A team-based care model can improve hospital lengths of stay and mortality rates, according to a blog post by several healthcare providers from Atlanta's Emory Healthcare in the Harvard Business Review.
In fall 2010, the 579-bed Emory University Hospital launched its first Accountable Care Unit (ACU) within the hospital's 24-bed medical unit, according to the post. The average length of stay fell from 5 days to 4.5 during the ACU's first year, while mortality rates fell from 2.3 per 100 encounters to 1.1.
The ACU's design features include:
Structured interdisciplinary bedside rounds: Emory's ACU includes the attending physician, the primary nurse and other involved healthcare workers. During the rounds, members of the team "cross-check perspectives and a quality-safety checklist with the patient, family, and one another and then develop a shared care plan for the day and create a specific discharge plan," according to the post.
Unit-based physician/nurse teams: The ACU team cut the number of physician teams in the intervention unit from five to two, which simplifies one-on-one discussions between patients and providers about any changes in conditions or needs, according to the article.
Performance reports by unit: By switching to unit-based assessments, the ACU "made it easier to engage frontline personnel, cultivate a sense of ownership for outcomes and enable process improvement."
Unit-level physician/nurse partnerships: By pairing the ACU's nurse manager with a physician, Emory provides role models for the collaborative care process and more directly manages the other unit personnel, according to the post.
There were two major challenges in making the transition, according to the article: assigning attending physicians to home units, and maximizing patient and family involvement.
As healthcare moves from volume-based care to a value-based model, providers will likely expand team-based care and the roles of non-physician providers, FierceHealthcare previously reported.
To learn more:
- read the blog post