SPEAKERS: Jason Stein, MD, SFHM, associate vice chair for quality, Department of Medicine, Bryce Gartland, MD, FHM, associate director, section of hospital medicine, Emory University School of Medicine, Atlanta
In an age of increasing technology, just getting technology into a hospital isn’t the answer. It’s about integrating it into practice to improve care.
At Emory, the marriage of “low-tech solutions” and patented data displays has resulted in what Drs. Stein and Gartland call an accountable-care unit (ACU). The unit-based team features geographic ownership and structured interdisciplinary bedside rounds (SIBR). Perhaps more important, the unit generates real-time data captured on monitors, allowing teams of hospitalists, nonphysician providers (NPPs), residents, interns, and social workers to “visually digest immense amounts of information in a very short time period,” Dr. Gartland said.
Dr. Stein defined an ACU as a bounded geographic inpatient area responsible for the clinical, service, and cost outcomes it produces. To help manage beds, Emory instituted a system called “e-Bed,” a McKesson system that tracks room availability. The system shows whether rooms are occupied, being cleaned, or somewhere in between. It has icons to show whether patients are elsewhere in the hospital for treatment, as well as clinical data capacities. Unit teams round together and use a portable workstation or tablet computer to input clinical data, notes, or other comments into real-time dashboards that can then show everything from VTE prophylaxis to whether a patient is at high risk for falls.
The project has been in the works for several years, and Dr. Garltand noted that any hospitalists looking to push similar initiatives at their institution need to ensure that they have buy-in from providers and a commitment to seeing the project through.
“Timing is everything,” he said. “If we tried to force this … a few years ago, it would not have worked.”
SPEAKERS: Patrick Kneeland, MD, hospitalist, Providence Regional Medical Center, Everett, Wash.; Christine Kneeland, COO, Center Partners, Fort Collins, Colo.; Niraj Sehgal, associate professor of medicine, associate chair for quality and safety, Department of Medicine, University of California at San Francisco
Lincoln Godfrey, DO, a hospitalist at Baxter Regional Medical Center in Mountain Home, Ark., was sitting and listening to strategies to lure and keep hospitalists when his hospital CEO sent him a text asking how his recruiting efforts were going with a would-be hire.
“I said I’d get back to him,” Dr. Godfrey jokes.
The C-suite’s passion is understandable, though, as the fight to hire experienced staff outside of major markets continues to stymie many HM groups. Dr. Godfrey says he can’t hire anybody without first getting them to the Ozark Mountains to learn the hospital, its people, and its community.
“There’s going to be a limited talent pool of people who will come at all,” he says. “But I don’t get anybody who doesn’t work with us for a bit first.”