Reactive Care vs Proactive Care
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.
The Solution: Proactive Care
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. 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.
Proactive care delivers dramatically different results.
Reactive Care
Proactive Care
The High Cost of Reactive Care
Cost of Doctor Turnover
$250,000 per physician
Source: Buchbinder et al. 2001. Primary care physician job satisfaction and turnover. The American journal of managed care, 7, 701-713.
Cost of Nurse Turnover
$88,000 per RN
Source: Jones, C.B., 2008. Revisiting nurse turnover costs: adjusting for inflation. Journal of Nursing Administration, 38, 11-18.
Physician Burnout Rates
46% of US physicians experience symptoms of burnout
Source: Jones, C.B., 2008. Revisiting nurse turnover costs: adjusting for inflation. Journal of Nursing Administration, 38, 11-18.
Nurse Burnout Rates
34% of hospital nurses experience symptoms of burnout
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.
What Does Proactive Care Look Like For You?
Patients
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.
“The changes on the Unit have made my recent stay very different to my previous ones. I feel listened to. I feeling like my needs are being met quickly. And I like the daily rounds where I see my doctor and my nurse.” -patient
Nurses
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.
“It’s totally patient centered…We can tell you axactly what time the doctor is going to come everyday… We’re not spending all day trying to get a hold of doctors” -Nurse, Canada
Doctors
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.
“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 has helped us establish a culture of safety. Now we have a unit where patients don’t die and don’t even fall.” -Unit Medical Director.
Allied Health
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.
“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?”
Executives
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.
Government
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.
Client Testimonials
See what our valued clients have to say about our process.
“I try to listen to which patients either have fallen or we’re very worried about falling because if the bed alarm goes off and you’re the only person sitting in the nurses station, you want to know how fast should I run to that bed alarm? I think that’s very useful information that we parse out in the morning huddle.”
– Charge Nurse
Huddle - "how fast should I run"
Charge Nurse
“There’s a couple of times that we’ve had patients that have needed a little bit more emotional support. And so that’s been noted in the change of shift huddle, which I think is really appropriate, especially for us [nurses] because we’re all in and out of each other’s rooms for most of [the] shift.”
– Nurse
Huddle - "a little bit more emotional support"
Nurse
“I really liked the quality safety checklist with the Foley Catheters. Sometimes I think they get left in longer than they’re supposed to. People forget about it. You know, foley was in and this has been in for so many days, can we do a voiding trial on this patient?”
– Nurse
Handover - quality-safety checklist
Student Nurse
“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 keeps 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.
– Nurse
Handover - "cuts out all the unnecessary information"
Nurse
“A young nurse had to handover a patient to the ICU team, went over there with absolute confidence standing in front of ICU physicians and nurses all staring at her. She didn’t feel nervous because she just pulled out the bedside handover tool and she just went through it like we do on the ward, systems approach, and then she looked at everybody. She expected all these questions to come, but she’d covered everything. Not even the doctors had any questions and she came back to the ward really proud and really confident that she’d given it a great handover.”
– Charge Nurse
Handover to ICU team
Charge Nurse