We have the 2008 Annual Report, complete with leadership teams, available as an electronic download (pdf)
We have the 2008 Annual Report, complete with leadership teams, available as an electronic download (pdf)
The University of Rochester Medical Center’s new strategic plan paints a vision of high-quality, error-free clinical care that’s both patient-centered and infused with innovative science. Our emphasis on translational medicine ensures that our patients benefit from fresh ideas that flow from our laboratories to our bedsides. At the same time, we are focusing on optimizing our processes and structure (facilities, technology, and people) in order to achieve the best possible outcome for each patient. The goal is to be among the top-performing academic medical centers in patient care quality, safety and service.
As an early adopter of quality improvement strategies like Lean Six Sigma and as a charter member of the Institute for Healthcare Improvement (IHI), Strong Memorial Hospital has been at the forefront of national and local efforts to reduce variation in care processes. We’ve also been a proponent of public reporting; Strong was among the first institutions to voluntarily disclose its data on a variety of process measures to CMS’ Hospital Compare Web site. And we were the very first hospital in the nation listed to support the IHI’s Five Million Lives campaign, a dramatic effort to reduce the incidence of medical harm.
In 2008, URMC defined an overarching metric for measuring our effectiveness in clinical care. The focus is clearly on monitoring and improving mortality, taking aim at reducing the ratio between observed and expected mortality. As new members of the University HealthSystem Consortium (UHC), we have the opportunity to benchmark our performance in real-time against other peer institutions, and we have access to comparative mortality information at a DRG-specific level. This allows us to identify and address concerns quickly so that we can reduce preventable deaths and complications.
Strong and Highland Hospital also introduced a new system for reporting medical errors or near misses. Consistent with our non-punitive culture, the new system has an option that allows individuals to report events anonymously, which encourages the universal reporting needed to make our systems safer.
Experts agree that the single most important step hospitals can take to eliminate preventable deaths is rigorous infection control. To this end, Strong Memorial and Highland have redoubled their campaigns to achieve 100 percent compliance with mandatory frequent and thorough hand-washing practices and use of protective attire. Further, by introducing “bundles” of simple measures shown to reduce infections, institutions like URMC are lowering infection rates to levels once thought unachievable, as low as one-quarter of the previous target. Specifically, we’re working to reduce infections associated with central lines, urinary tract catheters, ventilators, surgical site infections, and infections caused by drug-resistant organisms.
As medical care becomes more specialized and technology-driven, it must be safely delivered by teams of professionals who trust and communicate well with each other. That’s why URMC has adopted the national Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) process developed by the Department of Defense Patient Safety Program in conjunction with the Agency for Healthcare Research and Quality. TeamSTEPPS improves outcomes by emphasizing team leadership, situation monitoring, communication, and mutual support. Strong’s success with Rapid Response Teams (RRT), groups of ICU staff who respond to rescue destabilizing non-ICU patients, demonstrates the power of teamwork. The RRT concept is being expanded so that every inpatient unit is now paired with an ICU team; the goal is to avoid ICU readmissions and prevent deaths.
The strategic emphasis on quality, safety and service at both Strong Memorial and Highland hospitals has led board members, clinical leaders, physicians and staff to demand more real-time information to gauge our performance. In 2008, both hospitals began providing more frequent, monthly reports to their respective boards on a variety of over-
arching and specific measures. In addition, weekly reports that tally avoidable incidents such as falls, pressure ulcers, and infections are distributed to department heads, nursing, and other clinical leaders. These snapshots keep everyone focused on solving and avoiding problems as they occur.
Outstanding people and processes are only one part of the formula for delivering safe, high quality care that exceeds our patients’ expectations. Appropriately sized, efficient facilities also are key to providing superior care, and as URMC’s patient load has expanded, its facilities have been stressed to accommodate the demands of both staff and patients.
The University of Rochester Medical Center is maximizing its existing footprint with renovations and additions that modernize facilities and allow physicians to offer more comprehensive services at both Strong Memorial and Highland hospitals. New construction, also on the horizon, will expand the number of hospital beds at Strong Memorial, desperately needed in the Rochester region.
Here are highlights of new construction and renovation programs in 2008:
The University of Rochester Medical Center’s bid to improve patient access and safety was granted in October by the New York State Department of Health, which approved the addition of 83 beds to Strong Memorial’s license, with the ability to add up to another 40 beds if demand continues to outpace capacity.
The Pediatric Replacement and Imaging Sciences Modernization (PRISM) project to be built west of the Emergency Department will include 56 beds for Golisano Children’s Hospital, 56 adult beds for Strong Memorial, plus additional space for imaging sciences (radiology) including a dedicated area for pediatric patients.
With all available patient care space currently in use, the PRISM expansion is essential to the Medical Center’s ability to continue caring for patients and contributing to the vitality of the Rochester region. In light of the national economic downturn, the Medical Center now plans to begin construction as soon as market conditions stabilize to allow for favorable financing.
In the interim, renovations at Strong over the past 18 months have maximized space within the hospital to address serious overcrowding. In September, the hospital reached the limit of its existing 739-bed license when it opened a new adult medical unit on 4-3400, providing 10 additional beds. Renovations are under way on 4-1200 to add 15 adult palliative care beds, and to and tap into the reservoir of new beds granted by the state. Meanwhile, Strong Memorial is working to maintain access by maximizing its partnerships with Highland Hospital and nursing homes, working to reduce length of stay, and avoiding lower acuity admissions whenever possible.
Cancer care and translational research in Rochester found a new home in May with the opening of the James P. Wilmot Cancer Center. Its contemporary, open design infuses natural light throughout patient and common areas in the four-story, 164,000-square-foot center. By nearly doubling the medical oncology clinical space, caregivers can now provide chemotherapy infusions for up to 46 patients at a time.
With scientists and patient care experts together in a single building, the Center epitomizes the Medical Center’s effort to speed research breakthroughs into every day clinical practice.
New patient amenities include a volunteer ambassador service to escort newly diagnosed patients on their first day of treatment, and an expanded Frank and Cricket Luellen Patient and Family Resource Center. Patients also benefit from a $10 million investment in the Radiation Treatment Center, which increased from three to five linear accelerators. The Center brings novel cancer treatments to the upstate New York region, including the Tomotherapy Hi-Art System, a next-generation technology that allows doctors to treat multiple tumors at once, and the new Trilogy system that delivers radiation with pinpoint precision.
Patients with breast abnormalities can take advantage of the Comprehensive Breast Care Center, a unique care model to upstate New York. Radiologists, pathologists, oncologists, radiation oncologists and surgeons work as a team to help women efficiently navigate the spectrum of care, from screening and diagnosis to cancer treatments.
Two major renovations are helping Highland Hospital better meet patient demand. Its Medical Oncology and Infusion Center more than doubled in size, reducing wait times for patient appointments and enabling caregivers to provide chemotherapy infusions for up to15 patients at once. Individual televisions, wireless computer access and walled partitions enhance patient comfort and privacy, while clear line-of-sight between nurses and patients optimizes safety during treatments.
Highland also opened its new Endoscopy Center, which provides modern equipment in three procedure rooms and a dozen recovery rooms, all staffed by a specialized endoscopic team. The Center offers optimal comfort and privacy for outpatients and inpatients undergoing colonoscopies, gastroscopies and bronchoscopies. The Center’s physicians offer two innovative treatments for lung cancers, cryotherapy and endobronchial intratumoral chemotherapy.
Enhancing privacy and comfort for families its serves, Golisano Children’s Hospital at Strong renovated and expanded its outpatient treatment center. The B&L Wholesale Pediatric Treatment Center added seven private rooms, bringing the total to 10 private spaces able to serve up to 300 children every month. Rooms are furnished with televisions and top-quality infusion chairs that double as beds. They are complemented by a large, sunny playroom that provides a welcome change of pace for children undergoing treatments.
A new multidisciplinary Psoriasis Center is addressing the complex needs of those who suffer from psoriasis, a chronic disease that affects millions of Americans. Launched through a collaborative effort between the Allergy/Immunology and Rheumatology Division and Department of Dermatology, the Center also involves specialists in arthritis, cardiovascular disease, ophthalmology, gastroenterology, endocrinology, psychiatry and nutrition, to meet patients’ multiple needs.
Patients with neurological conditions were greeted with larger, more modern facilities this year as the departments of Neurology and Neurosurgery relocated. For Neurosurgery, the move marked the first portion of a two-phase plan to
consolidate the majority of neurosurgical outpatient care for its 10 faculty physicians into one convenient location. With 14 exam rooms, the new off-site clinic has successfully reduced wait time for urgent care, new patients, and follow-up visits.
A culmination of years of growth and planning, the Department of Neurology opened a 19-room outpatient clinic on the first floor of the Ambulatory Care Facility adjacent to Strong Memorial. The clinic’s new home improves accessibility for patients and will enable the program, which currently sees more than 110 patients a day, to continue to grow.
A $2.38 million grant from Eastman Dental Center (EDC)’s Foundation Board of Directors is allowing EDC to begin a significant clinical re-engineering initiative, greatly needed to replace aging equipment and expand overcrowded facilities. Changes are under way for URMC Dentistry including new technology to increase efficiency in scheduling and implementing treatment plans, ongoing staff training, and a new patient records room for faster, and streamlined access. More updates are in the works to greatly improve its facilities, operations and staffing, and will result in new procedures, increased capacity and more patient visits at its main campus and other locations.
New technology in hands of skilled experts is key to advancing patient care. From improvements in surgical techniques to advanced imaging technologies, the year’s highlights included numerous improvements throughout the URMC network.
With the acquisition of the technologically advanced da Vinci Robotic Surgical System, Highland Hospital surgeons are now using the da Vinci robot, most commonly used for prostate cancer surgery, to replace open surgeries typically performed for bladder and kidney cancers. Gynecologic oncologists at Highland also are employing robotics to provide minimally invasive options for treating cervical, uterine, and ovarian cancers; simple and radical hysterectomies; and removal of lymph nodes to stage cancers.
Surgeons at Strong Memorial Hospital continue to advance the frontiers of minimally invasive surgery, using smaller and more flexible instrumentation. Urologists this year conducted what is believed to be the nation’s first single-incision laparoscopic surgery to remove both kidneys from a patient. Instead of inserting the various laparoscopic instruments through six holes across the abdomen, surgeons completed the complicated procedure with just one small incision through the patient’s navel. This single-port access (SPA) technique offers multiple benefits including decreased risk of wound complications, shorter hospital stays and recovery time, less pain and discomfort, and little to no scarring.
A multimedia experience awaits patients as they undergo a scan with Strong Memorial’s new open magnetic resonance imaging (MRI) machine. Equipped with a high-field strength magnet, Strong’s open MRI produces superior images to conventional open scanners. Pediatric patients too young to hold still and anxious adult patients can avoid sedation by taking advantage of the machine’s open configuration and its “ambient experience” system. Patients can personalize the exam room by choosing a color to softly light the room, and select from 10 themed images which are projected on the wall, complete with sound effects. Strong Memorial was the first in New York state with such a system, and remains one of only four hospitals in the entire Northeast region with this audiovisual enhancement.
Health Buddy, Visiting Nursing Service’s (VNS) pioneering telemedicine program, grew from 40 to 120 monitors in 2008. Using a small in-home wireless device, high-risk patients with heart failure, diabetes, and asthma take and transmit their vital signs, such as blood pressure, weight and blood oxygen levels, to VNS. Individualized health education is transmitted back to patients based on information they submitted. Meanwhile, VNS staff review patients’ vital signs and make adjustments to treatment and visitation plans to improve or maintain a patient’s health status.
VNS is also using Health Buddy to help prevent rehospitalization of patients with congestive heart failure (CHF), who nationwide have the highest risk of returning to the hospital within 30 days after discharge. Collaborating with Medical Center primary care physicians, cardiac specialists, nursing and social work leaders, VNS has developed a specific set of health criteria for patients to maintain while at home. Health Buddy is used to monitor their progress and communicate status with patients’ physicians, who can intervene before a trip to the emergency room is needed. Leaders are hopeful that this pilot program will help reduce the need to readmit CHF patients by 18 percent.
The Medical Center’s ability to realize the goals enumerated in our overall 2007-2012 Strategic Plan – especially, enhancing the quality and safety of patient care – squarely hinges on a comprehensive upgrade to our inpatient and outpatient information technology systems. At issue is the lack of interoperability of the various systems installed throughout acute care areas. For example, while receiving care for a heart attack, patients and their families may need to repeat their medical history several times as the patient is transferred to different areas of the hospital, and eventually discharged to an outpatient clinic. Not only is the duplication of data-gathering inefficient, it can lead to delays in care and, sometimes, sacrifices in safety.
Physicians in the departments of Imaging Sciences and Neurosurgery are using a new type of Magnetic Resonance Imaging (MRI) scan to make brain surgeries as safe as possible. Functional MRI, or fMRI, involves using a 3T MRI scanner to non-invasively conduct “brain mapping,” or pinpoint to millimeters areas of the brain that generate specific actions, such as speech or movement. Surgeons have found this precise information invaluable when planning for brain surgeries that may impact brain tissue near areas that control movement or cognition.
Department of Emergency Medicine faculty are the first in the nation to use video podcasting as a way to improve pre-hospital care for older adults, the largest users of ambulance transportation. Videos outlining proper techniques in starting care for geriatric patients while en route to a hospital are posted to a Web site (www.rochesterems.org) where they can be viewed and/or downloaded by emergency medical technicians (EMTs) and paramedics. This level of high-tech distance learning covers the most common issues EMTs encounter with seniors, and can earn CME credit for New York state emergency personnel.
Eastman Dental Center (EDC) continues to be a magnet for specialty dental services in upstate New York. Specially trained pediatric dentists and experts from the Golisano Cleft and Craniofacial Center at the Medical Center are part of the only team in the state outside New York City to provide a non-surgical treatment to help babies born with cleft lip and palate. The team uses a retainer-like device custom fit to the baby’s mouth and nose to reduce the gap between the gum pads and the discontinuous upper lip before the first corrective surgery. Children who use this nasoalveolar molding appliance, or NAM, benefit from enhanced feeding as an infant, a much shorter initial surgery at around four months of age, a potential for fewer subsequent surgeries, and diminished scarring around the surgically repaired lip and nose.
Patients from throughout upstate New York and beyond are attracted to the Medical Center for the expertise of the University of Rochester School of Medicine and Dentistry faculty. Working closely with basic and clinical scientists, these physicians are often the exclusive providers of unique approaches to care in our region. As a result, over the past seven years, inpatient volume has jumped almost 13 percent, a stark contrast to other markets where hospitals struggle to maintain adequate occupancy rates. Read more about new services now available at the Medical Center with faculty recruited in 2008.
Two Medical Center departments collaborated to bring a procedure to the Rochester region that has successfully decreased or, in some cases, eradicated debilitating side effects in stroke patients. The departments of Imaging Sciences and Neurosurgery each recruited neuroendovascular experts, creating a formidable team to offer this minimally invasive procedure around-the-clock to patients in our region. Treatment involves using a catheter-like instrument to inject clot-busting drugs directly into a brain clot, and even suction out the clot itself. By tripling the amount of time stroke victims have to receive treatment for stroke, physicians are able to give patients yet another chance at recovering a fully independent life.
The Department of Surgery welcomed six new, high-profile surgeons to its growing faculty, extending the region’s expertise in colorectal surgery, surgical oncology, vascular, thoracic and plastic surgery.
New procedures and programs include intravascular ultrasonography, a new way to view the inside of blood vessels in real-time; minimally invasive thyroidectomy and parathyroidectomy, performed by surgical oncologists; and the development of Life After Weight Loss, the second program of its kind in the country to offer body contouring after significant weight loss by specially trained plastic surgeons.
These new recruits are evidence of the growing capabilities and reputation of the Department of Surgery, which was recently selected to host the Society of Clinical Surgery’s annual conference in 2010. In addition to the presentation and discussion of the latest surgical research, the meeting includes “operative clinics,” during which attendees visit the surgical suites of the host institution.
The Department of Medicine appointed new chiefs in four of its 10 divisions. A mix of stellar internal and nationally recruited candidates, these new chiefs will drive academic and clinical strategies in cardiology, infectious disease, endocrinology and general medicine. Brief summaries of the appointments follow.
The Department of Orthopaedics maintains its decade-long tradition of posting significant volume growth across all of its services. Between 2007 and 2008, patient visits jumped by 7 percent; inpatient and outpatient surgeries rose by 9 percent; and outpatient procedures by were up by 10 percent, making it one of the busiest orthopaedic practices in the nation.
These increases were, in part, driven by faculty additions – including two recruits to its Hand and Upper Extremity division, a pediatric spine specialist, and a geriatric fracture expert – who each extend URMC’s range of patient services. For example, expandable spinal implants are now available for young scoliosis patients to give their lungs more room while they — and their spine — grow.
Our ability to handle our patients’ health care needs in all stages of their life is capably met through our thriving primary care network, as well as our senior living and skilled nursing facilities. Improvements in facilities and infrastructure is under way at all of these organizations.
The Center for Primary Care reached a milestone when 100 percent of its Primary Care Network practices fully converted to electronic medical records – an achievement shared by less than 30 percent of physicians’ offices nationwide. Today, approximately 100 physicians can access information for more than 175,000 patient visits per year at the touch of a button, an efficiency that improves quality, safety, and access.
The Primary Care Network aims to exceed community and national primary care benchmarks for patient and physician satisfaction and quality through its participation in the Greater Rochester Practice-Based Research Network. For example, in 2008, all of its physicians began a continuing process of internal peer review – quarterly audits of colleagues’ patient charts to review best practices and learn new methods for managing patient issues.
Finally, the Network successfully recruited eight outstanding physicians in 2008 making URMC’s care available to more patients.
The Living Center at The Highlands at Pittsford is developing a program that incorporates advanced approaches in the care and understanding of nursing home residents with dementia. The Creative Care Neighborhood features six distinct concept areas, each with specific therapeutic benefits that enable residents to engage in activities they enjoyed earlier in life. Some may choose to continue “working” in The Office setting, which simulates a work environment, while The Nursery provides a place for residents to care and nurture their “baby,” fold its clothes, and sing it a lullaby. The program “leads the way back home” for residents, and brings back cherished memories; the concept also required intensive training for staff to interact with residents living in The Neighborhood.
With almost 40 percent of residents at The Highlands at Pittsford having direct University of Rochester affiliations as retirees, alumni or relatives of employees, The Highlands is transforming itself into a university-based retirement community. For example, University faculty offer educational programming to Highlands residents through such programs as To Your Health! and UR Always Learning. In 2008 alone, more than 1,300 participants participated in the To Your Health! lecture series. This type of environment is proving attractive to alumni, retirees and in recruiting professionals and their extended families to the Rochester area.
Understanding that staff satisfaction has a direct correlation to resident perceptions of care and overall outcomes, The Highlands at Brighton launched a comprehensive program aimed at improving staff morale and retention. Components include establishing official career paths for staff members; creating a staff skills-training program to further neurobehavioral management skills; and exposing staff to the full continuum of care by participating in a paraprofessional training initiative in conjunction with The Living Center at The Highlands at Pittsford and Visiting Nurse Service. The facility also served as host for a region-wide Emergency Preparedness Drill, involving a simulated evacuation of its residents. The drill mimicked a tornado disaster, and provided invaluable experience to Highlands’ staff and their ability to transfer, place and care for its special-needs residents in the event of a natural disaster.
Thriving clinical programs at the Medical Center were celebrated in 2008, with some marking significant milestones.
The Program in Heart Failure and Transplantation performed its 100th cardiac transplant surgery in February 2008. The largest program in upstate New York and the region’s only comprehensive heart failure and transplant service, the transplant team has grown from four team members to 19 to accommodate its increased patient load. The program’s one-year survival rate is 88.1 percent, comparing favorably with some of the nation’s best transplant centers.
In May, the Strong Fertility Center celebrated 25 years of helping families grow. The Center is the longest-running program in upstate New York and boasts one of the earliest successful in vitro fertilization programs. Today the Center’s experts provide the latest treatments and are active in infertility research. In this milestone year, the Center launched a series of educational programs exploring links between fertility and diet, environmental factors, and acupuncture as a complement to treatment.
The country’s third oldest Meals On Wheels (MOW) program turned 50 this year and, in that time, served nearly 10 million meals throughout Monroe County. Visiting Nurse Service, which operates MOW, manages the massive operation that each year organizes more than 2,000 volunteers to deliver 400,000 meals to 2,000 individuals. Today, VNS’ MOW program is ranked among the top two percent of programs in the U.S., is accredited by the Meals On Wheels Association of America, and has been recognized as one of the most remarkable and unique community collaborative efforts in the country.
As upstate New York’s leader in allogeneic and autologous transplant procedures, as well as collection and stem cell processing procedures, URMC performed its 2,000th transplant in October. Founded in 1988, the Samuel E. Durand Blood and Marrow Transplantation Program performs about 120 procedures each year, and its 100-day survival rates surpass national benchmarks.
Strong Memorial’s surgeons reached the 2,000th mark in robotic surgeries, placing the institution among the top 10 in the country for its expertise in this specialized technology. The milestone reflects patients’ growing demand for less invasive surgeries that offer faster recovery and fewer complications.
Awards and citations are yet another measure of patient-focused, high quality care. This past year, the Medical Center was cited by multiple organizations, often earning honors for consecutive years.
The James P. Wilmot Cancer Center earned kudos as a Blue Distinction Center for Complex and Rare Cancers by Excellus BlueCross BlueShield. The designation recognizes expertise and multidisciplinary cancer care provided to people with a wide range of complex cancers, such as acute leukemia, bladder, bone and pancreatic cancers, and provides an easily accessible resource to help people afflicted with rare cancers to make decisions about where to seek treatment. The Wilmot Cancer Center is the only center in the region to have this designation, joining just 85 centers across the US.
The National Committee for Quality Assurance (NCQA) recently gave the University of Rochester Medical Faculty Group (URMFG) a perfect score for its credentialing and privileging systems, and recertified it as a Physician Organization. The NCQA seal is a widely recognized symbol of quality, and provides assurances that the Medical Center rigorously reviews the credentials of each physician – from medical school graduation to the present – before granting privileges. URMFG, an organization of 982 faculty physicians, also works in partnership with the Medical Staff Office, which manages the credentialing of health care providers for Strong Memorial and Highland hospitals. In 2008, it launched an ambitious three-phase plan to move to a paperless credentialing and recredentialing process, making it one of a handful of health systems in the country to do so. More than 1,700 health care providers review and update their information over a secured server, and submit it to a software program that imports and stores the documents.
Strong Memorial earned multiple awards for strict adherence to evidence-based care guidelines established by the American College of Cardiology and the American Heart Association to treat cardiac and stroke patients. Strong was the only hospital in the region to receive the 2008 ACTION Registry – Get With The Guidelines Silver Performance Achievement Award and the Triple Performance Achievement Award. Coronary artery disease and stroke care also received individual Gold Sustained Performance Awards to mark two or more years of adherence to all Get With The Guidelines standards, while heart failure care received a Silver Performance Achievement Award for 12 consecutive months of compliance to performance measures.
For the second consecutive year, ICUs at both Strong Memorial and Highland hospitals received the prestigious Beacon Award for Critical Care Excellence. Given by the American Association of Critical-Care Nurses, the Beacon Award recognizes critical care units that achieve the highest quality outcomes, exhibit high quality standards, and provide exceptional care of patients and their families, as well as a healthy work environment.
Highland Hospital was recognized as a top-performing participant in the National Surgical Quality Improvement Program (NSQIP) sponsored by the American College of Surgeons. Designed to both measure and improve surgical outcomes, NSQIP assigns ratings to 220 hospitals that supply data on their patients and post-operation mortality and morbidity information.
The Artificial Heart Program, part of the Program in Heart Failure and Transplantation, received for its work with ventricular assist devices a Certification of Distinction from the Joint Commission, the nation’s predominant standards-setting and accrediting body in health care. To earn this distinction, the program underwent an extensive, unannounced, on-site evaluation by a team of Joint Commission reviewers.
For the thirteenth consecutive year, Strong Memorial Hospital won the National Research Corporation’s (NRC) Consumer Choice Award. The annual award identifies hospitals that health care consumers have chosen as having the highest quality and image in the U.S.
Orthopaedic and geriatric faculty at Highland Hospital continue to receive worldwide attention for their unique approach to treating bone fractures in the elderly at its Geriatric Fracture Center (GFC). A Switzerland-based research group is funding work to replicate its care model at hospitals in the U.S. and abroad. Work at the GFC has demonstrated superior patient outcomes by focusing on rapid evaluation of elderly patients to reduce their time to surgery; close medical co-management by orthopaedic surgeons and geriatricians throughout patients’ hospitalization; and using a total quality management approach that reduces medication errors and other complications.
Strong Memorial Hospital has been redesignated as a Nursing Magnet Hospital, the highest and most prestigious honor an organization can receive for excellence in nursing and quality patient care. The international quality nursing designation is awarded to only about five percent of hospitals in the country, and highlights the work and accomplishments of the nurses at Strong and their continued commitment to continuously improve patient care and the health of the community. Research has shown that Magnet hospitals enjoy better outcomes, including lower mortality rates for patients, and that they outperform their peers in recruiting and retaining nurses. Strong Memorial was first designated as a Magnet Hospital in August 2004, when it became the first hospital in the Rochester region to receive this recognition of nursing excellence.