Although there are several leaders in the patient and safety quality across Michigan, St. Joseph Mercy Ann Arbor (SJMAA) stands out in their commitment to transform health care delivery through keeping patients at the center of care at their facility. At all levels, staff are able to articulate patient-centeredness and the commitment to the triple aim framework in all they do. As a learning organization, they readily spread their knowledge with others while continuing to learn themselves. SJMAA understands and exemplifies the critical component of the culture that drives action to engage patients and families each day.
SJMAA’s culture-focused on person-centered care rather than hospital-directed care, took several years and a public health disaster to reinforce its importance. Relationships were redefined between patient and caregiver, and the way staff communicates with each other. To achieve system-wide change, they based the foundation of their work on the Institute of Medicine Triangle to shape the remarkable patient care experience: strengthening the interdependent relationship with physicians to foster integrated person-centered care, inspiring and equipping St. Joe’s colleagues, partnering within their communities to improve access and delivery of health care.
Using a 360-degree approach to the community and patient engagement involved numerous strategies and countless individuals. The most impactful programs are listed within this nomination
Transparency: Transparency regarding clinical cores measures, quality improvements, patient safety, and patient satisfaction are routinely shared and utilized to inform and improve. Data is typically shared with leaders with the expectation and tools to cascade learning to all staff. Public reporting, use of website, internal dissemination strategies, and unit huddle boards assist in informing. Transforming knowledge into validated, measured and sustained actions is key. Rounding on colleagues, patients/family, physicians, and internal customers assures that the voice of other stakeholders is understood. Without a culture that supports this framework, striving for remarkable care delivery becomes only a slogan.
Experience Advisors: The Patient/Family Experience Advisor Program currently has over 75 advisors. Their council is tasked with strategic planning, identifying and removing barriers, development of communication and education plans, and infrastructure to manage this direction. All efforts are aimed at shaping a culture that embraces patients and the community as true partners in the delivery of health care. This concept permeates organizational processes as evidenced by the fact that staff asks, “Have you run this by the council” or “Did you get the voice of the patient on this issue?” Outcomes include everything from significant changes in patient discharge summaries, education materials, care handoffs, and patient portal.
Crucial Conversations: Recognizing that honest communication is vital to the success of a HRO, SJMAA equipped staff with the skills to successfully hold important conversations, through conducting mandatory crucial conversation seminars with all employees.
Crisis Shapes Person-Centered Culture: SJMAA person-centered care model was put to the test when they became the epicenter of a national public health disaster. Hundreds of people were stricken with rare and deadly fungal infections from a contaminated steroid made by an unregulated compounding center. Challenged by 240 admissions to an active hospital’s volume – at a length of stay of 13 days or more – required staff collaboration to treat an infection rarely seen in humans. The hospital became a learning laboratory as the massive outbreak required groups of physicians, nurses, administrators, pharmacy staff, housekeepers and others to come together immediately with a single goal. During this intense period, countless unsung heroes called upon a lifetime of training to treat patients and engage them in their care. The decision was made to cohort these patients in one location to provide consistent, coordinated, focused and evidenced-based care. The organization committed to the patient’s well-being, despite the fact that reimbursement and the burden of high census and length of stay would likely push the limits especially from a business perspective. Dedication to the patient’s care experience provided high quality, and likely saved lives – linking to our mission. Many lives were saved as a result of St. Joe’s swift, proactive and patient-centered response.
- Results for SJMAA have placed the organization in the Truven Health Analytics annual study of 100 Top Teaching Hospitals in the country. St. Joe’s has won this achievement six years in a row.
- Colleagues feel like they can speak up for patient safety. From 2012 to 2013, on a nationally-validated perception survey from AHRQ, St. Joe’s had 95% of all clinical patient caregivers participation and greater than top quartile national performance in all 10 domains of safety.
- Colleagues overall perception of safe patient care was at 72%; an 11% improvement from 2012’s results. National benchmark for top quartile performance is 71%.
- Maintaining a just culture, for which communication / openness scores improved 8% for 2013 from 2012, indicates that colleagues feel safe communicating openly and advocating for patient safety within teams, with leadership, and with patients.
- Our caregiver’s perception of patient safe practices hospital handoffs and transitions increased from 40% to 53%.
- Risk-adjusted mortality rates are lower than expected with averaging about .72
- Likelihood for patients to recommend and rate hospital consistently remains top quartile performance.
- To-date, 26 community members volunteered 104 hours to participate as ‘family members’ in clinical simulation training with health care staff.
- 6 Experience Advisors (out of 31 total observers) have been trained to observe physicians while they round and provide feedback on their communication behaviors with patients and family. The goal is every physician will be observed.
- Identified as a best practice model on Patient and Family Engagement for all 82 Trinity Health-CHE hospitals by replicating infrastructure and programming into learning toolkit to be fully disseminated by 3rd quarter 2014.
- Experience Advisors participate on various committees including Quality and Safety, Patient Safety Rounds, Pain Management, Cancer Advisory, NICU Family Advisory, Rehab Steering, Clinical Informatics, Provider Communication and Cardiac Patient Education.