Presentation on theme: "Faculty Institute for Teaching and Learning"— Presentation transcript:
1 Faculty Institute for Teaching and Learning Achieving Medicine of the Highest Order – Cultural Transformation Based on “Horton Hears a Who”Bradford C. Berk, MD, PhDMay 22, 2013Faculty Institute for Teaching and Learning
5 I’ve learned what’s important Treating patients and families with dignity and respectShowing compassion and attentivenessValuing the patient and family as an integral part of thehealth care teamListening to our patients and their families
6 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.
7 2013-18 URMC Mission and Vision DRAFTMission: 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.
9 And he climbed with the lad up the Eiffelberg Tower. “This,” cried the Mayor, “is your town’s darkest hour!The time for all Whos who have blood that is redTo come to the aid of their country!” he said.“We’ve GOT to make noises in greater amounts!So, open your mouth, lad! For every voice counts!”Thus he spoke as he climbed. When they got to the top,The lad cleared his throat and he shouted out, “YOPP!”And that Yopp…That one small, extra Yopp put it over!Finally, at last! From that speck on that cloverTheir voices were heard! They rang out clear and clean.And the elephant smiled. “Do you see what I mean? ...They’ve proved they ARE persons, no matter how small.And their whole world was saved by the Smallest of All!”
10 Strategy MapHow can diversity and inclusion help us achieve our objectives?
11 People and Culture- Key Component of Strategic Plan Enhancing Standard HR duties — benefits, hiring, payrollNew-Implement Business Partners:who understand the specific HR challenges that their clients faceto learn time-tested tactics for fostering employee engagementto be able to help managers structure incentives that drive peak performanceTalent management software to function with existing HRMS systemBoost Evaluation Process and Tools
12 The healing power of touch Compassion – We need to show we careAttentiveness – We need to pay attention to show we care
13 My personal experiences: as a leader,a care provider anda 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 Communication, Compassion and Attentiveness are Critical Transforming a culturePatients and families are repeatedly telling us we need to do better in these areas:Response to your concerns/complaintsStaff addressed your emotional needsStaff included you in decisions regarding treatmentNurses and Physicians kept you informedStaff worked together to care for youTime physician spent with you(Taken from the Press Ganey Priority Index)Communication, Compassion and Attentiveness are Critical
16 URMC components of PFCC SafetyCouragePatient andFamily-CenteredCareQualityCaring
17 Creating value enhances PFCC Create Value (Quality/Cost) by implementing LEAN process improvement strategyEliminate waste in our system without diminishing the patient experienceremove extra steps in patient flowsimplify operational processeseradicate duplicate and unnecessary paperworkresults in better patient and staff satisfactionUtilize LEAN approach to help create a patient and family-centered care culture
18 Building a PFCC Culture Areas of Focus:FacilityMedical AdvancesInformation TechnologyDelivery of CarePeople
19 Facility PFCC requires a comfortable supportive environment private rooms with familysleeping spacesatmosphere that promotes healingCancer Center ExpansionNew Children’s HospitalUpgrade of Current Facilities
20 Information Technology eRecord will promote PFCCprovides immediate and more thorough understandingprovides improved communication among providerscan identify high-risk patients to ensure comprehensive care plan and enhanced communicationcan encourage attentiveness and compassioni.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 involvementpromote 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 teamsdevelop specialized Hospitalists to promote efficient, but compassionate careshift from episodic approach to care to full continuum of careadvanced medical homes
22 People are the most important part of PFCC Train all medical staff and employees to be respectful and offer compassionHow we communicate determines how effectively we convey compassion and attentivenessWe need to convey to our patients compassion and attentiveness by communicating about things that matter to themThe healing power of touch
23 Caring for the caregivers Our employees need to feel cared for to provide patient/family-centered careStaff need to be:treated with respectsupportedempoweredrecognized
24 URMC PFCC Steering Committee PFCC across URMC delivery systemPatient and Family MembersURMC PFCC Steering CommitteeSMHHighlandVNSHighlands at BrightonHighlandsat PittsfordURMC Steering Committee charged to coordinate PFCCimplementation throughout URMCEach facility has it’s own leadership team charged to oversee PFCC implementation - all leadership teams report up through URMC Steering CommitteeGCHAS
26 Influences on Patient Experience Personal – behaviors/cultureOperational – systems/processesPhysical – environment/facilityfocus ofPFCCinitiativeCoordination of 3 broad efforts- medical center-wide- department/unit level26
27 PFCC efforts are making a difference of the 8 HCAHPS domains at national averageof the 8 HCAHPS domains exceeded national avg.Hospital EnvironmentPain ManagementHospital wide rollout – next stage of PFCC initiativeClearly defining ‘desired patient experience’Focus on ‘consistent delivery’ of the experienceMaking progress butstill below national average27
28 Patients’ Overall Score for Hospital is Improving 28
32 Measuring Workforce Commitment Difference from:Workforce Commitment Item2012 URMC ClinicalEntrprs% UnfavNatl UHC AvgNatl HC Avg2011 URMC Clinical EntrprsI am proud to tell people I work forthis organization.4.383%+.02+.0649. I would recommend this organization to family and friends who need care.4.34+.05+.0156. I would like to be working at this organization three years from now.5%+.0859. I would stay with this organization if offered a similar job elsewhere for slightly higher pay.3.7115%.00-.01+.0764. I would recommend this organization as a good place to work.4.29+.14+.11+.1065. Overall, I am a satisfied employee.4.106%+.03+.09These are the six items used to measure Commitment/Engagement. Green, large numbers indicate significantly outpacing respective comparison. Later slides describe comparisons. Improvement on all items from 2011 survey, all but one improving statistically significantly.32