News
New website showcases 24 models of innovative healthcare in US
30 April 2008
The Innovative Care Delivery Model website has been launched by
Health Workforce Solutions LLC (HWS), a California-based research firm
focused on workforce issues in healthcare. Funded with support from the
Robert Wood Johnson Foundation, it aims to be a one-stop source to learn
about new ways hospitals and health systems from around the US.
The website shows how innovative healthcare organisations are
devising approaches to curbing health costs, improving quality and
safety, managing chronic disease, increasing patient satisfaction and
accommodating nursing shortages.
When a large urban hospital in Florida put nurses in charge of
managing and facilitating round-the-clock care for a designated unit of
patients, it dramatically cut length of stays, improved medical
outcomes, and increased satisfaction levels among patients and staff.
The story of how Miami Baptist Hospital's 12-Bed Hospital elevated the
role of nurses to transform the way care is delivered to patients is one
of 24 models of promising health care delivery that are profiled on the
website.
"Given the pressures in healthcare today, the need for new models of
care delivery cannot be overstated," says David Cherner, Managing
Partner of HWS. "We selected these 24 models to showcase on this site
because they are truly sustainable and replicable and are having a
material impact on cost, quality and patient satisfaction in both
hospital and outpatient settings," he adds.
"The way healthcare is organised and delivered today is neither
sustainable nor ideal — which is why we need to explore creative
strategies for delivering care," says RWJF Senior Program Officer Dr Sue
Hassmiller RN. "There are a lot of lessons to be learned from these 24
models, because of their effectiveness in leveraging nurses and other
healthcare professionals to deliver services more efficiently and
economically, resulting in better quality care in a variety of
settings," she adds.
The two dozen models profiled fall into three categories of care
delivery: acute care, bridging the continuum, and comprehensive care.
Visitors to the website will be able to read a complete description
of each model, the impetus for why they were created, the results of the
effort, what needs to be considered for replication, challenges and
lessons learned, and helpful tools. Each description also includes
information about the leaders who helped create or managed the
development of each model. Models profiled include:
- Johns Hopkins' Hospital at Home project, which allows patients
with specific conditions, including congestive heart failure and
cellulitis, to remain at home rather than be treated in the
hospital. Physicians and nurses visit the patient at home and can
provide comparable and more focused care that is less expensive,
results in fewer complications, and increases patient satisfaction.
The project has been replicated in a number of different sites,
including Portland, Oregon.
- A rural collaborative in West Virginia that uses telemedicine
and conducts outreach programs to address chronic health problems
and narrow disparities in care. Minnie Hamilton Health System's
Comprehensive Rural Care Collaborative has improved access to
primary care and provided care to more than 10,000 poor people
living in rural areas of the state.
- Griffin Hospital's Planetree model in Connecticut, which puts
patients at the centre of the care system. Having transformed itself
from a failing institution that couldn't recruit physicians because
of its poor image in the community, the facility is now cited as
having one of the highest rates of patient satisfaction in the
country.
- The Southcentral Foundation's values program in Alaska, which
involves a unique primary care team and extended family in the care
of Native Alaskans. By embracing the culture and values of the
community into its care model, the program involves patients and
families in care and as a result has kept people healthier and out
of the hospital.
- University of Pennsylvania's transitional care model, which has
nurses monitor patients beyond discharge to ensure that they get the
appropriate care they need in the community and don't end up back in
the hospital. This has been replicated in several sites, including
Kaiser Permanente in California.
Although each of the 24 delivery models is distinct in its own way,
many share the following common elements:
- Elevate the role of nurses by shifting them from a traditional
caregiver role to one that integrates and coordinates care for
patients; nearly all of the projects do this.
- Deploy an interdisciplinary team for care that includes nurses,
physicians, physical therapists, social workers, and pharmacists.
- Bridge the continuum of care by extending their focus beyond the
sponsoring organizations primary setting; nearly half of the models
provide care that follows the patient outside of the hospital in the
home, outpatient clinics, or long-term care setting.
- Promote home as the setting of care. Six of the projects
profiled extend the typical definition of healthcare, relying on
patient home as the primary location.
- Target high-users of healthcare, focusing on older adults who
are heavy users of healthcare.
- Sharpen the focus on patients by actively involve patients and
their families in care planning and delivery.
- Incorporate new technologies. In some models, new technology
served as a catalyst for developing a new model.
- Push for improved satisfaction, quality and cost. All models
were prompted by specific problems or concerns about quality,
patient and provider satisfaction, or unsustainable costs and
utilization.
"What makes these models stand apart is that they represent
improvements over the existing system," says Bobbi Kimball, a nurse who
is the principal investigator for the Innovative Care Delivery Model
project. "All of these projects have embraced goals around improving
cost, quality and satisfaction. These are the true leaders who
understand that the future healthcare system will demand a new level of
interdisciplinary teamwork, involve families and patients as active
partners in care to a much greater extent, and will have to leverage
nurses in new and expanded roles."
Further information
1. To learn more about these 24 projects and the Innovative Care
Delivery Model project, visit
www.innovativecaremodels.com
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