title: Taking a patient safety approach to an integration of two hospitals.
abstract: BACKGROUND
  Consolidation of inpatient care between two acute care medical centers brings many challenges, including an increased risk of an untoward event during patient transfer and impaired hospital performance during the postintegration period. When the Jesse Brown Department of Veterans Affairs (VA) Medical Center in Chicago integrated two acute medical-surgical inpatient facilities, the challenges intrinsic to simultaneously integrating acute medical-surgical programs and academic training programs necessitated a novel approach. STRATEGIES USED: Several patient safety-related tools were used for the safe transfer of patients and for sustaining hospital performance after integration. These tools included Failure Mode and Effects Analysis (FMEA) of the move process, process action teams to bridge the differences in standard nursing unit operation, and an integration score card to monitor and evaluate the impact of the integration on organization performance.
  
  
  RESULTS
  Patient care was not disrupted except for a transient reduction in elective surgical procedures during the week before the move. Postintegration data indicated reduced operating room cancellations, sustained inpatient capacity and access, and comparable findings in patient falls and methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci infections.
  
  
  CONCLUSIONS
  The impact of several patient safety tools and interventions was reflected in the fact that performance remained constant or improved for the predefined measures of access and quality.
authors.affiliation: Edward Hines Jr. VA Hospital, Hines, IL, USA. Jeff.Gering@med.va.gov
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Gering
authors.forename: Brian
authors.initials: B
authors.lastname: Schmitt
authors.forename: Alesia
authors.initials: A
authors.lastname: Coe
authors.forename: Donna
authors.initials: D
authors.lastname: Leslie
authors.forename: Jennifer
authors.initials: J
authors.lastname: Pitts
authors.forename: Trent
authors.initials: T
authors.lastname: Ward
authors.forename: Prakash
authors.initials: P
authors.lastname: Desai
mesh_terms: D002641:Chicago; D006273:Health Facility Merger; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control*; D009935:Organizational Affiliation / Q000458:organization & administration*; D017751:Safety Management / Q000458:organization & administration*; D017749:Total Quality Management / Q000379:methods