Patient
We are a group of doctors, nurses and engineers focused on improving global best practices in care
Hospitalists use of time- Indirect patient care 69%
- Communication 24%
- Indirect patient care 69%
- Communication 24%
Source: O’Leary et al. 2006. How hospitalists spend their time: insights on efficiency and safety. Journal of hospital medicine, 1, 88-93.
Causes of adverse events- 93% organizational causes
- 93% organizational causes
Source: Smits et al. 2010. Exploring the causes of adverse events in hospitals and potential prevention strategies. Qual Saf Health Care, 19, e5-e5.
Rate of preventable adverse events- 51% highly preventable
- 51% highly preventable
Source: Wilson et al. 1995. The quality in Australian health care study. Medical journal of Australia, 163, 458-471.
The Problem: Reactive Care
Reactive care is the greatest constraint hospitals face and it exacts a massive price.
Details are missed and windows of opportunity close. Complications multiply. Patients suffer. Staff try to catch up while they slowly burn out. Time and resources are wasted.
Yet reactive care is considered normal because care teams are fragmented geographically and have no standard for what, when, or how to communicate with each other.
We think that’s not good enough.
Source: Buchbinder et al. 2001. Primary care physician job satisfaction and turnover. The American journal of managed care, 7, 701-713.
Source: Shanafelt et al. 2012. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Archives of internal medicine, 172, 1377-1385.
Source: Jones, C.B., 2008. Revisiting nurse turnover costs: adjusting for inflation. Journal of Nursing Administration, 38, 11-18.
Source: Mchugh et al. 2011. Nurses’ Widespread Job Dissatisfaction, Burnout, And Frustration With Health Benefits Signal Problems For Patient Care. Health Affairs, 30, 202-210.
The Solution: Proactive Care
Proactive care delivers dramatically different results.
But proactive care is possible only when doctors and nurses coordinate with the patient at the bedside to plan ahead and stay ahead.
Our solution creates the conditions to make proactive care routine.
How?
We give our fellow physicians and nurses a new care model that lets them communicate at a much higher level and deliver better care together.
That care model is called the Accountable Care Unit (ACU) and its defining feature is Structured Interdisciplinary Bedside Rounds (SIBR). With ACUs and SIBR, healthcare organizations finally have a way to make proactive care routine.
What does proactive care look like for you?
Hospitalizations are stressful events for patients and their families: 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!
Proactively including patients in their care plan and decisions from door-to-door should be the norm. We have the solution!
“This is the way healthcare should be.”
Patient
“I have the opportunity to ask questions about going home and what I need to do when I get home so that’s good.”
Patient
Working as individuals or in silos can only do so much for patients. Proactive care enables more and better quality patient centered care and can create actual teams with shared decision making, open communications, inter- and intra- professional respect and accountability.
Standardized processes and information flows get you the information you need, when you need it and allow you to contribute your critical thinking to patient care every day.
“[Nurses First bedside handover] gives you information and it gives you a reliance on your, on your team member that you’re going to get the information you need to have a great experience with that patient”
Kathy
Director of Nursing
“So if we have relieving staff, we use the huddle to introduce them. Everybody says hi, we let everybody know their name and who they’re working with so that people can see them in the corridor and check in if they’re okay and they know their name and it. It historically has made the relieving staff really feel welcome and valued and happy within the unit and happy to come back to the unit as well.”
Amy
Charge Nurse/Team Lead
“I think it cuts out all the unnecessary information that isn’t needed that nurses may just pass on that doesn’t need to be included. So it keep us focused on the patient and what they’re here for and the medical facts and not social things or other things that can sometimes creep into report.
Robin
RN
Proactive care allows doctors to combine the attention, effort, and skills of the entire care team.
Face-to-face coordination results in a much more efficient and rewarding hospital practice, with better patient outcomes and fewer pages, phone calls, and missed signals.
“We’ve been teaching the same way for 50 years, but with this care model we now teach delivery of care. This is exactly where healthcare is heading. Staff and trainees today need to understand that prescribing a therapy is the easy part. The hard part is getting a huge, complicated system to deliver that therapy to the right patient at the right time, while being alert enough to recognize-and-respond when therapy fails or patients drift off course. Traditional hospital care does none of that. But this care model does. This is the future. This is the ‘new way’ and the ‘old way’ just looks crude and unacceptable by comparison.”
Physician
ACU Medical Director
“This care model has brought real teamwork to our hospital. Beforehand, doctors had no idea what members of the care team were doing and nurses knew very little about what doctors were thinking. Today, those problems are gone. Communication is infinitely better and there’s a collegiality and empathy among staff that many of us never imagined was possible.”
Physician
ACU Medical Director
“The ACU difference is dramatic. It’s like we have twice the number of hands on deck, but we haven’t hired anyone new. We’ve just trained everyone to coordinate with each other and with greater purpose. You can see this remarkable belief here now. We know we’re delivering the care we’d want for our family members or ourselves.”
Unit Medical Director
In proactive care based settings, allied health staff gain a valuable way to contribute to patient care and recovery. Allied health resources can be better aligned with care teams and patient needs, to proactively identify issues, optimize the discharge process and prevent undesired events.
By better integrating the vital inputs of allied health staff, the care team can help the patient reach their potential sooner and with greater certainty.
“we recognize change fast because we’re attending rounds daily, so when someone starts to do really well and maybe not do so well, it’s recognized that day, not a week later”
“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.”
Pharmacist
“I believe that pharmacists should see this because it’s a real eyeopener in my opinion. It’s the way pharmacy should be done in a hospital and not working in isolation, making your solutions and figuring out problems that don’t actually even exist, right?”
With an organizational perspective on proactive care, unit managers can recruit, retain, and develop a more stable and high-performing workforce. Managers gain a powerful way to set expectations and hold teams accountable to individual and unit outcomes.
“Accountable care gets rid of the chaos and fosters teamwork with all people providing care and with a much improved relationship with the patient and their families. It’s so obvious to me that this is what we’re supposed to be doing.”
Unit Medical Director
” I think the good thing about the [Nurses First] bedside handover is that you can tweak it to your unit. So handovers before would not have been potentially as accurate as what I would like them to be or expect them to be. Whereas now we’ve got this process and yeah you could give that handover and it’d be 98% accurate.”
Kathleen
Unit Nurse Manager
“This care model has brought real teamwork to our hospital. Beforehand, doctors had no idea what members of the care team were doing and nurses knew very little about what doctors were thinking. Today, those problems are gone. Communication is infinitely better and there’s a collegiality and empathy among staff that many of us never imagined was possible.”
Physician
ACU Medical Director
Proactive care gives hospital leaders a powerful platform to control outcomes and costs.
Hospital leaders can ensure proactive care becomes the standard of care by providing doctors and nurses with the practice-based training and performance transparency required to make high-performance patient centered care routine.
“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”
Director of Patient Flow
“Often in our medical system I think patients sometimes feel they’re left out: what’s going on with their treatment, when are they going to see their doctor next. It was incredible what I saw… Less time waiting for an in-patient bed, shorter hospital stays, better patient outcomes, and an increased patient and family, and staff satisfaction.”
State Minister of Health
“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”
State Senior Medical Officer
Societal demand on hospital systems is rising rapidly while budgets dwindle. Fortunately, proactive care enables health service leaders to manage, measure and spread the quadruple aim of improving patient experience, health outcomes, avoidable costs and clinical team satisfaction.
Find out about state-wide government initiatives that we have mentored and how you could replicate significant change in your state.
“An innovative model of team based patient care.”
State Minister of Health
“Less time in hospital, the freeing up of beds. The care is better. The communication is better.”
Chair Regional Health Authority
“Often in our medical system I think patients sometimes feel they’re left out: what’s going on with their treatment, when are they going to see their doctor next. It was incredible what I saw… Less time waiting for an in-patient bed, shorter hospital stays, better patient outcomes, and an increased patient and family, and staff satisfaction.”
State Minister of Health