Patient-centered care helps hospital succeed

Families are part of whole experience

When Patewood Memorial Hospital in Greenville, SC, opened six years ago, the hospital administration recognized an opportunity to provide care that was centered around the patients and family members’ experiences, or patient-centered care, says Beverly Haines, MNEd, BRN, NE-BC, president of the 72-bed surgical hospital, which is part of the Greenville Health System. The hospital earned a bonus under the Centers for Medicare & Medicaid Services’ Value-Based Purchasing Program.

“We concentrate on making sure our patients and family members are part of the whole experience. We have a very strong interdisciplinary staff who work closely together. All of the clinical services report to me so people don’t have to go up the chain to get anything done. We all talk to each other,” she says.

Before the hospital opened, the staff sat down and talked about how to make the surgical process focused on the patient and family, Haines says. “Most of the staff was accustomed to the traditional model of care and there was some push-back, but we worked through the objections and now everything is done around what patients want to experience when they are in the hospital,” she says.

For instance, the anesthesiologists and the certified nurse anesthetists were reluctant at first to have family members come into the recovery room once the patient is settled in after surgery. Now the hospital encourages two family members to sit with the patient. “It reduces the anxiety for the family as well as the patient, and they love it,” she says.

The majority of patients are admitted for orthopedic and spine surgery. Patients who are scheduled for joint replacement surgery and their families attend a comprehensive joint day, three weeks before the surgery, to learn up-front what to expect during and after surgery says Susan Ballew, RN, BSN, nurse manager on the orthopedics unit. A multidisciplinary team, including physicians, presents a class to prepare patients for the surgical experience.

“The moment patients enter the building for surgery, they know what to expect, beginning with pre-op, the operating room, the recovery room, and the nursing unit. It helps to allay their fears and help them feel more comfortable about the surgical procedure,” Ballew says.

During their preoperative visit, patients are pre-assessed by nursing and anesthesiology, and meet with a hospitalist who may make referrals, such as to a cardiologist, if further assessment is needed. Patient education classes are taught by nursing, and a physical therapist who teaches them exercises that can help them recuperate from surgery faster and have a shorter length of stay.

They meet with the case manager, who completes an assessment to determine patients’ postoperative support system, their home situation, and their discharge needs. The case manager educates the patient and family members about the anticipated length of stay and what they need to do to prepare for discharge. The case manager has the patient name a “care partner” who will participate in the discharge education and care for the patient after discharge. Care partners are identified by name and given a badge that alerts the staff as to who they are and allows them to visit at any time.

Those who walk into the hospital are escorted to their destination by a volunteer or a staff member who tells them his or her name, credentials, and role. “We set the bar high and have kept it there,” Haines says.

Instead of the traditional dietary menu, the hospital offers a liberalized upscale menu created by a chef. “Patients who have diabetes and other conditions know what they should eat, and we’re not going to be able to change their eating habits during a short stay. We let them choose from appealing and nutritious foods,” Haines says.

A panel of discharged patients and their families serve as Patewood Healthcare Partners and advise the staff on various projects. Their input was used when the hospital participated in an AHRQ project to develop a patient and family engagement guide and in the hospital’s initiative to change the shift report to the patients’ bedsides. Patewood is one of only four hospitals nationwide that participated in the AHRQ project.

“The staff at Patewood Memorial Hospital take ownership in delivering excellent patient-centered care, continually exceeding national standards. The hospital received the April 2013 Studer Group Healthcare Organization of the Month Award for its commitment to excellence,” Haines adds.