Abstract W P285: Communication is the Driver of an Efficient Health Care Team

Abstract

Background: Comprehensive Stroke Centers provide hyperacute stroke care within hours of symptom onset. Patients benefit from this intervention but still have needs that have yet to be addressed. Health care must be delivered efficiently while meeting the expectations of the public. A methodical solution achieves excellent outcomes for providers, payers, and patients. Purpose: The goal of the health care team is to provide a clear assessment and discharge planning process that enhances communication amongst team members. With an annual volume increase of 10-20%, throughput is a daily challenge at this academic hospital due to rotating physicians and students. Methods: A comprehensive assessment is documented in the electronic medical record within 24 hours of admission by the case management team. This assessment includes screening for depression and need for respite services. A resource guide is immediately provided to the patient and family. Five days a week, the health care team is assembled for “patient care huddles”. These are attended by the vascular neurologist, case management social worker and nurse, speech and physical therapy, stroke program coordinator, pharmacist, utilization review, research coordinator, neurology residents, and each bedside nurse. The 2 minute per patient discussion centers on “plan for the day, plan for the stay”. Results: The number of ischemic stroke and TIA patients has increased 25% over two years. In the same time period, the average length of stay index has decreased from 1.17 to 1.00 and the average cost index is 1.08. Patient satisfaction, as measured by Press Ganey, is at the 98 th percentile for stroke patients over the last two years. Conclusion: Communication among all team members is enhanced through daily patient care huddles and allows discharge planning to start at admission. Comprehensive assessments leading to efficient discharge planning can be achieved without compromising patient satisfaction or increasing costs or length of stay. Throughput is impacted by an efficient, cohesive team.