Voices from the Frontline
ACU 
Nurses First 
SIBR 
“They have a part to play on our ACU”
– Gillian, Unit Nurse Manager
“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
“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
“I’m not worried about going to work anymore.”
– 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
“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
“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
“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
“It’s a more fun way to work”
– Todd, MD
“A resilient ward with people who just do it”
– Ron, MD
“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
“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
“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
“Highlight of my career”
– Nancy, Pharmacist
“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
“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
“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
“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
“This is the way healthcare should be.”
– Patient
“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
“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
“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
“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
“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
“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
“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
“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
“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
“When you do it this way you have a cohesiveness on the unit”
– Ashlie, RN
“We see the benefits of having the uniform process.”
– Amy, RN
“From their eyes she could have been a nurse with 20 years experience”
– Ellen, RN
“She came back to the ward really proud and really confident that she’d given it a great handover”
– Amy, RN
“Help her to be a great member of this team, even if it’s only for today”
– Sarah, RN
” 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
“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
“This is the way healthcare should be.”
– Patient
“It’s been amazing how this has played out.”
– Kathy, AVP
“[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
“Nurses first has given us that structure that I think we need as nurses.”
– AVP Acute Care
“Less time in hospital, the freeing up of beds. The care is better. The communication is better.”
– 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
“What is the why for SIBR? The patient is the why!”
– Cassie, RN
“There’s a great continuity and a safety net effectively for every patient, every time, every day.”
– Sarah, Charge Nurse
“They have a part to play on our ACU”
– Gillian, Unit Nurse Manager
“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
“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
“A resilient ward with people who just do it”
– Ron, MD
“It’s a more fun way to work”
– Todd, MD
“SIBR made a remarkable change”
– Kish, MD
“Our metrics improved on every category”
– 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
“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
“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
“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
“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
“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
“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
“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
“This is the way healthcare should be.”
– Patient
“There’s not as many fires to put out because we see issues before they happen”
– Alana, Physiotherapist
“Remove the barrier between disciplines”
– Alana, Physiotherapist
“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
“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
“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
“Less time in hospital, the freeing up of beds. The care is better. The communication is better.”
– Chair Regional Health Authority
“An innovative model of team based patient care.”
– 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
“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
“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.”