Wednesday, January 9, 2013

Innovation Units at MGH

In 2012, Massachusetts General Hospital in Boston established twelve innovation units to identify and study how to help the hospital maintain their high standards of care. The units serve as a testing ground for strategies to improve patient outcomes, enhance patient family and staff satisfaction, and reduce costs and the length of stay for patients.

The innovations being tested are to:

  • Build relationship-based care into an educational curriculum
  • Implement the new attending nurse role
  • Enhance hand-over communication to include assessments and recommendations
  • Enhance pre-admission data collection including a revised admitting face sheet
  • Create a Welcome Packet for patients
  • Revisit and update domains of practice to ensure across-the-board understanding of each discipline’s scope of practice
  • Implement interdisciplinary team rounds to ensure effective communication between all members of the care team
  • Be proactive in discharge planning and readiness including implementation of a new discharge checklist tool
  • Implement new discharge follow-up phone calls
  • Make use of supporting technology such as electronic whiteboards, Voalte phones, and portable electronic devices
 Several technologies have been rolled out in the units. All innovation units are now using electronic whiteboards. These unit census boards help track patient flow, patient characteristics, and care teams

In addition, handheld electronic communication devices (Voalte phones) are now live in ten innovation units and have been a huge hit although there are challenges. They have improved staff communication, made it faster, easier to communicate, and greatly reducing overhead paging.

“Early findings on the effect of the innovation used in the units is positive”, according to Jeanette Ives Erickson, RN, DNP, FAAN, Senior Vice President for Patient Care and Chief Nurse. “Our creative thinking is making a difference. “

The information obtained on the innovation units is being tracked on the Dashboard at , to provide a view of data trends as compared to benchmarks. The Dashboard includes information on quality and safety data, fall rates, pressure ulcer statistics as well as infection control, length of stay, readmissions, patient satisfaction, staff satisfaction, patient volume and financial statistics.

“The innovation unit’s Dashboard demonstrates unit performance for key metrics for a baseline measurement period,” reports Amy Giuliano, Senior Project Manager in the Patient Care Services Office of Quality and Safety. “Measures and benchmarks are updated quarterly reflecting outcomes and performance during the period when each intervention is rolled out.”

Also, Rick Evans, Senior Director of Service Excellence is examining the patient experience through the hospital’s “Hospital Consumer Assessment of Healthcare Providers and System” (HCAHPS) scores. HCAHPS is the first national standardized publically report survey for hospital care from the patient’s perspective. This year the scores on the innovation units have risen at a rate exceeding the overall hospital rate.

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