A quality improvement program at Three Rivers Hospital
& Three Rivers Family Medicine

At Three Rivers Hospital, we’re always looking for ways to do better — for our patients, our staff, and our community. That’s why we launched Bridge to Excellence, a training and quality improvement program designed to strengthen our systems and improve patient care across the hospital and clinic.

This program is made possible through grant funding and in collaboration with Virginia Mason Institute, a nationally recognized leader in health care improvement.

We’re proud of the dedication our staff have shown and grateful for the opportunity to build a stronger, more responsive health care center.

A Culture of Learning and Feedback

As part of the training, leaders and staff regularly conduct Genba walks — visiting departments to see the work being done firsthand and hear directly from staff. These visits encourage team feedback and promote real-time problem solving.

Departments are also using whiteboards to track key metrics and improvement goals. These boards make progress visible to everyone and support a culture of transparency and accountability.

Training with Virginia Mason

About two dozen staff and leaders began the training in November with in-person sessions at Virginia Mason in Seattle. Since then, the learning has continued here in Brewster through workshops and team projects.

Each month, participants share updates during daily huddles, highlighting both successes and lessons learned. We’re already seeing improvements, including more organized departments and a noticeable reduction in duplicative steps.

One great example:
A member of our IT team is working on a new process where patients only need to sign a consent to treat form once — electronically. This change will save time, paper, and staff resources, while keeping documentation secure and streamlined in the electronic medical record (EMR).

What We’re Working On

Teams across departments are taking on focused projects to improve efficiency, reduce waste, and enhance the patient experience. Here are some highlights:

🏥 Central Supply

  • Improving how supplies are stored and distributed across care areas

🩺 Family Practice Clinic

  • Co-locating providers and support staff to improve communication

🔬 Specialty Clinic

  • Enhancing documentation and patient room setups
  • Improving programs like wound care and screening colonoscopies

💻 Digital & Paperless Initiatives

  • Empowering departments to adopt paperless practices tailored to their daily operations, as part of a facility-wide initiative
  • Expanding e-Faxing and consolidating e-signature platforms to reduce paper and streamline workflows
  • Standardizing outpatient scheduling and automated appointment reminders
  • Creating standard operating procedures for our electronic medical record (EMR), with step-by-step guides to support staff training

📋 Communication & Alignment

  • Posting department boards to share goals, projects, and updates across the facility

🩺 Acute Care Nursing

  • Rebuilding flow sheets using the Assess–Plan–Intervene–Evaluate (APIE) model to ensure efficiency, accuracy, and clinical quality

Our Long-Term Goals

While our team already works well together, Bridge to Excellence is helping us go even further by:

  • Strengthening communication between departments

  • Streamlining workflows

  • Empowering staff to identify and solve challenges

  • Creating a better experience for every patient who walks through our doors