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From left: Tower 14AB's Nursing Director Patricia Brita Rossi, nurse Jennifer Cartright and Medical Director Matthew Vitale gather for morning rounds.
Earlier this year, each pod in the General Medicine Service (GMS) units-Tower 14AB, 14CD and 10BA-was restructured to enhance communication among physicians and nurses, and provide more consistency for patients and family members.
This process, called regionalization, involved reorganizing the GMS model, with multidisciplinary teams including GMS physicians, nurses on med/surg floors, BWH Patient Access Services staff and the Emergency Department all working together. As opposed to having a team's patients spread across the hospital on multiple floors and units-which was the case prior to regionalization-teams are now associated with a single unit.
Six months after the launch, teams are already achieving improved communication and efficiency, as well as greater patient and family satisfaction.
"We've seen a marked improvement in getting information about the current day's discharges and pending information for the next day's discharges earlier in the day, which allow us to better place patients in the right bed and to the right team," said Sheila Harris, executive director of Patient Access Services. "Each team is on the floor, spending time caring for patients and not in transit. As a result, team-based care is improved, and the teams know their patients even better."
On the frontline of the patient and family experience, Patient Access Services has played a central role in the implementation of regionalization. As a result of the staff's efforts, GMS has consistently achieved its regionalization targets since the launch, despite its high patient census and high census on other services.
"This process is being done in the spirit of cooperation and teamwork, and the outcome is a wonderful thing for patients," said Harris. "As the process continues to evolve, we should be getting patients discharged even earlier."
Also part of GMS regionalization are new partnerships among GMS physicians and nursing directors. These "dyad" pairs are championing new processes and enabling nursing and physician leaders to work together and collaborate with other members of the multidisciplinary teams.
"Regionalization is great for patients, families and the care teams," said Patricia Brita Rossi, MS, RN, nursing director of Tower 14AB. "Everyone knows each patient's plan of care; there is no confusion. Everyone is working together in the same direction."
Added Matthew Vitale, MD, medical director of 14AB: "As a hospitalist, regionalization is very appealing. It is a team-based care approach, which makes an enormous difference. We're all working with the same staff for the same patients every day. You feel like you're sharing the effort in a meaningful way."
Regionalization has fostered the sharing of best practices among care teams and units.
"If one unit is doing something effective, other units can access that data, which is incredibly helpful," said Vitale. "It's a safe place to have challenging but enlightening conversations."
Tower 14CD's Esteban Gershanik, MD, MPH, agrees, and is inspired by the results so far.
"Feedback from physicians and nurses has been positive," he said. "All team members have been able to get to know each other much better and build great camaraderie and teamwork, but we are still learning and working to make the GMS redesign and regionalization process the best it can be. Our early and sustainable success could not have been achieved without the partnership and support we've had from everyone, including our colleagues in Patient Access Services and the ED."