In April of this year, St. Paul's Hospital began a new way to care for patients on 7th floor Medicine called Accountable Care. In mid-September, the unit celebrated the SIBR (Structured Interdisciplinary Bedside Rounds) certification of Amandeep Grewal. She became the first nurse on the unit and in the Saskatoon Health Region to receive this important certification.
Amandeep Grewal, 7th Medicine's first SIBR-certified nurse, and Sharon Misskey, Quality Improvement Nurse
SIBR requires all the members of the unit-based team responsible for the care of a patient (e.g., attending physician, primary nurse, pharmacy, social worker, CPAS, physical and occupational therapy, dietician, etc) to visit the patient together as a team. During this visit, which is scheduled regularly, team members cross-check perspectives and a quality-safety checklist with the patient, family, and one another to then develop a shared care plan for the day.
We adopted a SIBR certification program to teach the Interprofessional Practice Team, nurses and physicians specific skills to perform at the highest level and to enable hospital leaders to affirm the competence of professional staff and trainees. With this program all team members who work on on 7th Medicine can study from a training manual, receive online training, and achieve formal certification. This certification is important because it ensures standardization of quality and safety checklists, and consistent communication to the patient, family members and other team members.
The accountable care model is part of a larger provincial Connected Care Strategy to improve emergency wait times and patient flow, and strengthen team based care in hospital and in the community.
Accountable care units have four key components that drive their success:
Team approach including physicians, nurses, occupational and physical therapists, dietitians, pharmacists, social workers and Client Patient Access Services (CPAS), and others physically located together on the unit;
Bedside rounds that involve all members of the care team, including the patient and family, and meet at the same time every day;
Measuring patient outcomes at unit level rather than hospital or health system level; and
Nurse and physician co-leadership