At OSF HealthCare, we strive to deliver high quality, safe care to everyone we serve. To improve quality and create the value for our patients, we are focusing our efforts to define a one OSF standard of care in order reduce unnecessary clinical variation and improve outcomes

To achieve this we’ve created multi-disciplinary collaboratives and care councils to review, evaluate and recommend evidence-based standards throughout our Ministry. We’re continuing to invest in and perfect better ways to care for challenging health issues for our patients. All of these efforts are truly improving care for our patients in our communities.

The OB Collaborative was created with the goal to eliminate the early elective induction of mothers that resulted in babies being delivered before 38 weeks and increased the risk of being put on ventilators or experiencing other complications. Today, non-medical early elective delivery has been virtually eliminated at OSF HealthCare’s eight hospitals providing obstetrical care.

Last year, we continued to focus on standardizing protocols, terminology and classifications to improve the care our obstetrics patients receive throughout the Ministry. We have had measurable decreases in the episiotomy rates. New software for electronic fetal monitoring was purchased to be used Ministrywide, and we will be developing common training in this area for both doctors and nurses.

As for the future, the OB Collaborative likely will become the OB-Gyn Care Council as we continue to grow in our efforts of becoming One OSF. We will continue to expand our Enhanced Recovery after Surgery effort for C-sections to all our hospitals. Attention also will be given to gynecologic quality initiatives. Plans include extending our work with maternal hypertension, further decreasing rates of episiotomy and engaging patients using social media.

The most notable outcome last year in creating the Surgery Collaborative was simply putting in place the structure to begin discussions about surgical quality issues.

Two OSF HealthCare hospitals, OSF Saint Anthony Medical Center and OSF St. Joseph Medical Center, have started Enhanced Recovery after Surgery programs to decrease surgical complications, length of stay and improve the patient’s experience following colorectal surgery. About 50 patients have gone through Enhanced Recovery and experienced a decrease in the length of stay, a decrease in the use of narcotics and earlier ambulation. The goal two years from now is to reduce the length of stay to two or three days, lower the readmission rate to under 8 percent and reduce the incident of surgical site infection to less than 5 percent.

Focus will be given to extending Enhanced Recovery after Surgery programs to all of our hospitals and expand it beyond colorectal surgery. There also are plans to address other issues ranging from surgical site infection to opioid use and the use of surgical mesh.

Last year, the Heart Failure Collaborative was established with the goal to reduce the mortality and readmission rates for patients admitted to any OSF HealthCare hospital with a diagnosis of heart failure. While it’s too early yet to have realized any concrete outcomes, work continues on patient identification, early follow up after discharge, appropriate medications and advanced care planning.

The Heart Failure Collaborative will continue to evolve to include additional projects related to emergency department care and ambulatory care of heart failure patients. This work in improving the care for patients with heart failure is critical as it allows them to continue to live the fullest life possible.

In fall 2016, two OSF HealthCare hospitals expanded their use of Transcatheter Aortic Valve Replacement to patients with intermediate risk, after FDA approval cleared the way to help more patients avoid open heart surgery. TAVR improves quality and quantity of life for patients with aortic stenosis and is offered in Peoria at OSF Saint Francis Medical Center and in Rockford at OSF Saint Anthony Medical Center.

Previously TAVR was only approved for heart valve patients deemed high-risk surgical candidates – those too sick to undergo open heart surgery. This new intermediate designation means more patients will get the new heart valve they need, without the need for open heart surgery.

TAVR is a procedure for patients with severe aortic stenosis (narrowing of the aortic valve opening). The procedure uses a balloon expandable aortic heart valve – placing it into the body via a catheter-based delivery system. The valve is designed to replace a patient’s diseased aortic valve while the heart continues to beat – avoiding the need to stop the patient’s heart.

The less invasive TAVR procedure also comes with a quick recovery time. Most patients will leave the hospital in an average of four days, and can resume all normal activities within 10 days of the procedure. In comparison, traditional open chest surgery patients need up to seven days of hospitalization and six weeks of rehabilitation.

In Peoria, the TAVR team at Saint Francis is one of the busiest in the state.

“At OSF we go a step beyond, using the Minimal Approach TAVR (MA-TAVR) method,” said Dr. Sudhir Mungee, one of the lead Physicians of the Peoria TAVR team. “This means a patient comes to a hybrid catheter lab with only a peripheral IV. The TAVR is performed with no general anesthesia or intubation and no surgical incision. A Minimal Approach TAVR patient is normally up eating dinner that same evening. Imagine a Heart valve replacement without open chest, no skin incision and only minimal anesthesia.”

In Rockford, the team at OSF Saint Anthony Medical Center has successfully performed more than 110 TAVR procedures, which is also well above the national average.

“As there are only select hospitals in the country approved to provide TAVR, we have been so happy to be able to provide this life changing procedure here at OSF St Anthony Medical Center,” said Cardiac Surgeon Dr. David Cable. “Our patients comment they are amazed at how quickly their life is changed by this minimally invasive procedure.”

On January 18, 2016, OSF HealthCare Illinois Neurological Institute neurosurgeon Andrew Tsung, MD, performed the first surgery to remove a brain tumor in the newly constructed intraoperative MRI (iMRI) suite at OSF Saint Francis Medical Center in Peoria, continuing the OSF tradition of being on the forefront of technology.

Traditionally, a neurosurgeon would do their best to remove all of a brain tumor and close up the incision. A scan would be taken later, and if it revealed that some of the tumor was still present, the patient would heal, only to have to undergo a second surgery. With the iMRI suite, a neurosurgeon like Dr. Tsung can surgically remove a brain tumor and, without closing up the incision, have the patient shuttled to the MRI for a brain scan. The images of the patient’s brain are almost immediate, and can show if there is any tumor left inside the brain, and where it is exactly. The neurosurgeon can then go back in and remove the rest of the tumor immediately.

“We’re finding out that we never know how much we remove,” Dr. Tsung said. “We tend to remove less than we think we did, especially on certain types of tumors. Brain tumors meld with the brain itself so you can’t differentiate in surgery by texture or appearance the difference between the tumor and the brain. So you have to temporize your aggression for the safety of the patient. The iMRI allows you to remove more tumor.”

According to Tony Avellino, MD, MBA, Illinois Neurological Institute chief executive officer, the iMRI operating suite is only the second one in the state of Illinois and OSF Saint Francis is the only facility in the state that offers both iMRI and Gamma Knife radiosurgery treatment options. The new iMRI suite is also the only one located in a children’s hospital in Illinois.
The new technology is expected to also serve an important role from an education standpoint, according to Dr. Avellino. It can help with the development of things like virtual reality and 3D printing for both physician training and patient education. The iMRI can be a springboard for methods to train physicians to perform operations more safely.