1Unit’s flagship program, the Accountable Care Unit care model optimized for a pediatric setting. Understanding the needs of pediatric patients and families is key to supporting them through challenging in-hospital care.
The ACU® pediatric care model ensures the patient is the center of the team, includes the family in daily conversations and decision making, and opens communication between all team members.
Accountable Care Units are defined as geographic care areas consistently responsible for the clinical, cost, and satisfaction outcomes they produce.
Accountable Care Units have four complementary design features:
1. Unit-based physician teams
2. Structured Interdisciplinary Bedside Rounds (SIBR® rounds)
3. Unit-level performance reporting
4. Unit-level physician and nurse co-leadership
Organizing care teams by units creates predictability, cohesiveness, and better communication. At its core, the ACU is about bringing people together; to work together, to collaborate together, to care together. When you work together and look out for each other, it’s much easier to provide incredible care to patients, work doesn’t seem so hard and you’re reminded why you chose your career in the first place.
Decrease length of stay, complications, adverse events, mortality, inappropriate resource utilization. Increase patient and staff satisfaction.
The future of pediatric care starts here.
A hospitalization of your child is a stressful time: the concern for your child’s health, and the lack of autonomy, control, interval updates and communication contribute to the sense of frustration and uncertainty.
As patients and healthcare professionals ourselves we understand that the current delivery of hospital care does not meet your needs. Demand more, demand better!
The ACU Pediatrics Care Model puts the patient and family at the center of the care team. This means:
- significantly more bedside team based care in which you are welcomed into the daily processes,
- open discussions of interval test updates and notable events,
- proactive management of potentially compounding care factors, and
- shared decision making remove those common causes of frustration and uncertainty.
Proactively including patients in their care plan and decisions from door-to-door is what should be the norm. The ACU Pediatrics Care Model puts you and your child at the center of the care team and care plans.
“The changes on the Unit have made my recent stay very different to my previous ones. I feel listened to. I feel like my needs are being met quickly. And I like the daily rounds where I see my doctor and my nurse.”
“When I got to the unit, I was depressed. The team of people on the unit really talked to me and turned my attitude around. They got me on a better path so I was able to go home.”
“The care was remarkable … We should be so lucky that this kind of care is available to more people in our community. Just to be able to meet regularly with the physician and the nurses, to know what is happening.”
Working as individuals and in silos can only achieve so much for patients. The type of proactive care that is at the core of the ACU Pediatrics Care Model creates truly patient centered care. And, it facilitates more open communication between all teams members, and with patients and families.
- Know when the doctor will come to see the patients – no more guessing, no more uncertainty.
- Better integration of nursing shifts
- Structured information passed between shifts – keep your ‘brain’ sheets but get the key information your colleagues might ask you about
- Plan of care shared between all team members for each patient
- Better access to doctors
- Better integration of team member inputs for goals and discharge planning
“I don’t know how … we haven’t done this yet. It just makes sense. It makes sense for patient safety, and for patient advocacy. Just to have the physician there and support me as nurse, and know that he or she has my back and I can communicate face-to-face with that physician. That’s very important to patient safety.”
“It’s totally patient-centred… We can tell you exactly what time the doctor is going to come every day… We’re not spending all day trying to get a hold of doctors.”
“I’m not worried about going to work anymore.”
Pediatrics is a rewarding but challenging setting. With pediatrics the stakes are just higher!
The ACU Pediatrics Care Model can:
- Improve communication with patients and families
- Create a more integrated and welcoming space for patients and families
- Reduce family frustration and complaints
- Improve communication, care and discharge planning with your colleagues
- Proactively track and manage known complications of care
- Activate stakeholder groups within the unit and spread accountability amongst team members
“I was suspicious. It sounded too good to be true… When I started working on the ACU I felt how different it was. My days used to be filled with running from floor to floor, getting paged by worried nurses to come urgently to see a patient, flipping through patient charts trying to find that important piece of nursing information that would be key to understanding. Now I’m part of a team. And with that team I go and see the patients and listen to them and find out what are their key priorities that need to be addressed… I love my job again.”
“This is the best model for coordinating care that I’ve ever seen. Patients spend less time in the hospital, get better quicker, and don’t bounce back. Our Accountable Care Unit helped us establish a culture of safety. Now we have a unit where patients don’t die and don’t even fall.”
“To have the entire team together on the same page. If the nurse or the patient raises an issue we have the computer right there to change orders in real time.”
Integrating allied health in the pediatrics setting is key to optimal patient care. The ACU Pediatrics care model can:
- Standardize allied health inputs into team communication processes
- Integrate allied health critical thinking into decision-making
- Improve discussions about patients goal for the day and goals for discharge
- Facilitate improved planning for continuing care needs after hospital
“What we found was … more patients identified actually had an intervention performed by a pharmacist that aligned with our standards compared with the comparator ward.”
Pediatrics can be a challenging care environment as a Unit Leader. Additional emotional strain and pressures exist in pediatrics settings, than in other hospital settings.
The ACU Pediatrics care model can:
- Reduce patient and family frustration
- Return a sense of control and autonomy to staff, patients and families
- Reduce patient/family complaints
- Improve teamwork and unit culture
- Reduce turnover
- Foster improved inter-professional and inter-personal relationships: happier staff = happier patients and better care outcomes
- Reduce daily variability by standardizing care processes and driving those processes to the bedside to include patients and families
“At the risk of sounding like someone who is drinking the Kool-Aid, having reached the stage we are at now, and seen the changes and opportunities that exist in organizing care this way…if this does not become standard operating procedure, I will have to look for another job because I cannot imagine working somewhere that doesn’t support the value this is creating.”
“We are already seeing how physically locating these physicians in one place and the subsequent regular interactions through standardized rounding, is improving teamwork and communication among our care provider partners”
“Strangely, the chaos in traditional hospitals is still considered normal. Leaders seem genuinely surprised by complications and delays. So many resources and hours are wasted recovering from what could’ve been prevented in the first place. Our ACU reverses all that and the difference is profound. Every hospital unit should work this way.”
The ACU Pediatrics Care Model offers a step change in team performance, teamwork, collaboration and communications. The ACU Pediatrics Care Model can help facilities drive towards the Triple Aim of enhanced patient experience, improved population health, and cost reductions. It can help to achieve these aims by better supporting the staff tasked with meeting these aims.
The ACU Pediatrics Care Model program seeks to return autonomy, control, shared decision-making and accountability to the care teams delivering frontline care to patients. These are the organizations best resources available to meet the Triple Aim goals of healthcare.
“Two and a half months ago that [we] implemented [our] first Accountable Care Unit… So far this system has had a very positive impact on patient care. On average patients on this unit are heading home two and a half days earlier.‘
“An innovative model of team based patient care.”
“Physicians and staff are making comments like, ‘This is what medicine is supposed to be’ or ‘This is the work environment I always envisioned working in”
Structured Interdisciplinary Bedside Rounds
A major constraint in hospitals is the persistence of underperforming frontline clinical care teams. Hospital physicians and nurses have never been trained to coordinate efficiently and effectively with the patient and each other at the bedside.
It’s time for a change!
With 1Unit’s SIBR rounds, care teams come together working collaboratively with patients at the bedside, sharing critical-thinking based on new data points, cross-checking information accuracy, proactively identifying deviations from the expected course and making adjustments in real-time through a developed, shared and cohesive plan designed to best meet the patient’s needs.
With 1Unit’s services, hospitals can offer the practice-based training and real-time feedback physicians, nurses, allied health and leaders need to ensure staff become experts and remain experts in SIBR rounds.
Through tens of thousands of observations in hospital units all over the world, we identified the specific behaviors essential for physicians and nurses to master high-performance SIBR rounds.
We first created SIBR rounds for ourselves so we could be much more proactive for our patients. When we realized most hospitals have the same need, we created a solution for them too. While many hospitals have learned that the secret to proactive care is successful interdisciplinary bed- side rounds, most home-grown efforts are costly, typically overlook critical details, and are prone to fail. With the experience of more than 100 launches in a variety of hospital settings, we know exactly what hospitals need for successful inter-disciplinary teamwork.
Make proactive care routine, make proactive care the new normal.
PICU Rounding Time per Patient
- Pre (mins)
- Post (mins)
- Pre (mins)
- Post (mins)
Excellent/top responses from family satisfaction survey
- Post (p<0.001)
- Post (p<0.001)
PICU Resident's Perceptions of SIBR
1Unit’s Nursing Change of Shift program focuses specifically on key nursing shift processes that bedside nurses can utilize to ensure more efficient preparation of key patient information. Utilize the 1Unit Nursing Change of Shift program to start your bedside nurses on a pathway to ACU implementation: generate