In fall 2013, BWH launched a strategic initiative called patient progression to address extreme variability in the number of patients from day to day, as well as bed availability. The initiative, which takes a multi-pronged approach, has already seen many successes, including decreased length of stay, improved inpatient satisfaction with the discharge process and implementation of multidisciplinary huddles on all units. Additionally, Environmental Services staff have improved bed turnaround time, while Central Transport team members have exceeded their goal for trip turnaround time.
Patient progression focuses on placing patients in the right bed at the right time for the right amount of time, as well as improving care coordination and communication among all care team members and enhancing the care experience for patients and families.
Shapiro 8, which cares for cardiology, vascular surgery and cardiac interventional patients, was one of the first units to go live with multidisciplinary huddles a year ago. Dyad partners Alice O’Brien, MS, RN, and C. Keith Ozaki, MD, work together to ensure patients are moving through the system safely and efficiently and receiving the highest quality care. All members of the care team meet daily for huddles to talk about each patient and his or her care plan for the day, discharge date and potential barriers to discharge.
“Because of these huddles, the patient information shared is consistent,” said O’Brien, who in part credits the huddles for BWH’s national vascular scores on doctor/patient communication, which recently reached the 90th percentile. “It encourages participation from all team members, including physical therapists, social workers and dieticians. Consults are being placed in a timely manner because everyone is at the table, and communication about the plan of care among care providers and with the patient is clear.”
Ozaki says he and his colleagues are working to make multidisciplinary huddles part of the training of the next generation of physicians, so they can better understand the value of patient progression and its importance to overall patient care.
“We’re already seeing it become part of the fabric of the way we deliver care here,” said Ozaki, who has noticed an improved morale and sense of teamwork on the unit.
Dyad team Julian Robinson, MD, and Joan McColgan, RN, have experienced similar success in Obstetrics on CWN 10, another initial adopter of multidisciplinary huddles. They say the collaboration between nurses, physicians, midwives, lactation counselors and subspecialists encourages communication and earlier identification of potential challenges.
“It’s a new model in Obstetrics,” said McColgan. “This is an ongoing process. We’re proud of where we started and where we are today.”