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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.

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Presentation on theme: "Achieving Medicine of the Highest Order – Cultural Transformation Based on “Horton Hears a Who” Bradford C. Berk, MD, PhD May 22, 2013 Faculty Institute."— Presentation transcript:

1 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

2 May 30, 2009

3 Back to work

4 Thanksgiving 2009

5 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

6 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.

7 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. 7

8 8

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10 Strategy Map 10

11 People and Culture- Key Component of Strategic Plan 11 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

12 The healing power of touch  Compassion – We need to show we care  Attentiveness – We need to pay attention to show we care

13 My personal experiences : as a leader, a care provider and a patient

14 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.

15 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

16 URMC components of PFCC Safety Quality Courage Caring Patient and Family- Centered Care

17 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

18 Building a PFCC Culture Areas of Focus: Facility Medical Advances Information Technology Delivery of Care People

19 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

20 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 o 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”

21 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

22 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

23 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

24 PFCC across URMC delivery system GCHAS URMC PFCC Steering Committee SMH Highland Highlands at Brighton Highlands at Pittsford VNS Patient and Family Members

25 Creating an ICARE Culture I ntegrity - C ompassion - A ccountability - R espect - E xcellence

26 26 Influences on Patient Experience  Personal – behaviors/culture  Operational – systems/processes  Physical – environment/facility Coordination of 3 broad efforts - medical center-wide - department/unit level focus of PFCC initiative

27 of the 8 HCAHPS domains at national average of the 8 HCAHPS domains exceeded national avg.  Hospital Environment  Pain Management Hospital wide rollout – next stage of PFCC initiative  Clearly defining ‘desired patient experience’  Focus on ‘consistent delivery’ of the experience PFCC efforts are making a difference 27 Making progress but still below national average

28 28 Patients’ Overall Score for Hospital is Improving

29 Nursing Communication continues to rise 29

30 Staff Responsiveness exceeds national average 30

31 Employee Engagement/Commitment Scores

32 Difference from: Workforce Commitment Item 2012 URMC Clinical Entrprs % Unfav Natl UHC Avg Natl HC Avg 2011 URMC Clinical Entrprs 43.I am proud to tell people I work for this organization % I would recommend this organization to family and friends who need care % I would like to be working at this organization three years from now % I would stay with this organization if offered a similar job elsewhere for slightly higher pay % I would recommend this organization as a good place to work % Overall, I am a satisfied employee.4.106% Measuring Workforce Commitment

33 33 Top 10 NYS value based / readmission penalty

34 “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

35 Thank You

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