In streamlining patient care and making it safer, YNHH provided leadership to a Yale New Haven Health system-wide effort to develop a value innovation strategy which capitalizes on our people, programs and innovative ideas, as well as lessons learned through improvement initiatives and development of new processes and technology.

Our work to enhance quality and safety focused on high reliability, strategies and tools to reduce readmissions, and hospital-acquired infections.  As evidence of our success to date, the rate of serious safety events at YNHH declined by 77 percent since the beginning of the hospital's journey to be a High Reliability Organization (HRO) in September 2012.

Of note, several services including Transplantation, Children's Hospital, Obstetrics, Psychiatry, Laboratory Medicine, Shoreline Medical Center and Saint Raphael Campus Emergency Department went more than a year without a single serious safety event.

A performance improvement team explored ways to reduce Catheter-Associated Urinary Tract Infection (CAUTI) rates, focusing on catheter maintenance and twice-daily catheter care and cleanings. The team worked to reduce the use of Foley catheters, and using the rounding to influence model, "Foley Fridays" continued where clinicians audit the number of Foley catheters in use and see if CAUTI prevention procedures are being properly followed.

Results from the biennial Yale New Haven Health Culture of Safety Survey showed that our staff and physicians believe that our safety and quality initiatives are improving care. YNHH was at or above national benchmarks in eight of the 12 categories surveyed and demonstrated improvement in all 12 domains. YNHH's top three opportunities for improvement are overall perceptions of safety, teamwork across units and hospital handoffs and transitions.

Yale New Haven Children's Hospital's (YNHCH) marked 1½ years without a serious safety event. Quality improvement projects reduced hospitalizations and lengths of stay for sickle cell patients; reduced unplanned extubations by 40 percent (resulting in $300,000 in cost savings); and improved HPV vaccination. As part of a national collaborative, YNHCH achieved early detection of sepsis in 34 patients and treated them effectively. This year, YNHCH became a Certified Center of Excellence for Duchenne's Muscular Dystrophy and achieved a second accreditation as a pediatric sleep center for its Bridgeport Campus.

On the regulatory front this year, the Joint Commission conducted a full accreditation survey of YNHH, resulting in a very positive report and successful re-accreditation. The Connecticut Department of Public Health conducted a full survey, also with a positive outcome and successful licensure. YNHH achieved Magnet re-designation from the American Nurses Credentialing Center for the second consecutive time. This year it included the Saint Raphael campus – making Yale New Haven the largest Magnet hospital in the world.