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Achieving Medicine of the Highest Order – Cultural Transformation Based on “Horton Hears a Who ”. Bradford C. Berk, MD, PhD May 22, 2013 Faculty Institute for Teaching and Learning. May 30, 2009. Back to work. Thanksgiving 2009. I’ve learned what’s important.
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Achieving Medicine of theHighest Order – Cultural Transformation Based on “Horton Hears a Who” Bradford C. Berk, MD, PhD May 22, 2013 Faculty Institute for Teaching and Learning
I’ve learned what’s important • Treating patients and families with dignity and respect • Showing compassion and attentiveness • Valuing the patient and family as an integral part of the health care team • Listening to our patients and their families
2007-12 URMC Mission and Vision • Mission: Using Education, Science and Technology to Improve Health. • Vision: Develop a high quality, cost-effective patient-centered healthcare delivery; lead by our world class researchers, educators and clinicians.
2013-18 URMC Mission and Vision • Mission: The University of Rochester Medical Center is a home of healing, learning, research and innovation committed to improving health and quality of life for our patients, families and community. • Vision: To be nationally recognized by 2020 for improving community health through transformative approaches in compassionate care, education and research.
People and Culture- Key Component of Strategic Plan • Enhancing Standard HR duties — benefits, hiring, payroll • New- • Implement Business Partners: • who understand the specific HR challenges that their clients face • to learn time-tested tactics for fostering employee engagement • to be able to help managers structure incentives that drive peak performance Talent management software to function with existing HRMS system Boost Evaluation Process and Tools
The healing power of touch • Compassion – We need to show we care • Attentiveness – We need to pay attention to show we care
My personal experiences: as a leader, a care provider and a patient
Patient and Family Centered Care (PFCC) A set of principles and values that when implemented successfully improve quality, safety, and long-term outcome. In addition, data shows improvement in patient, family, care provider, and staff satisfaction.
Transforming a culture Patients and families are repeatedly telling us we need to do better in these areas: • Response to your concerns/complaints • Staff addressed your emotional needs • Staff included you in decisions regarding treatment • Nurses and Physicians kept you informed • Staff worked together to care for you • Time physician spent with you Communication, Compassion and Attentiveness are Critical
URMC components of PFCC Safety Courage Patient and Family- Centered Care Quality Caring
Creating value enhances PFCC Create Value (Quality/Cost) by implementing LEAN process improvement strategy Eliminate waste in our system without diminishing the patient experience remove extra steps in patient flow simplify operational processes eradicate duplicate and unnecessary paperwork results in better patient and staff satisfaction Utilize LEAN approach to help create a patient and family-centered care culture
Areas of Focus: Facility Medical Advances Information Technology Delivery of Care People Building a PFCC Culture
Facility PFCC requires a comfortable supportive environment private rooms with family sleeping spaces atmosphere that promotes healing • Cancer Center Expansion • New Children’s Hospital • Upgrade of Current Facilities
Information Technology eRecord will promote PFCC provides immediate and more thorough understanding provides improved communication among providers can identify high-risk patients to ensure comprehensive care plan and enhanced communication can encourage attentiveness and compassion i.e. electronic sticky notes can enhance patient and provider’s bond by reminding care providers to engage in topics most important to patient “I am very sorry to know that you recently lost a loved one” “I understand you are anxious to return home to care for your cat”
Transforming the way we Deliver Care • encourage patient/ family involvement • promote practices to improve patient/family and provider communication (i.e. rounding and shift change at the bedside) • breakdown silos – enhance communication among providers and multidisciplinary care teams • develop specialized Hospitalists to promote efficient, but compassionate care • shift from episodic approach to care to full continuum of care • advanced medical homes
People are the most important part of PFCC • Train all medical staff and employees to be respectful and offer compassion • How we communicate determines how effectively we convey compassion and attentiveness • We need to convey to our patients compassion and attentiveness by communicating about things that matter to them • The healing power of touch
Our employees need to feel cared for to provide patient/family-centered care Staff need to be: treated with respect supported empowered recognized Caring for the caregivers
PFCC across URMC delivery system Patient and Family Members Highlands at Brighton GCHAS Highland URMC PFCC Steering Committee VNS SMH Highlands at Pittsford
Creating an ICARE Culture Integrity - Compassion - Accountability - Respect - Excellence
Influences on Patient Experience • Personal – behaviors/culture • Operational – systems/processes • Physical – environment/facility focus of PFCC initiative Coordination of 3 broad efforts -medical center-wide - department/unit level 26
PFCC efforts are making a difference Making progress but still below national average • 2010 - 2 of the 8 HCAHPS domains at national average • 2012 - 6 of the 8 HCAHPS domains exceeded national avg. • Hospital Environment • Pain Management • 2013 - Hospital wide rollout – next stage of PFCC initiative • Clearly defining ‘desired patient experience’ • Focus on ‘consistent delivery’ of the experience 27
“I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” - Maya Angelou
