UC Davis aims for ‘excellent’ patient experience
Team huddles have become part of the daily routine among physicians and staff at the family and community medicine department of UC Davis Health System, since the clinic system undertook a “patient-centered medical home” approach starting about two years ago.
Tired of seeing merely “good” to “very good” results on patient surveys, the clinics launched the project to figure out how to change their culture and improve the patient experience whenever possible, an effort that also has included the implementation of an electronic health-record system throughout its network of 100-plus physicians. These efforts have earned UC Davis the Spirit of Excellence Award for Service.
“We wanted to get beyond the good and very good scores” on surveys by Professional Research Consultants, a company that measures patient and employee satisfaction, says Angela Gandolfo, performance improvement adviser for the Sacramento, Calif.-based system. “We facilitated focus groups to find out what patients wanted from us. … We wanted to know, ‘How do we live in a patient-centered world?’ ”
Patients who rated their overall quality of care as “excellent” hit a new high of 78% in July after rising steadily, with occasional ups and downs, from 55% in February 2009. Similarly, the ability to schedule timely appoint- ments hit a new high of 88% in July, up from 29% in February 2009.
A key part of that journey has been the twice-daily team huddles—among faculty teaching physicians, residents, nursing and medical assisting staff, clerical staff and supervisors—that give everyone a chance to go over a “mini-agenda” for patients coming up in that session, such as special needs and teamwork-related goals.
“Medicine isn’t very good at … having dialogue across silos,” observes Tom Balsbaugh, the residency program director at UC Davis. “That’s probably one of the key interventions—doing it in a way that’s breaking down roles, so that each person has the ability to have discussions and to ask questions.”
In addition to putting doctors and patients on the same page with regard to medical history, the electronic health-record system has freed medical assistants from clerical duties and enabled them to become more patient-focused, Balsbaugh says.
“People began to understand that having fewer clerks wasn’t a problem; it was an opportunity,” he says.
While residents readily adapted to the new technology, physician champions helped to overcome resistance among their more traditional faculty-physician peers, Gandolfo says.
“We still have some of that challenge,” she says. “It’s the old school vs. the new school. But we’ve come a long way. We’ve tackled it through the team huddles, getting one champion at a time—but you also need a communication plan and solid support from hospital leadership.”
Next up: expanding this model to the UC Davis Cancer Center, internal medicine clinics and multispecialty groups.
At UC Davis, team huddles are a chance to go over a “mini-agenda” for patients.