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Oct. 1, 2010

Pacemaker formula for success

Patients on UPMC Montefiore’s Unit 9-north know they’re in the best of hands and the numbers prove it. For four consecutive quarters, physicians on this orthopaedic surgery and urology unit have ranked in the 99th percentile for patient satisfaction. At a ceremony in August the unit was presented with the quarterly Pacemaker Award, part of UPMC Presbyterian Shadyside’s “Excellence … You’re at the Heart of It All” program.

The program recognizes physicians, staff, and units for achievements in providing outstanding patient care and service as reflected in Press Ganey patient-satisfaction scores and other criteria. To have sustained 99th percentile ranking over a year’s time is a rare achievement, especially in a group context.

The physicians — Timothy Averch, MD, Urology; William Donaldson III, MD, Orthopaedic Surgery; Gary Gruen, MD, Orthopaedic Surgery; James Kang, MD, Orthopaedic Surgery; Joon Lee, MD, Orthopaedic Surgery; and Joseph Lipinski, MD, Internal Medicine — are team players who work well together and with their nursing and ancillary staff. The patients, primarily undergoing orthopaedic spine surgery, respond to the high level of expectations set by their physicians.

“These physicians are great partners in the provision of patient care,” says Mary Beth Pais, RN, MNEd, unit director, 9-north. “They truly care about their patients. Though each has his own patients, they also work collaboratively. They communicate well with each other, and with their patients, families, and staff.”

Dr. Donaldson, chief, Division of Spinal Surgery, and Dr. Kang, executive vice chairman for Clinical Services, Department of Orthopaedic Surgery, have worked consistently for more than a decade to ensure continuity and quality of care.

“This award represents a well-deserved recognition for all of our 9-north staff,” says Dr. Donaldson. “The long-standing respect we have for each other translates into a complete and coordinated team approach. The physicians can be only as good as the staff they work with and rely upon on each day.”

While a combination of individual expertise, caring, and collaboration is at the heart of Unit 9-north’s success, there is another factor contributing to the unit’s high patient-satisfaction scores: organization. Since April 2009, the unit’s Orthopaedic Postoperative Spine Flight Plan systematically has guided communication among physicians, ancillary staff, and patients from the time a patient first schedules surgery to discharge and postdischarge.

“We set a definitive departure date for each patient,” says Ms. Pais, “and we all work toward that goal. No matter whom the patient speaks to, whether it’s the physician, the nurse, the resident, people in pre-op evaluation or same-day surgery, the physical therapist, recovery room staff, the primary nursing care coordinator, housekeeper, or dietary worker, everyone, including the patient, is working toward the same goal of healing.”

The patient is provided with a letter that explains everything to expect, and signs are posted inside and outside the patient’s room with a definitive departure date, so that everyone is on the same page with the same expectations. Since the initiative has been in place, patient length of stay has been reduced on average by almost one full day. This net effect decreases patient costs and increases patient satisfaction.

The model of patient care exemplified by Unit 9-north is gaining influence beyond the unit itself. Two neurosurgery units already have adopted the Flight Plan initiative.


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