Making it Easier to Work as a Team on a Hospital Unit

It is easier to accomplish complex work involving multiple people when those people routinely work closely together. Teams that get to know one another generally do better than people who rarely work together and don’t know each other. At GBMC, it is no accident that Units with a close knit team of doctors, nurses, other clinicians and support people get better outcomes and generally have better employee, physician, and patient engagement scores than those who don’t work and reflect together daily.

On units where nurses work routinely but physicians, care managers, and others come and go because they have patients on many units it is very hard to get the communication- and therefore the care- right.

In order to achieve our vision of the care we would want for our own loved ones delivered to every patient, every time, we need an environment that supports optimal collaboration among clinicians, as well as multidisciplinary team member inclusion in daily care-planning.

So earlier last week, on the GBMC medicine inpatient units, we started using the Patient­-Centered Care Team (PaCT) model of care. Work spaces on each unit will offer physicians and care managers private areas to tend to documentation, while still being within reach should a patient care need or question arise. Having nursing, physicians and care managers located together on every medicine unit will allow for easier scheduling of multidisciplinary rounds and will enable additional care providers a chance to gather with the team to improve patient health outcomes.

Dr. Neal Friedlander, our Chairman of Medicine, has been a champion of “collocation.”  He has been concerned about how physicians were spending hours each day walking to different units and because of this not being readily accessible to their patients, nurses or other care team members. He has been concerned that there were preventable rapid responses called, and discharge planning was difficult because care managers and physicians were not in geographic proximity.

In order to accomplish keeping a patient with one team more commonly, we had to make telemetry available on most units to eliminate unnecessary patient transfers; physicians and case managers will now join their nursing colleagues on a single unit; multidisciplinary rounds will include all members of the care team by unit (simultaneous rounds); medical directors and their partner nurse managers are now accountable for the care on each unit.

Over time, other support services may be assigned to individual units. JoAnn Ioannou, DNP, MBA, RN, NEA-BC,our Senior Vice President of Patient Care Services and Chief Nursing Officer, told me how thrilled she is to witness some of the early benefits of the PaCT Model on our units, for both our patients and staff. case.

I am very grateful to Neal, JoAnn, Cathy Hamel, our Vice President for Post- Acute Care and to everyone who has helped us implement this change!

What’s on your mind about EPIC?
Last week, in my blog I discussed the production, B’MORE EPIC, and how It gave attendees a comedic perspective on how EPIC will help clinicians assist patients through the care continuum and make it easier for us to achieve our vision.

This week though, I want to hear from you.  If you have a question about EPIC or its implementation, please enter it here and we will address them in the last blog post for June. Thanks!