Leadership for Patient-Centered Care Dedicated Servants and Bedside Champions

1. Leadership for Patient-Centered CareDedicated ServantsandBedside Champions Cy Huffman, M.D. Chief Medical Officer Erlanger Health System

2. Institute of Medicine – 6 aims: • Health care must be safe • Health care must be effective • Health care must be patient-centered • Health care must be timely • Health care must be efficient • Health care must be equitable

3. Must “Must is a hard nut to crack, but it has a sweet kernel.” Charles Haddon Spurgeon

4. Voice of the Patients “Keep Me Safe” “Get Me Well” “Treat Me Nice” Jamie Orlikoff

5. Patient Centered Care • Patients are safer “keep me safe” • Patients receive effective care every time “get me well” • Patients receive friendly & timely care “treat me nice” • Staffing on every unit is regularly adjusted to clinical needs of patients “in quality” staffing • Administration provides focused support to RN’s and MD’s in improving their work “quickly responding & removing boulders”

6. Physicians NursingStaff Patients Administration Deaver Shattuck, M.D.

7. Patients Receiving Patient-Centered CareBedside Co-Champions (RN’s, MD’s)Unit and Cross-unit Management Partners (RN’s, MD’s)Dedicated Servants (hospital/system executives)

8. Bedside Co-Champions(RN’s, MD’s) • “Nobody hurt on our watch” • “We give the best care for every patient, every time” • “We also look after each other” Example: CUSP Teams (Comprehensive Unit-based Safety Program) • http://www.tnpatientsafety.com/ • http://www.hopkinshospital.org/ Example: TCAB Teams (Transformation of Care at the Bedside) • http://www.ihi.org/ihi • http://www.rwjf.org/ Example: Positive Deviance approach • http://www.plexusinstitute.org/ • http://www.rwjf.org/ • Recent Webinar by Nancy Iverson at Billings Clinic

9. Unit and Cross-Unit Management Partners(RN’s, MD’s) • “we take responsibility for the patients and caregivers on our unit(s)” • “we will also put a smile on the CEO’s face” Example: RN unit manager MD partner for excellence Responsibilities: • first line of support for bedside caregivers • accept responsibility for measurable outcomes of patient-centered care

10. Patient-Centered Care ScorecardUnit/Department/Inpatient Service • safety outcomes (reduction of harm) • % execution of best practice (reliability) • patient satisfaction • “in quality” staffing (efficient, adjusted to patient needs) • RN & MD satisfaction

11. For example………Defining quality staffing on a pt care unit Out of Quality Staffing on the high end: Too many staff Census In Quality Staffing Out of Quality Staffing on the low end: Too few staff Days Lean-Six Sigma for Healthcare: Jim Brexler

12. Dedicated Servants(hospital/health system executives) • “we will look to our doctors and nurses for solutions and believe in them” • “we will quickly respond to requests from bedside champions and unit-level management partners” • “we will steadily move the boulders that obstruct those committed to delivery of patient-centered care” • “we will decide nothing about them without them” • “we look forward to sharing the victory”

13. Enthusiasm “Nothing great or new can be done without enthusiasm. Enthusiasm is the fly-wheel which carries your saw through the knots in the log. A certain excessiveness seems a necessary element in all greatness.” Dr. Harvey Cushing