Learning at the Bedside

Shelly Harkins, MD, Beacon Health System Chief Medical Officer

Today’s health care industry is spinning with scorecards and rankings. It can be easy to get lost in an onslaught of surveys and reports from dozens of sources judging the degree of quality and the level of safety each institution is providing.

And though most of these publications are from patient data that is often a year or more old, the information presented consumes our desk space, occupies our thoughts, fills our meeting agendas and guides our strategic direction. There is good reason it consumes us, of course. Those numbers and rates and percentages carry dramatic meaning in our ability to negotiate contracts, in how much we are reimbursed for care this year, or penalized, and determine our reputation to the community and world.

In essence, the outcomes and experiences of patients in our beds last year, dictate the reality of our today. The gravity and importance of those numbers will not change and to some extent, they will continue to guide our strategic thinking. But Beacon leaders are taking pause. They are saying, “Wait a minute! Are we still talking about last year’s patients?” They are asking, “What’s going on with the patients upstairs in our beds today. And what do our associates need from us right now to make that patient have a better outcome?“

“As a physician, I usually found my answers to the tough diagnostic questions at the bedside and often right out of the mouth of my patients. I find it poetic that as an administrator, the bedside continues to be the place where answers and solutions are waiting to be uncovered.” Dr. Shelly Harkins

Q (Quality) & S (Safe) Close Sessions

Beacon’s Q&S Close sessions typically take place the second week of the month. In 2016, they will focus on the Strategic Imperative ‘Big Dots:’ falls prevention, pressure-ulcer prevention, readmission prevention for COPD and CHF, and inpatient mortality reduction.

Taking place in the Cancer Center boardroom at Memorial and the boardroom at Elkhart with live video feed between the two sites, front line associates discuss the details of cases of concern from the prior month. Ideas are suggested and often solutions are recommended right on the spot.

“Show Me” Rounds

“Show Me” rounds are exactly as the name implies. Quality teams and executive leaders who have participated in the Close session round on the floors asking associates to show them how things are working and what they are doing around the system’s ‘Big Dots.’ The rounding teams visit patients and ask questions right at the bedside with nursing staff. The patients are encouraged to offer their suggestions and share their real-time experience. The associates showing their realities at the bedside, along with the patient’s welcomed comments, provide a wealth of understanding and an element of realism to leadership teams.

This rounding is a unique opportunity that empowers you and can bring to light ways in which we can improve patient care across the health system. Truthful, vigorous and enthusiastic participation will make a real difference in the lives of our patients. These sessions are designed to find real-time solutions for some of today’s toughest health care challenges. This is not about accusing or assigning blame in any way. Be fearless during rounding when bringing up concerns or talking about the realities you and your patients face. Your input is absolutely critical to our success.

Although today’s efforts may not show up on a published report or scorecard until next year or later, at Beacon we understand that getting it right today, is the best way to operate.