Straight TalkA weekly update from management on the issues that matter most. Nov 1, 2018 Patient-centered care is the reason NCH has achieved astounding quality, safety, and outcomes for the patients we serve. Embedded hospitalists collaborating with primary care physicians, consulting with specialists, and focusing on standardization are creating teams that embrace best practices to continue this success, as previously presented in “Straight Talk” on September 27, 2018: The powerful positive force of cultural transformation when applied to patients’ best interests has profoundly wonderful consequences. NCH is currently jumping to the next higher level of patient experience while simultaneously lowering hospital acquired conditions and length of stay. We have maintained our 5 star rating—the top ranking from the Centers for Medicare and Medicaid (CMS). Of the seven categories, safety of care, readmissions, and efficient use of imaging are standard deviations better than the other 4,000+ rated hospitals. Mortality, timeliness of care, and effectiveness of care are similar to other systems. However, we are addressing the weakest of our CMS ratings, namely patient experience. www.medicare.gov/hospitalcompare/search.html Past patient-centered changes in the care process have often been met with some drama. Examples include two of NCH’s flagship programs: Save-a-Heart (heart disease mortality locally 21.7% vs. nationally 25%) and Save-a-Brain (stroke mortality locally 2.31% vs. nationally 5%). While these programs were initially resisted, our community is now thankful that heart disease and stroke are no longer the leading causes of death in Collier County, as they are in most of the nation. Cancer is first locally. We don’t have more cancer; rather, thanks in large part to these programs, we are surviving heart attacks and strokes, with individuals in our community now living six years longer than the average American. NCH’s new patient-centered model of care, being piloted on select units, is another example of change which is being welcomed by some and questioned by others. Interestingly, primary care physicians, comprised of concierge physicians along with traditional primary care physicians, who cumulatively admit fewer than 3% of the total patients to NCH, are among the most vocal opponents. Over 97% of patients are already being admitted and having their care managed by specialists such as cardiologists, orthopedists, etc. or a hospitalist physician. Instead of having only one physician who visits for minutes, patients in this new model will have a continually available team led by an NCH hospitalist who is physically located full time on that unit and whose sole job is to lead the team, directly managing the care patients receive. Answers to many frequently asked questions can be found at Patient Centered FAQ. Having practiced internal medicine, geriatrics, and rheumatology (board certified in all three) for twenty-three years, I understand and appreciate the doctor-patient relationship. The new model does not interfere with this bond, but rather supplements it. Nothing in this new care model prevents your primary care physician from coming to the hospital, reviewing your medical record, receiving updates on your condition, recommending tests/procedures/specialists, and working collaboratively with the geographically embedded NCH hospitalist and other members of the care team. The units that are piloting this new model have produced real data demonstrating improved patient satisfaction, lowered hospital acquired complications, and decreased length of stay—all helping everyone live a longer, happier, and healthier life. P.S. DO YOU HAVE A COLLEAGUE OR FRIEND WHO WOULD BE INTERESTED IN UPDATES? Please enter their email address at nchmd.org/straighttalk, and we will add them to our complimentary mailing list.