Planning Celebration was a chance to build the best
Benchmarking showed what to include at all levels
At Celebration (FL) Health, benchmarking is more than just a concept; it’s a way of life. When planners began the process of developing the hospital five years ago, they incorporated the search for the best of the best into every step.
One example is the hospital’s women’s center. A task force spent two years envisioning the center and made a dozen benchmarking site visits in the process. Hospitals that had components Celebration wanted — women’s health as a top priority, physician offices on-site, a healing environment, openness — were studied, resulting in a women’s center like none other.
"The woman never has to leave the facility to have all of her physician and diagnostic care," says Des Cummings, CEO of the development division for Florida Hospital. "We have a team concept as opposed to three or four different sets of nurses and physicians working in different locations and not necessarily communicating. If a woman has osteoporosis and needs nutritional counseling, an orthopedic consult, and some hormone therapy, we can do that in one place. This idea is usually applied to areas like cancer and not to women’s medicine where the conditions aren’t necessarily life-threatening."
A multidisciplinary team of physicians — OB/GYN, family practice, perinatology, GYN/oncology, infertility, and urogynecology — has offices in the center, and the diagnostic imaging center and a special women’s resource library are also on-site. There is one main number to call for scheduling or information.
Putting patients in control
"We learned so much from our site visits, including what the other hospitals wish they could do differently," says coordinator Mary Lou Cummings, RN, BSN. "We’re getting excellent feedback from our patients. They have a much different attitude about their health. They feel more in control, and they know they have options."
Celebration Health’s orthopedics department is another example of the value of best practices. An interdisciplinary committee that includes not only physicians, nurses, and physical therapists but also the office manager and representatives from marketing and accounting is working to set up a joint institute.
"We’re looking at how we can best care for our patients and minimize their hospital stay," says David Dore, MD, an orthopedic surgeon specializing in hip and knee replacement who is the director of joint reconstruction. "We have all the data from national and state averages to numbers from the best of the best, and we think we can get our numbers within those best practice parameters."
The best practice standard for length of stay after knee replacement, for example, is 3.3 days, Dore says, and four days for hip replacement. Dore’s goals are the same for his unit, with an extra challenge: Those numbers will have to reflect 75% of patients being discharged to home instead of rehabilitation. "The information just isn’t there in the literature about whether those numbers reflect patients going home. But if you’re getting them out of the hospital just to send them to rehab, all you’re doing is cost-shifting."
Best practices incorporated in orthopedics include intensive preoperative education, where patients are brought in the night before their surgery to get instruction on postoperative physical therapy and other care. The physical therapists work with patients in groups of four before and after surgery to provide peer support and motivation.
Also, the physicians work with other specialists throughout the hospital on issues relating to their patients. Dore, for example, recently attended a seminar on cholesterol. "I never worry about the joint replacement itself," he says. "I worry about the possibility that something else could go wrong with the patient, like a heart attack or stroke."
Dore says the positive atmosphere at Celebration has a direct impact on patients. "From an orthopedic standpoint, these are well patients who have this one problem. I don’t want to get them in a sick mode just because they have to come to the hospital."