ChristianaCare’s Christiana Hospital, Union Hospital and Wilmington Hospital have each received an ‘A’ grade in the Spring 2025 Leapfrog Hospital Safety Grade, a national distinction that recognizes ChristianaCare’s achievements in protecting patients from harm and providing safe health care.
“At ChristianaCare, patient safety is our highest priority and an essential part of our mission of service to the community,” said Kert Anzilotti, M.D., MBA, system chief medical officer and president of the Medical Group of ChristianaCare. “We are incredibly proud of this achievement.
“This ‘A’ grade is not just a letter; it’s a testament to the hard work and passion of our caregivers, who strive every day to ensure our patients receive the highest quality care and feel safe throughout their journey with us.”
The Leapfrog Group assigns an ‘A,’ ‘B,’ ‘C,’ ‘D’ or ‘F’ grade to hospitals across the country based on over 30 performance measures reflecting the prevention of errors, accidents, injuries and infections.
This Leapfrog recognition comes on the heels of multiple other recent quality and safety awards that ChristianaCare has received, including:
• ChristianaCare was recognized as one of the best hospitals in the nation by Money in its 2025 hospital rankings, making it the only hospital in Delaware to achieve this distinction.
• ChristianaCare is ranked by Newsweek among the World’s Best Hospitals and rated by U.S. News & World Report as the No. 1 hospital in Delaware.
• ChristianaCare earned the Beacon Award for Excellence from the American Association of Critical-Care Nurses (AACN) for three of its intensive care units: the Medical Intensive Care Unit (MICU), the Surgical Critical Care Complex (SCCC), and the Transitional Surgical Unit (TSU) at Christiana Hospital in Newark, Delaware.
• ChristianaCare is the only four-time Magnet-designated health care organization in Delaware, recognized for continued dedication to excellence and innovation, high-quality patient care and experience, nurse engagement and work culture.
“Learning is a journey. It is continuous,” said nurse Hellen Okoth, MSN, CCRN, RN-BC, of the Transitional Surgical Unit. She was one of the learners on that journey through ChristianaCare’s professional development program Achieving Competency Today (ACT).
ACT, a 12-week graduate-level program dedicated to health care improvement, will celebrate its 40th session in 2025. Some 1,000 caregivers have graduated from ACT and have tested some 140 innovative project ideas since the program’s launch in 2003.
On April 9, three ACT teams presented their quality improvement projects at the John H. Ammon Medical Education Center on ChristianaCare’s Newark campus.
Interdisciplinary, experiential learning programs like ACT create a rich and dynamic learning environment,” said Tabassum Salam, M.D., MBA, FACP, chief learning officer for ChristianaCare.
“The emphasis on continuous improvement and real-world applications of the educational content sets our ACT graduates up for lifelong learning and repeated application of these new skills.”
The ACT course is a collaborative experience that brings together learners from diverse disciplines to tackle real-world health care challenges. Participants learn from health system leaders and gain a broad perspective on health care through coursework.
They work in teams to complete problem-solving projects from start to finish using the Plan-Do-Check-Act (PCDA) model of continuous improvement. Facilitators, who are experts in improvement science and team effectiveness, guide the teams through the process, ensuring that each project is meticulously planned and executed.
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“The hands-on projects in ACT enable learners to innovate and test out solutions in settings that directly benefit patients, leading to better outcomes and a higher quality of care,” Salam said.
The three most recent teams presented improvement research that has the potential to expand beyond their pilot stage to other areas of the health system.
‘Hush! For the Love of Health’ In “Hush! For the Love of Health,” an interdisciplinary team worked to reduce noise levels on the Cardiovascular Critical Care Unit (CVCCC) at Christiana Hospital. Their goal was to decrease ambient noise levels by 10 decibels during the study period. Intensive care units often experience noise levels that can exceed 80 decibels. A quiet environment is 30 to 40 decibels.
Members of the “Hush” project found creative ways to reduce noise on an intensive care unit.
Ambient noise refers to all sounds present in the background, which research shows can interfere with communication, concentration and comfort. In a hospital setting, these sounds may include alarms, conversations, announcement and pages and carts moving by.
The team looked for opportunities to safely reduce the number of alarms sounding. By collaborating with Philips technology company to lower alarm volumes and eliminate redundant alarms, they reduced the number of alarms sounding from 10,000 to 3,000 daily and successfully decreased noise levels by 13 decibels, exceeding their goal.
“It’s good for patients to have a quiet environment and it fights alarm fatigue for caregivers,” said Dylan Norris, a pre-medical student from the University of Delaware and participant in the ACT course.
‘Show Up and Show Out’ Reducing the no-show rate among patients in primary care practices improves health outcomes and conserves resources. In “Show Up and Show Out: Boosting Patient Attendance in Primary Care,” the project team aimed to reduce the incidence of no-show appointments at the Wilmington Adult Medicine (WAM) practice by 10%.
The “Show Up and Show Out” project team used personalized communication outreach to patients to encourage keeping their primary care appointments.
“Our literature review showed that personal relationships with providers are one thing that can encourage people to attend appointments,” said team member Christi Karawan, MS, BSN, CCRN-CSC.
The key to their problem-solving strategy was using a secure messaging platform for automatic appointment reminders specifically for WAM that were personalized with the provider’s name and thanking the patients for letting WAM be a part of their healthcare team. Other steps on the road to success were signage around the practice encouraging patients to update their contact information and calls from office assistants and medical assistants to unconfirmed patients the day prior to their appointments.
The team achieved a 9.5% reduction in no-shows, just shy of their goal, over a two-week period.
An office assistant who participated in the pilot said, “Outreach has been helpful not only in getting people in but in getting people to reschedule or cancel. We can catch it before it becomes a no-show.”
‘Magnetic Efficiency’ To address delays in patient transport from MRI testing at Newark campus, an ACT team created a new communication workflow to directly connect patient escort dispatch to the MRI charge technician. The ACT team aimed to decrease patient wait times following MRI completion for stretcher transport back to patients rooms by 25% — and “a bold goal,” said one colleague — during the study period.
The “Magnetic Efficiency” team identified a new workflow to get patients back to their hospital rooms faster after MRI testing.
Using Vocera wearable communications tools, the team created a thread for direct communication between Escort Dispatch caregivers and MRI charge technicians. Also, when an Escort transporter dropped off a patient for an MRI, the transporter asked MRI staff if any patients were ready to go back to their rooms. These changes in communication and empowerment consolidated transports and led to a 17% reduction in wait time during the two-week pilot.
“We don’t want people to work harder,” said team member Tim Kane, BSN, RN. “We wanted to avoid preventable delays.”
Both teams expressed satisfaction and improved communication with the new process and they expressed interest in continuing the process after the pilot ended.
Future forward The ACT course has a rich history, originating from a specific initiative piloted by the Robert Wood Johnson Foundation with ChristianaCare among the early adopters along with Harvard University, the University of Pennsylvania, Johns Hopkins University and Beth Israel Deaconess Medical Center.
Through the years, ChristianaCare ACT team members have seen their projects live on both as permanent changes throughout the health system and, more personally, in their professional growth.
“I was able to enhance my creativity, organizational and problem-solving skills,” said Starr Lumpkin, a staff assistant who was on the “Hush” team. “This was a pivotal journey for me.”
ChristianaCare is growing its program to develop a pipeline for the next generation of health professionals, said Safety and Quality Education Specialist Claire Rudolph, MSM, CPHQ. “We have a varied group of learners and facilitators who are making an impact on health care quality, cost and safety.”
Dylan Norris was the first participant from a new partnership with the University of Delaware for pre-med students to get quality improvement experience.
“I have learned so much about what goes into a quality improvement project. Buy-in from the stakeholders is key in implementing any new project successfully,” she said. “I have also learned about the importance of the initial research that goes into creating a new project and how much pre-planning goes into it.”
Closing the event, Clinical Effectiveness Officer Christian Coletti, M.D., MHCDS, FACEP, FACP, called on the ACT graduates to use their newfound “superpowers” — “vision, seeing the future, catching something before it breaks.
“It’s not a glitch in the matrix,” he said. “You are the most important people at the bedside – hearing the alarms going off or the stretchers piling up. Work to identify problems and move toward solutions in your own microenvironments. Pass on your powers with reckless abandon.”
Hundreds of nurses and their colleagues at ChristianaCare gathered in a conference room at Christiana Hospital and listened through a livestream across the organization’s campuses and practices for an announcement they’ve been anticipating for many months.
“For your commitment to nursing excellence and quality care, we are thrilled to recognize ChristianaCare with its fourth consecutive Magnet designation,” said David Marshall, JD, DNP, RN, chair of the American Nurses Credentialing Center’s Commission on Magnet Recognition. “This accomplishment is a powerful testament to your dedication to the nurses who practice there, the entire health care team, and — most importantly — the patients you serve.”
Shouts erupted, balloons and streamers floated up and, in the happy commotion, there was even a little cowbell. As the only four-time Magnet-designated health care organization in Delaware, ChristianaCare has achieved this global recognition — the highest honor in nursing practice — for continued dedication to excellence and innovation, high-quality patient care and experience, nurse engagement and work culture.
“Magnet designation recognizes ChristianaCare nurses are simply the best!” said ChristianaCare President and CEO Janice E. Nevin, M.D., MPH. “A fourth Magnet designation is an incredible achievement and reflects the vital importance and commitment of our nurses as we serve together with love and excellence.”
ChristianaCare has more than 3,000 nurses, and they make up the largest segment of ChristianaCare’s workforce. ChristianaCare is the largest nonprofit organization and private employer in the state of Delaware.
This most recent designation for ChristianaCare includes Christiana Hospital, Wilmington Hospital, ChristianaCare HomeHealth and Community Care Services, through early 2029.
What it means to be Magnet “Our fourth consecutive Magnet designation means that our nurses and all of our caregiver colleagues have upheld the ANCC’s very high standards in patient care since our first recognition in 2010,” said ChristianaCare Chief Nurse Executive Danielle Weber, DNP, RN. “That is a long time to bring your ‘A’ game every day — through 15 years of change, including a pandemic — and to sustain growth in professional practice, innovation and culture. Magnet recognition raises the bar for patient care and inspires every member of our team to achieve excellence every day.”
The Magnet Recognition Program — administered by the American Nurses Credentialing Center, the largest and most prominent nurses credentialing organization in the world — identifies health care organizations that provide the very best in nursing care, exceptional nurse engagement and professionalism in nursing practice. The Magnet Recognition Program serves as the gold standard for nursing excellence and provides consumers with the ultimate benchmark for measuring quality of care.
The ANCC Magnet Recognition Program® has conferred Magnet status to less than 10% of hospitals and health systems in the United States. There are 621 Magnet-designated health organizations internationally. ChristianaCare was the first in Delaware to achieve Magnet designation, in 2010.
For nurses, Magnet Recognition means education and development through every career stage, which leads to greater autonomy at the bedside. For patients, it means the very best care, delivered by nurses who are supported to be the very best that they can be.
While Magnet is a nursing-led initiative, the designation reflects the work of caregivers across the organization. Magnet redesignation itself is a rigorous process. Health care organizations must reapply for Magnet status every four years and demonstrate adherence to the Magnet concepts for nursing excellence and engagement and measurable improvements in patient care and quality.
The ANCC commended ChristianaCare on these exemplars:
Advocacy for and acquisition of organizational resources specific to nurses’ well-being. particularly through the Nursing Integrative Care Program. An innovative strategy to address the shortage of certified registered nurse anesthetists in Delaware through a partnership program between ChristianaCare and Wilmington University to launch the state’s first Nurse Anesthesiology program. Outstanding nursing research engagement and growth of the nursing research enterprise especially through the Nursing Research Fellowship in Robotics and Innovation.
