses Credentialing Center’s Magnet status. "We offer patient care delivery models that are very effective in regards to nursing," McKenna said.
2. Improving communication among caregivers. This is particularly important, McKenna says, because the Joint Commission has cited communication breakdown as the single greatest contributing factor to sentinel events and delays in care in U.S. hospitals.
3. Information technology. McKenna said it’s very important to ensure that Advocate Lutheran General Hospital is providing physicians the right level of support. “When physicians come to work here, we want it to be an easier place to get things done, more reliable, higher safety, and higher satisfaction,” he said.
4. The physician-hospital organization. Specifically, he said, how committed the organization is to providing, contracting, pay-for-performance, and outcomes is crucial.
5. Overall quality. “We’re committed through our physician hospital organization and other elements of the program to provide the highest level of care possible,” said McKenna.

Hospitals have been working on building and improving clinical integration programs for nearly a decade. According to the American Hospital Association, “clinical integration is needed to facilitate the coordination of patient care across conditions, providers, settings, and time in order to achieve care that is safe, timely, effective, efficient, equitable, and patient-focused.”

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As McKenna sees it, an effective clinical integration program can lead a hospital down the path of becoming an accountable care organization (ACO).

“Advocate is becoming an ACO, and ACOs have to reliably get information and data to clinicians to deliver care,” he said. “We have to have ways we can communicate with each other in a timely and reliable fashion."

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“We have to have very effective means of communication that are both timely and accurate," said McKenna. "For example, if you look at patient safety events, the most common thread that goes through them is communication errors. People either didn’t communicate, had trouble communicating, or some aspect of that.”

Advocate Lutheran General Hospital uses a clinical communications system developed by Knoxville, Tenn.-based Perfect Serve to improve communication among its nurses, physicians, and hospital staff. McKenna said the system makes it easy to find a physician and offers numerous ways to leave messages or get information to a doctor and makes it easier for nurses, doctors and other clinicians to communicate.