| Simple ideas are often the most striking. Take the permanent bulletin boards,
complete with small wipe-off boards updated with patient-specific information, that
were installed in patient rooms in the new oncology and orthopedic units at the
hospital in Fargo. The bulletin boards wouldn’t exist if the project hadn’t taught
administrators to solicit the ideas of the workers who would use the units. The healthcare workers had other ideas too. Beds that could be made firmer and softer—controlled by the patients—were installed. Instead of one central nurses station, there are nurses “pods” along the hall. The MeritCare system spans two states and has 26 sites and 300 physicians, offering a range of services with a 250-mile radius. “We are fairly complex for our rural state, yet everyone understands what a ‘stakeholder’ is now,” said Ruth Hanson, MS, RN, an internal consultant with MeritCare Health Systems and the project coordinator. The nurse-physician relationship also has been strengthened. That happened as nurses and physicians worked together on standardizing care, and has been helped along by a code of conduct instituted in the operating room. It has “dramatically changed the tolerance for less-than-desirable behavior,” Hanson said. The code was developed and is implemented jointly by physicians and nurses. MeritCare was hierarchical before the study, like many other healthcare facilities, Hanson said. It still is, but it is progressing beyond compartmentalized lines. “The concept of reaching across departments using interdisciplinary teams and multilevel teams will stick forever,” she said. |