The Accountable Care Unit (ACU care model) with Nurses First and SIBR rounds increase HCAHPS
Top Results
Overview
UC Health recognized an opportunity to deliver improved patient care through a more interdisicplinary approach and contracted 1Unit to support implementation of the Accountable Care Unit (ACU care model) with Structured Interdisciplinary Bedside Rounds (SIBR rounds) on two of their hospitalist led units.
Objectives
Hospital leadership wanted to deliver a more patient-centered care model on their hospitalist units and had identified the ACU as their preferred model. Hospital leaders hoped that through improved patient engagement and engagement, the units would see benefits in terms of patient satisfaction scores, discharge coordination and potentially throughput and costs.
Methods
1Unit supported ACU implementation on two hospitalist led units:
Online training was provided to all nurses for the Nurse First Change of Shift Huddle and Bedside Handover,
Online training was provided to all care team staff on the fundamentals of SIBR rounds,
1Unit facilitated customization of the Nurses First and SIBR templates and job aids,
Onsite training was then provided to all staff on their new processes, including simulation scenarios, role plays and advanced best practices,
Process monitoring and data collection were used to support long-term implementation success, and
Weekly mentoring meetings were facilitated by 1Unit to identify challenges, barriers and opportunities for success.
Results
Significant improvements in HCAHPS scores were observed in the months following implementation:
'Nurses listened carefully to you' increased from the 3rd percentile to the 58th
'Doctors listened carefully to you' increased from the 6th percentile to the 46th
'Would recommend facility' increased from the 25th percentile to the 45th
'Rate the hospital' increased from the 1st percentile to the 75th
Conclusion
Implementation of the ACU care model with Nurses First and SIBR rounds programs resulted in significant increases in critical HCAHPS scores. Hospital leaders also reported that Nurses First and SIBR "provided the structure for long-term sustainability of the interdisciplinary bedside rounds" processes, which the hospital had struggled to achieve previously. Unit leaders noted that 'team collaboration was strengthened and is more cohesive' following implementation.
