Converting a unit to patient-focused care.

OBJECTIVE

St. Vincent Hospitals and Health Services, Indianapolis, implemented the patient-focused care concept, Care2001, to maintain or improve the quality of patient care and to reduce the overall complexity of delivering healthcare, which adversely affected St. Vincent's efficiency. With the streamlining possible using the patient-focused approach, St. Vincent hoped to realize cost savings as well. Pilot program: In January 1990 St. Vincent introduced the Seton Unit, a patient-focused care pilot program serving a homogeneous group of surgery patients. Program design: The Seton Unit required facility redesign, such as replacing the traditional central nurses' station with nurse substations,and job class reconfiguration, which established five job classifications: unit representative, unit support assistant, team care specialist, pharmacist, and clinical manager.

RESULTS

The Seton Unit initially offered better quality care and increased patient, physician, and staff satisfaction; increased direct care; reduced length of stay; improved service; and reduced costs. After the initial impact of Care2001, satisfaction levels dropped somewhat, necessitating refinements. Satisfaction levels have since improved.

IMPLICATIONS

The patient-focused care concept is succeeding at St. Vincent. The hospital has already expanded it to other units and is committed to implementing the concept hospital-wide.