Over the past several years, the need for a coordinated approach to care delivery in all clinical specialties has become evident to many organizations across the country. Only through the use of a highly-integrated team can exceptional care be consistently delivered 24/7/365 for the benefit of both patients and the hospital.
Corazons vast experience in program development illustrates the importance of open communication and coordination of care when a multi-specialty team approach is required for success, as is the case in the Cardiovascular and Neurosciences service lines.
For instance, the number of physicians, sub-specialists, and ancillary and nursing staff involved in the care of a stroke patient can easily exceed 25 during the initial hospitalization. Even with this broad spectrum of clinical involvement, stroke continues to be the third leading cause of death in the U.S., with a cost to the economy in the billions of dollars annually.
Corazon has identified the following components as necessary for a successful multi-disciplinary team model.
1. Find a Physician Champion
The physician leader of a successful neuroscience team must first be clinically qualified and possess the training and experience to garner the trust and respect of colleagues. The ideal physician champion is not only clinically-qualified, but also a dynamic leader that conveys passion to the team through active involvement in program development and operations. It is essential that this physician have the ability to see beyond his own individual area of expertise and respectfully consider the input of all members of the team. The ability to see both big picture strategic elements and also the details of daily operations across specialties and departments is key.
2. Facilitate Open Communication
A multi-disciplinary team approach to care requires an organization-wide focus on exceptional communication. While it is important that appropriate care protocols be developed, written, and adopted, it is equally important that these same protocols be fully and uniformly implemented at every level of an organization. For this reason, Corazon recommends the formation of a multi-disciplinary operations committee, with representation from each medical specialty. Support from hospital Administration is also essential. Such an approach can help to illustrate the importance of the initiatives discussed, while providing the leadership necessary to identify and/or circumvent any political or operational barriers that could emerge.
3. Adopt Standardized Order Sets
The complexity of the neuroscience patient requires a consistent approach to care, grounded in solid evidence-based clinical practice guidelines. Collaborative development and implementation of standardized order sets, under the direction of the physician champion, allows all members of the team to be a part of care delivery decisions and plans. For instance, the current emphasis on time-to-treatment for the stroke patient has been facilitated by a strict application of evidence-based protocols. Open dialogue during the development process affords all physicians involved the opportunity to participate in the creation of a comprehensive plan of care. Corazon experience proves that a much greater sense of ownership and a much higher degree of compliance is achieved via an open and inclusive approach.
4. Implement Processes to Track and Improve Performance
A program-specific quality tracking tool should be developed to measure outcomes, validate the data, and explore opportunities for improvement. Again, administrative support of the quality program must be a priority. Only after these steps have been followed, can meaningful information be presented to the team and reasonable, well-informed decisions be made in regard to necessary change.
The development and implementation of a multi-disciplinary team is only the beginning of what should be an ongoing and continuous process intended to improve care quality within this clinical specialty. Corazon anticipates that as the options for treatment of the neuroscience patient continue to multiply, so will the challenges facing organizations committed to the care of the increasing numbers of these patients. Early adoption of sound clinical practices under the leadership of a dedicated physician, solid operational processes, and active administrative involvement will do much to position an organization for success.
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