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Monday, September 18, 2017 in St. Paul's Hospital

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-August, teams presented their 90 day post-implementation report to the organization, which highlighted how this new model is providing better care and better patient outcomes.

"We are either exceeding our targets or are seeing improvements towards our targets," says Bryan Witt, Director of General Medicine for Saskatoon Health Region. "Each month I am excited when I see the data and am proud to be part of this team that is creating a new way of providing improved care for our patients."

One of the targets that exceeded expectations from the very beginning of implementation was length of patient stay. A target of reducing length of stay by 10 per cent from 13.93 days to 12.53 days was set prior to the model of care launch. By 90 days (three months into implementation), length of stay was 10.57 days - a 22 per cent reduction from baseline. This significant improvement is important for a number of reasons. For the patients, it means improved satisfaction as they are able to return to their normal life as soon as possible. It also means improved safety as prolonged hospital stays can reduce mobility and increase the likelihood of falls. For other patients, a reduction in length of stay means an improvement in overall bed availability which reduces the waits for those needing admission to an inpatient unit for care.

Another area of significant improvement is in staff satisfaction with communication among the healthcare team. With a baseline of 10 per cent prior to implementation, just 90 days later, nursing staff satisfaction jumped to 85 per cent being very satisfied.

"We know we are seeing improved communication and satisfaction because of standardized interdisciplinary bedside rounds. These rounds happen every day at the same time at the patient's bed with members of the care team," continues Witt. "These rounds are one of the core components of the accountable care model and have been very well received by staff and patients."

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:

  1. 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;

  2. Bedside rounds that involve all members of the care team, including the patient and family, and meet at the same time every day;

  3. Measuring patient outcomes at unit level rather than hospital or health system level; and

  4. Nurse and physician co-leadership (on traditional units, physicians are not included in unit management).

Last Modified: Monday, September 18, 2017 |
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