The Best Care Giving Practices in Northwestern Memorial Hospital - Case Study Example

Patient Care Excellence: A Review on the Best Care Giving Practices in Northwestern Memorial Hospital The Northwestern Memorial Hospital (NMH) in Chicago is part of the McGaw Medical Center of Northwestern University, and is one of America’s finest academic and medical centers, fostered by the long tradition of leadership in patient care and research. This premier 897-bed hospital includes the Stone Institute of Psychiatry and the Prentice Womens Hospital and Maternity Center. This medical institution has more than 5,000 employees and 1,200 affiliated physicians and specialists which are recognized worldwide for their outstanding clinical and surgical skills in areas such as cardiothoracic and vascular care, gastroenterology, neurology and neurosurgery, oncology, organ and bone marrow transplantation, and womens health. (Northwestern) This prominent hospital’s history can be traced back when in 1966 the McGaw Medical Center at Northwestern University was formed and led the mutual planning between the university and its associate hospitals. Passavant Memorial and Chicago Wesley Memorial Hospital, two of Chicago’s oldest and most distinguished medical institutions, responded by merging their nursing schools and combining clinical areas. The culmination of the strong consolidation of these two hospitals happened on September 1, 1972. (Northwestern) To meet the demands of the advancement in healthcare facilities and to support medicine’s rapid technological developments, Northwestern Memorial Hospital opened its new, two million square-foot healthcare facility on May 1, 1999. Amidst the attention focused on NMH as a primary health institution and given healthcare as one of society’s most demanding function, I want to look into the current nursing practices and services of this hospital. This report focuses on the exceptional patient care provided by the Northwestern Memorial Hospital. I will highlight nursing accomplishments in various areas such as best practices, quality improvement and in education and research. Patient First Mission Together with the Northwestern University’s Feinberg School of Medicine, Children’s Memorial Hospital and the Rehabilitation Institute of Chicago, the Northwestern Memorial Hospital is committed to contributing to clinical advancement, medical innovations and most importantly to scientific research to benefit the patients in the future. (Northwestern) Currently the institution remained focused on financial planning and discipline to advance their Patient First Mission which is more than just investing in facilities and equipment modernization. Northwestern Memorial Hospital launched their “The Best Care Begins With Us” campaign last 2006 and 2007 which gathered popular response. The success was highly evident with the significant increase in annual patient volume, making the Prentice Women’s Hospital and Maternity Center the largest birth center in Illinois with more than 8,000 deliveries in 2007. (Northwestern) Furthermore, the Northwestern Memorial Hospital has been investing on hospital organizational excellence and striving to provide the “Best Patient Experience” for every patient they serve. Their physicians, nurses, healthcare professionals and other medical staff, practice innovative patient care techniques and are constantly under a dynamic learning environment to ensure quality performance and outcomes. As a result, this medical establishment is the sole winner to be chosen as the number one consumer–preferred hospital in Chicago and on the nine-county areas. (Nursing) Currently, the Northwestern Memorial Hospital has now become a leader both in medical and academic excellence. Catering annually to hundreds of medical tour groups both nationwide and all over the world, it is a model facility for healthcare providers. It is the recipient of numerous prestigious medical awards, including the Awards For Clinical Excellence and the National Research Corporation Consumers Choice Award. Moreover, Northwestern Memorial Hospital was recognized for the ninth consecutive year since 1999 as Chicagos healthcare consumers’ first choice for: Best Physicians, Best Nurses, Best Quality, and Best Image and Reputation. In the recent, U.S News Ranking, Northwestern Memorial Hospital made it to the top 20 in the fields of Endocrinology, Gynecology, Heart and Heart Surgery, Neurology and Neurosurgery, Rheumatology and Urology.( Northwestern) Advancing Nursing Excellence Health has been identified as a public priority in some countries around the world – and nurses play a critical role in delivering health services. The broad spectrum that nurses occupy covers patient and public health education, illness and injury prevention, care provision along with rehabilitation program participation. No other health care professional has such an extensive and influential role. The Joint Commission, an independent, non-profit organization of medical professionals which started way back in 1910. This body aims to continuously improve the safety and care catered to the public by providing health care accreditations to American hospitals under strict international standards. In its latest annual report last year, the Commission reported that some of America’s hospitals performed against evidence-based quality measures. More significantly, what tops the standard compliance issue (as published by this commission) is the improvement of effective communication among caregivers, with a disturbing 58% non-compliance rating.( Improving) Hence it is the goal of Northwestern Memorial Hospital to go beyond normal patient care. In response to the Joint Commission’s demand for excellent measures, NMH is dedicated in developing and in implementing – behind the intention of accreditation – evidence-based protocols in advancing nursing excellence and improving patient supervision. Recently, this medical institution developed a special patient-centered model for care and distinctive interdisciplinary team training for its staff in Labor and Delivery at Northwestern Memorial’s Prentice Women’s Hospital. Three years ago the Joint Commission emphasized that more than 85% of maternal deaths nationwide is largely due to miscommunications within the pool of caregivers and among the patients themselves. As a result, NMH designed a group interactive program complete with simulations, safety cues for expressing levels of concern on patient status, and thorough group discussions to help caregivers communicate more effectively on how labor and delivery is progressing. (Nursing) “The training emphasized the importance of interactions among the whole team in producing positive outcomes for patients”, says William Grobman, MD, an obstetrician on the medical staff at Northwestern Memorial and associate professor of Obstetrics and Gynecology at Northwestern University’s Feinberg School of Medicine. 1 A closer one-on-one relation between its nurses and the patients leads to stronger communication. This kind of relation helps nurses and other medical staff in assessing relevant and important safety concerns like possible patient risks, open wound infections and pressure ulcers development. The distinguishing characteristics of this newly implemented model are the individual staff’s critical thinking and more importantly creating a personalized plan for care with unique approaches to accident prevention. In fact, Northwestern Memorial Hospital needed to undergo drastic organizational changes which involve hourly rounding, evaluating and communication where nurses discuss and exchange plans for care with each patient. (Nursing) Through this method, the next shift of nurses will have a complete knowledge of every patient’s needs and condition. “Designing treatment plans that take into account a patient’s unique needs and abilities helps (sic) make recovery easier and more efficient. By spending more time with patients, we can better understand what they need and help them better engage in their plan of care.” says Charisse Washington, RN, a nurse in Transplant/Hepatology, Northwestern Memorial Hospital2. The nurses at Northwestern Memorial Hospital gained public acknowledgement as the recently concluded Gallup Employee Survey highlighted them to have an exceptional responsibility for the care they provide to their patients. Annually, NMH nurses take part in nationwide projects aim to improve patient outcomes. More specifically, their nurses participated in almost 30 workshops that focused on the reduction of hypothermia3 in post operative patients and in the prevention of hypoglycemia4 in newborns. Nurses worked in close collaboration with surgeons and anesthesiologists and created a process to lower postoperative hypoglycemia. Previously, the hospital recorded that 50% of the patients that underwent surgical operations have body temperatures less than or above than recommended. For this reason, they adapted a process similar to the DMAIC (define, measure, analyze, improve and control) process. And, drawing in on the latest up-to-date researches, Northwestern Memorial Hospital achieved 95-100% compliance as recommended by the nation’s Surgical Care and Improvement Project (SCIP). (Nursing) Furthermore, the NMH medical staff conducted the revolutionary implementation of the Hypoglycemia Protocol. Due to the significant increase in neonatal health problems (an estimated 13% out of 10,000 live births), NMH medical practitioners examined evidence-based practices to determine appropriate steps. They concluded that in order to maintain glucose levels in newborns, first feeding should occur sooner. Aside from that, they found out that delaying the first newborn bath could lessen infant stress which could deplete their stored glucose. The success of this protocol is best shown with the drastic decrease of incidence since its implementation. (Nursing) Being a chief academic and medical center, Northwestern Memorial Hospital is dedicated to educating their student nurses and in helping to address the nursing faculty shortage. Mutual efforts and partnerships with other colleges and universities in Chicago area help support these efforts and therefore add to a dynamic teaching and learning environment at the hospital. NMH sees the value in partnering with other nursing universities. In fact, seven of their nurses are currently clinical and an academic instructor for nursing students in one or two of the hospital’s affiliated universities.(Nursing) They believe that their nurses can provide a richer clinical experience than form someone outside their hospital since their nurses know their mission and goals and the system itself. “Using Northwestern Memorial nurses as clinical instructors rather than bringing the school’s educators into the hospital is a current best practice,” says Jill Rogers, RN, PhD, director of Professional Practice and Development at Northwestern Memorial.5 To remain true to their mission in improving patient care, Northwestern Memorial Hospital supports their medical practitioners in their individual efforts and researches, aimed for the enhancement of patient welfare and development. An extraordinary example of such medical practitioner is Linda Boardman, a BFA and at the same time an RNA who is currently working in Northwestern Memorial’s Stone Institute of Psychiatry’s Emergency Housing Program at Chicago’s Lawson House YMCA (the largest low-income single room residence provider in the state). She beautifully blended her love for the craft with her research about the use of art in psychiatric recovery, and offered acrylic painting classes to her patients. She, together with NNH gained nationwide acclaim. Furthermore she presented her wok in the 14th National Evidence-Based Practice Conference at the University of Iowa Hospitals and Clinics. (Nursing) Just like any other medical and health care institutions, Northwestern Memorial Hospital faces yearly malpractices suites. One of the most recent is the medical malpractice lawsuit filed by the parents of Joshua Radis, alleging NMH of negligence on the part of the medical practitioners resulting in their child being born brain damaged. They accused the attending physician and the hospital of the failure to deliver Joshua Radis on time despite indications that the baby was not tolerating labor. As a result Joshua Radis was born with cerebral palsy6. (Hospital) Another controversial birthing malpractice recently settled August this year ($9.7 Million, as settlement fee), was the hypoxic ischemic encephalopathy7 sustained by Madeline Maturino, caused by the aggressive administration of the clinical drug Pitocin. This misjudgment created a series of premature contractions which came very close to each other and gave tremendous stress to baby Madeline. The baby’s brain tissue was damaged from oxygen deprivation. Born last 1998, the injury left 10-year old Madeline with limited speech abilities and occasional sudden occurrences of anger. (Malman) Malpractices and medical errors bring a greater impact on a hospital’s financial burdens rather than affecting hospital efficiency. In fact, malpractice pressures improve the technical efficiency of hospitals. Medical institutions are willing to pay more in organizational and technical changes than risk millions for malpractices payments and settlements. (Bagga) Compliance as defined by the Joint Commission’s National Patient Safety Goals (NPSC) means consistent performance of certain requirements. When an institution is labeled to be “non-compliant” it means that the organization is not doing the requirement constantly and repeatedly. Therefore an active hospital environment must be well kept and observed. (Nursing) Hospitals must continually analyze basic workflow arrangements and redesign faulty systems. Hospitals must go beyond simply performing requirements to achieve accreditation; it is the obligation of every healthcare provider to improve their accuracy, which could take time, motivation, and several critical decisions. In the genuine efforts of advancing innovative and quality patient care, Northwestern Memorial launched the Patient Center Model of Care last July 2007. The highlight of this model is the focused one-on-one communication between patients and caregivers. The pilot programs achieved overwhelming results which included; 0% incidence of pressure ulcers, a fall-rate decrease of 1.6%, and a decrease in call light usage of 8%. With direct focus in reducing post-operative hypothermia among surgical patients and in hypoglycemia cases in newborns, NMH came up with creative and evidence-based actions. In the new post-operative hypothermia measures, post-pilot statistics revealed an estimated 95% compliance with the recommended temperature range. Similarly, the cases of hypoglycemia in newborns, dropped from 12.88% in July 2006 to 2.11% in July this year. (1) Striving to attain educational fineness, NMH employs their own nurses to better prepare nursing student form different colleges and universities with the commitment the hospital has for excellence and quality. More importantly, this medical institution encourages their heath care practitioners, especially nurses to get baccalaureate or a master’s degree in their respective fields. And to date, 86 of their current staff attained graduate level. (Nursing) Works Cited Northwestern Memorial Hospital Online. 2008. Northwestern Memorial Hospital. 20 Sep. 2008. Read More