New model of patient-centered communication shows promise

Team approach shortens patient stays and improves outcomes, experience and satisfaction

“So … tell me everything you told your nurse five minutes ago.”

This may sound familiar. The traditional model of care in hospital units around the country dictates that nurses and physicians round separately. In many cases, the timing of those rounds is unpredictable, resulting in haphazard communication with patients and families. In addition, communication between providers in different disciplines is not coordinated, duplicating work.

The ACU is really a patient communication tool.

Patti Fisher, MD, medical director, Case Management and Medical/Surgery

In the fall of 2015, with the support of The Jeffords Institute for Quality, we introduced our first Accountable Care Unit (ACU), where care is designed to reduce fragmentation by organizing physicians, nurses and allied health professionals into high-functioning teams.

The ACU features:

  • Unit-based teams: Such teams are associated with improved communication between physicians and nurses, decreased length of stay, improved patient and nurse satisfaction, and a decreased rate of cardiac arrest.
  • Structured interdisciplinary bedside rounds: This patient- and family-centered approach brings the nurse, physician, case manager and other health professionals to the patient’s bedside at the same time. It allows for communication that includes a quality-safety checklist and plan of care, which is associated with a reduced rate of adverse events of almost 50 percent.
  • Unit-level performance reporting: Regular unit-level reports improve patient satisfaction while reducing hospital-acquired infections, length of patient stays and readmissions within 30 days of discharge.
  • Unit-level nurse and physician co-leadership: Having a nurse and physician team helps set expectations, ensures effective communication and rounding, and helps introduce best practices.

In the year since we put the ACU in place, the average length of patient hospital stays and unplanned readmissions have decreased. Patient satisfaction scores have increased dramatically.

“The ACU is really a patient communication tool,” says Patti Fisher, MD, medical director, Case Management and Medical/Surgery. “It’s about making sure that the patient and family aren’t hearing 16 different things from 16 different people.”

We hope to put this model in place around the organization.