Quality & Safety

Quality & Safety

We aim to provide our patients with the safest, highest-quality care possible. As a regional quality leader, we challenge ourselves every day to find better ways to keep patients safe and to improve health outcomes. We measure our progress and hold ourselves accountable through transparent reporting of our quality data.

Quality is consistent excellence in the care and services we provide to increase the likelihood of desired outcomes. It ensures the care we provide is safe, effective, timely, patient- and family-centered, efficient, and equitable.

From ongoing quality improvements to care and the systems we use, protocols are in place to ensure a healthy environment for patients, staff, and visitors. Elliot Health System is committed to a culture of improvement — to become better tomorrow than we are today through a whole system quality approach.

The Elliot is committed to the pursuit of excellence by delivering care and services to our patients that meet or exceed all areas of the quadruple aim, including quality, value, patient satisfaction, and provider experience, through continuous improvement and respect for people. Wherever possible, we strive to provide evidence-based care in a way that is consistent across care delivery settings, and we use data to monitor our performance as well as to identify areas of opportunity for improvement. We promote ethical, innovative, professional, and compassionate care within an environment that nurtures our patients’ physical, social, and emotional needs.

The Elliot’s improvement philosophy is to engage everyone, every day in problem-solving in order to meet the evolving needs of our patients and community. We build structures and systems with processes that make it easier for the healthcare workforce to move toward achieving our shared vision for quality. We have an organizational cultural commitment to applying the scientific method to designing, performing, and continuously improving the work delivered by teams of people, leading to measurably better value for patients and other stakeholders.

We achieve our quality vision in several ways

  • Through our Quality Management System, we focus on providing the highest quality care and best patient and provider experiences, ensuring health equity and affordability.
  • Our staff, including those most involved in patient care, are empowered in ensuring quality of care and making The Elliot a safer place to give and receive care. Staff receive consistent information, learn problem-solving approaches, and gain tools to ensure quality patient care across Elliot Health System.
  • We lead with a culture of compassion and patient safety, and always strive for excellence to ensure that respect for people is at the center of our work.
  • We believe that transparent communication with our patients and our co-workers is essential to delivering safe care. We encourage patients, families, and employees to contact our Patient Relations team at 603-663-2666 to report a concern regarding the safety or quality of care given to our patients.
  • We aim to continuously improve by closely monitoring quality and effectiveness of care using data and robust analytics.
  • We provide evidence-based care and compare our quality metrics with benchmarks in the industry to be sure we are meeting industry standards.

Industry Recognitions for Quality

  • Elliot Hospital is a DNV accredited hospital, which adheres to the National Integrated Accreditation Health Organization (NIAHO) standards inclusive of the CMS Conditions of Participation.
  • The Elliot earned Orthopaedic Center of Excellence Designation from DNV Healthcare USA Inc. affirming our excellence in delivering a comprehensive, unified, and standard structure for surgical quality across all surgical specialties that includes a foundation of quality reporting and transparency.
  • The Elliot earned the American College of Radiology Accreditation gold seal of accreditation, representing the highest level of image quality and patient safety.
  • Nationally verified Level II Trauma Center by the American College of Surgeons with a documented ability to provide exceptional care for trauma patients and improve outcomes in this patient population.
  • Accredited by the American College of Surgeons (ASC) American Society for Metabolic and Bariatric Surgery as an MBSAQIP Accredited Center in accordance with nationally recognized bariatric surgical standards.
  • Awarded 2 out of 3-Star Rating from the Society of Vascular Surgery (SVS) Vascular Quality Initiative (VQI), recognizing our commitment to improving patient safety and the quality of vascular care delivery.

To learn more about recognitions achieved by The Elliot, visit our Awards page.

Infection Prevention: Ensuring a Healthy Environment

Elliot Health System works to ensure that our environment is healthy and safe for all. We do this with dedicated staff and carefully managed infection control policies.

Elliot Health System’s dedicated Infection Prevention team works to prevent and control infections. Infection Prevention is staffed by an infection prevention officer and two full-time infection prevention coordinators, and is supported by an infectious disease physician. Infection Prevention works closely with the Manchester and State Health Departments.

Helping Our Community Through COVID-19

Elliot Health System has remained committed to caring for our community throughout the COVID-19 pandemic. This includes sharing important information about vaccines, boosters, testing, our visitor policy, and other safety measures to keep yourself and your loved ones safe. Visit our COVID-19 information page for more information.

Supporting All Staff Engaged in Quality and Safety

We have departments committed to providing a range of support services so that all colleagues have the right tools, resources, and systems to improve.

The Operational Excellence department supports Elliot Health System by focusing on long-term change in the organization's culture and leadership philosophy. The team partners with colleagues to systematically manage and improve our business and operational processes to meet patient expectations by focusing on becoming a learning organization and developing our people. Functions of the department include: Accreditation; Analytics; Continuous Improvement; Quality Program Management; Value-Based Care.

Our analytics team provides consulting, coaching, research, analysis, and reporting support for Quality, Utilization, Regulatory, Operations, and Performance Improvement initiatives. The analytics team is responsible for the design and development of intuitive, data-driven tools that inspire self-directed decision-making. The analytics team leverages a variety of data sources, including Elliot Health System’s vast collection of patient health data using numerous tools, including MS SQL Server, Tableau, and Business Objects.

The Continuous Improvement Team supports the delivery of operational excellence by coaching leaders and teams, leading improvement projects, and connecting learning across the system.

The team leads and facilitates improvement projects within the organization, using improvement science and methodologies such as lean and six sigma. This includes working with and coaching members of senior leadership, area leaders, and front-line teams using a data-driven, scientific, problem-solving approach while teaching continuous improvement methods.

Our philosophy for improvement is built on an attitude that continuous improvement is part of everyone’s job. This entails everyone applying an experimental mindset and using the Plan-Do-Study-Act (PDSA) Cycle to approach improvement work to ensure the best outcomes are achieved through iterative learning.

Our philosophy for improvement is also built on Respect for People, where every employee is valued for their knowledge, capabilities, and contributions. At Elliot Health System, we believe that the people who do the work are closest to the problems and therefore hold the knowledge for the best way to solve problems. We believe everyone should have the autonomy and skills to improve their work.

DNV Healthcare Accreditation

The Elliot Hospital is accredited by DNV Healthcare with a certification in ISO 9001:2015 international quality standards. In healthcare, ISO compliance ensures hospitals implement and maintain an effective quality management system (QMS), which demonstrates commitment to improving patient safety and quality of care, increased management confidence and assurance, active identification of areas of improvement, and improved staff satisfaction and motivation. 

The DNV Healthcare accreditation program supports hospitals to achieve development and continual improvement of healthcare quality and patient safety. Every year, a DNV survey team certified and credentialed in the healthcare industry perform an onsite comprehensive assessment of Elliot Hospital’s systems, processes, and facilities to ensure we are compliant with the standards and requirements as governed by CMS. The partnership between The Elliot and DNV has a goal of establishing an environment that leads to a collaborative, educational, and transparent survey experience. It has improved the way we approach opportunities of improvement so we can provide exceptional care to our patients.

As a DNV accredited hospital, The Elliot has established a high-quality health system with an openness to learn and continuously improve.

Patient Safety Department

The Patient Safety Department is led by a dedicated Patient Safety Officer (PSO). The PSO oversees all aspect of the patient safety system, promotes action to prevent harm and mitigate risk, and applies proven methods to support a culture of safety. The unit-based clinical nurse leaders, Infection Prevention team, Perinatal Safety and Quality RN, Inpatient Wound and Ostomy RNs, and Inpatient Diabetes Educator RN are all integral members of the Patient Safety Department.

Serving as an Accountable Care Organization

The Elliot is committed to achieving better health for our individual patients and better population health for our community. The Elliot serves as a member of the SolutionHealth Accountable Care Organization (ACO) in partnership with Southern New Hampshire Health.

ACOs provide opportunities for patients and providers to work together to achieve enhanced quality of care, reduced costs, and improved health outcomes.

The goal of coordinated care is to ensure that patients — treated both as individuals and as members of populations — get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors.

ACOs are proving to be one of the most promising solutions to bend the cost curve and provide high-quality patient care and are a premier payment model in the shift to value-based care.

For more on the SolutionHealth ACO, please see https://www.solutionhealth.org/solutionhealthaco/.

Elliot Health System employs a diverse and talented team of caregivers and dedicated administrative professionals. Collectively, this team strives to support patients with high-value, equitable, and coordinated care.

When we succeed in delivering high-value, accountable care, we improve the healthcare system both locally and nationally, sometimes generating savings for patients, providers, and payers.

We aim to leave patients feeling satisfied with their care and providers having felt joy in their work. We have a vested interest in ensuring that the care delivered to patients and populations is as high in quality as it is equitable, regardless of where it is delivered, how it is delivered, or to whom it is delivered.