At St. Mary’s, the president and all directors make daily rounds to speak with patients individually and solve issues on the spot.
It’s hard to change processes and start new initiatives when administrators aren’t in touch with patients and staff. It’s not their fault, they need to focus on running the hospital. At the same time, it can be frustrating for staff to receive mandates from people who don’t fully understand what they do. With transitions specifically, it’s hard to get support from administrators when they are so separated from the patient experience.
St. Mary’s Medical Center is a non-profit teaching hospital in San Francisco, CA. It has 300 beds and serves a primarily elderly Medicare population with multiple comorbidities. Their transitions program began in 2009 and is influenced by Project RED and IHI’s Transforming Care at the Bedside.
What We Tried
As part of a hospital-wide quality improvement program, we started having administrative rounds every morning for a half hour. The rounds include people like the director of quality, the director of transformational care, the CFO and CEO. The point of the rounds is both to talk with patients about their care and connect with staff about any concerns or updates they have.
The administrative rounds have really created a culture of transparency and collaboration at the hospital. We’re still a top-down organization in many ways, but people aren’t anonymous anymore. The administrators are more aware of what the staff do and what the patient experience is like and the staff can put faces to the names of people who are making policies for the hospital.
For the transitions program, these rounds have helped us get the support of our administrators. They learn about the challenges that patients face first-hand and see how our work is helping them overcome those challenges. Our patients also see that the hospital is invested in their health, so they’re more willing to open up to us and give us feedback. When the administrators hear about patient issues during rounds, we try to solve these issues together on the spot.
Patients feel good that they met the President of the hospital. They share that with other staff—and, we are sure, with their friends and family as well. It’s good PR!
When administrators find out from patients about a special nurse or other staff they write a post it note and display it in a case in the hall for all to view. Public recognition!
We are all there to make the patient experience the best it can be. Persuade leadership it’s the right thing to do and they will learn first hand.