“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.”

– Nurse

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

Nurse

“I really like 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

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 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.”

– Nurse

Nurse

“I’m not worried about going to work anymore.”

– Nurse

Nurse

“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. 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.”

– Charge Nurse

Charge Nurse

“Nurses hear [the information] for the entire floor. So it triggers you to say, okay, so 21 has a bed alarm. That’s not my patient, but 21 has a bed alarm, so I need to make sure that if something happens in that room, I [know when I] go in there, we’re all responsible.”

– Nurse

Nurse

“The change of shift huddle kind of gets everybody ready, gets everyone there and … gives you a positive attitude for the day and you know incoming admissions, discharges, what’s planned.”

– Nurse

Nurse

“We’re incorporating [the] patient more with the bedside handoff reports so they’re more aware of what’s going on with their care. And, their questions and their input.”

– Nurse

Nurse

“The bedside report that we use in bedside handover gives you a head to toe assessment. It keeps you organized so you’re not  bouncing between subjects. And it paints a better picture that way.”

– Nurse

Nurse

“Having something already filled out by the previous nurse, handing it to you, and you going in together, you’re just looking along and you can listen, you’re not worried about writing down and that’s made this much easier.”

– Nurse

Nurse

You’ve got a structure and you make sure you don’t miss anything. It’s really easy to just write in the information and as you go through you think of something that you didn’t even remember at the time, but because it’s already there to sort of remind you, it helps with bringing on that memory. But I think [Nurses First] is really good.

– Student Nurse

Student Nurse

“We had a Medical Emergency Team response one night. And one of the new Grad nurses was in charge of this patient, she gave handover to the MET team as they arrived. And I was so proud of her. She did an amazing job and the MET team just looked at her and from their eyes she could have been a nurse with 20 years experience.”

– Charge Nurse

Charge 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

Charge 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

Nurse

“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

Charge Nurse

” 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.”

– Unit Nurse Manager

Unit Nurse Manager

“I think change of shift huddle is exciting. The nurses really enjoy that and they take time to prepare the change of shift huddle … it’s unbelieveable. They’re doing a great job at it. So I think that’s something that’s really enjoyed.”

– Unit Nurse Manager

Unit Nurse Manager

“This is the way healthcare should be.”

– Patient

Patient

“[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.”

– Director of Nursing

Director of Nursing

“Nurses first has given us that structure that I think we need as nurses.”

– AVP Acute Care

AVP Acute Care

“Less time in hospital, the freeing up of beds. The care is better. The communication is better.”

– Chair Regional Health Authority

Chair Regional Health Authority

“We rolled out hospital-wide almost overnight. We were able to embed the same process for change of shift in every unit. We were able to free our nurses to focus on care, not information gathering.”

– CNO

CNO

“[This] is a skillset that we knew we needed…Staff watched the video and had immediate interest, asking “Where do we sign up?”

– CNO

CNO

“[It elevates] what nurses have to communicate. It’s professionalism, it’s accuracy…So learn it, stick with it, follow our lead and you won’t be sorry.”

– CNO

CNO

“It has truly changed the way that we start our shift…it’s just amazing how this has played out.”

– Director of Nursing

Director of Nursing

“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.”

– CNO

CNO

“If I had to tell myself something now that I wish I knew three, six months ago, it would have been, we should have done this sooner. We should have been after Nurses First a year ago.”

– AVP Acute Care

AVP Acute Care

“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.”

– Nurse

Nurse

“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.”

– Nurse

Nurse

“SIBR made a remarkable change”

– Kish, MD
Kish, MD

“Our metrics improved on every category”

– Jon, MD
Jon, MD

“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”

– Physiotherapist

Physiotherapist

“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.”

– Physician

Physician

“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?”

– Pharmacist

Pharmacist

“so my job becomes a little bit easier because I don’t need to think about all the other pieces that I should have maybe known. I don’t need to know the answer because I have a team member who can answer that out for me”

– Pharmacist

Pharmacist

“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

Pharmacist

“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.”

– Unit Medical Leader

Unit Medical Leader

“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.”

– Unit Medical Leader

Unit Medical Leader

“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 Leader

Unit Medical Leader

“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.”

– Patient

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

Patient

“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.”

– Family

Family

“We knew when to expect [the care team] each day and knew they would answer all of our questions.  They knew our names and really involved us in the process.  It really is a wonderful”

– Family

Family

“This is the way healthcare should be.”

– Patient

Patient

“Less time in hospital, the freeing up of beds. The care is better. The communication is better.”

– Chair Regional Health Authority

Chair Regional Health Authority

“An innovative model of team based patient care.”

– State Minister of Health

State Minister of Health

“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.‘

– President and CEO

President and CEO

“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

Director of Patient Flow

“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.”

– CMO

CMO

“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.”

– Nurse

Nurse

“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.”

– Nurse

Nurse

“I’m not worried about going to work anymore.”

– Nurse

Nurse

“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.”

– Unit Medical Leader

Unit Medical Leader

“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.”

– Unit Medical Leader

Unit Medical Leader

“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 Leader

Unit Medical Leader

“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.”

– Physician

Physician

“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

Pharmacist

“so my job becomes a little bit easier because I don’t need to think about all the other pieces that I should have maybe known. I don’t need to know the answer because I have a team member who can answer that out for me”

– Pharmacist

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?”

– Pharmacist

Pharmacist

“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.”

– Unit Medical Leader

Unit Medical Leader

“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

Director of Patient Flow

“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 Leader

Unit Medical Leader

“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.”

– Unit Medical Leader

Unit Medical Leader

“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.”

– Unit Medical Leader

Unit Medical Leader

“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.”

– Patient

Patient

“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.”

– Family

Family

“We knew when to expect [the care team] each day and knew they would answer all of our questions.  They knew our names and really involved us in the process.  It really is a wonderful”

– Family

Family

“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.”

– Patient

Patient

“This is the way healthcare should be.”

– Patient

Patient

“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.”

– CMO

CMO

“The Accountable Care Unit makes patient interactions more meaningful and predictable, which is decreasing patient length of stay by eliminating barriers to discharge.”

– VP Practitioner Staff Affairs

VP Practitioner Staff Affairs

“An innovative model of team based patient care.”

– State Minister of Health

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

Chair Regional Health Authority

“This is more than just a Unit, this is a culture change. The other floors want to look like the [ACU]… This is the way to do it.”

– CMO

CMO