Betsy Ryan is president and CEO of the New Jersey Hospital Association. Her blog, Healthcare Matters, examines the many issues confronting New Jersey's hospitals and their patients. Readers are encouraged to join the discussion, because healthcare matters - to all of us.

POLST Empowers Patients in End-of-Life Care

Gov. Christie recently signed into law a new program called “POLST,” which stands for Physician Orders for Life-Sustaining Treatment. This is a new vehicle for patients and their doctors to – voluntarily – spell out for future caregivers and family members the patient’s goals, particularly at the end-of-life. Working closely with a physician or advanced practice nurse, an individual can put into writing the types of care that he or she wants – or does not want – during the end stages of a life-limiting illness or chronic disease. Because the document is signed by a physician or advance practice nurse, the experience of other states has been that POLST is followed by other practitioners of care. And because family members see that mom, or dad, or Aunt Betty signed the form themselves, they are more comfortable with the decision. POLST will empower patients. Its use is voluntary, but we at NJHA think it’s a powerful tool for us to improve the care we provide at the end of life. We urge you to watch for POLST to be rolled out in New Jersey in the coming months and to use it as a catalyst to talk to your clinician and take control of your healthcare wishes. You can learn more at
Written by Betsy Ryan at 14:50

Cheers for Our Nurses and for NJ’s Great Strides in Cardiac Care

Great news for New Jersey: The state’s latest report card on cardiac surgery care in the state’s hospitals shows continued improvement. In fact, New Jersey’s mortality rate following heart surgery has now fallen to the lowest point since the state first started reporting the data in 1994-95.

Quality improvement is no accident. I happen to be writing this on Nurses Day, and I know that our nurses play a major role in our accomplishments in patient safety and quality improvement. Our steady, progressive improvement is the result of commitment, communication, attention to detail and persistence by those dedicated nurses as well as hospital leaders, physicians and the state Department of Health and Senior Services. It’s a partnership to examine our processes and outcomes in caring for cardiac patients, confront any shortcomings we find and dedicate ourselves to improvements that make our care better and safer.

All told, about 2 percent of patients undergoing coronary artery bypass graft surgery died following the procedure in 2007, the report states. That’s a serious operation and clearly there are risks involved. But we aren’t content with that 2 percent rate – although it does represent a 54 percent decline over the last 15 years. Our goal is zero. Some would say that’s unattainable, but the important thing is the journey – every step along the way improves healthcare for our patients.

To our nurses and physicians, keep up the good work. To state Health Commissioner Dr. Poonum Alaigh, thanks for the leadership and kind words. And to the patients of New Jersey, rest assured, we’ll keep working to provide you the best care possible.

Written by Betsy Ryan at 15:23

N.J. Hospitals Go 4 for 4, but Quality Work Continues

Some valuable new data was released recently showing progressive improvement in the quality of care given in New Jersey hospitals. So while my previous blog may have convinced you that I’m only focused on the Sports page (it’s looking good for that N.J. Turnpike series!), I also read with great interest the Hospital Performance Report issued by the N.J. Department of Health and Senior Services. This report showed that N.J. hospitals continue to improve the quality of healthcare in our state. Our hospitals improved their performance in all four overall categories contained in the report – heart attack care, pneumonia care, surgical care and heart failure care. In fact, this year we saw an increasing number of “100s,” which is the top score that reflects full compliance with certain standards of care. This year’s report also included several patient safety indicators for the first time, and New Jersey’s hospitals performed better than or on par with the national average in 10 out of 12 indicators.

Hospitals and their dedicated teams of physicians, nurses and other healthcare professionals work hard at providing quality care and looking out for patient safety. This work is continuous as new improvement strategies are identified and implemented. Earlier this month, another report issued by the ratings service HealthGrades reaffirmed what we saw in the state report – continued improvement in the quality of care provided by New Jersey hospitals. The HealthGrades report showed New Jersey among the top five states in the country in improvement for heart failure and stroke care, along with coronary intervention procedures.

At NJHA, we have focused a lot of time and attention on helping hospitals improve through the NJHA Institute for Quality and Patient Safety. We can’t and won’t rest on our laurels. Quality and patient safety are too important.

Postscript: For those who responded to my last blog post, I must report that my husband and son are telling me I‘ll have to move out if we do indeed have a Yankees versus Phillies World Series. I am almost sure they are joking.

Written by Betsy Ryan at 19:41