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New patient care model helps staff do more for the patient and family


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Staff at Loyola University Medical Center in Maywood, IL, always put the patient care experience first, but they wanted to do more. They wanted to spend more time, pay more attention, and have time for more care. At Loyola, they call this "magis."

Magis is a Latin term meaning "to do more," which is a perfect description of the new patient care model they developed to reflect the organization's values.

"We needed to manage patient care differently—and the patient and family needed to be at the center of what we did," says Paula Hindle, RN, MSN, MBA, vice president, chief nurse executive at Loyola.

Loyola had just built two new inpatient units as part of an expansion plan to improve patient satisfaction and was looking to change its patient care model. Jesuit ethical and spiritual values are incorporated into all aspects of patient care at the medical center, which categorizes its values into four areas:

  • Care
  • Concern
  • Respect for others
  • Commitment

Hindle and Debbie Jasovsky, PhD, RN, CNAA, BC, associate chief nurse, conducted a literature search on patient care models and recognized these four concepts occurring in several different models. So they decided to take elements from several and combine them to create their own model that would truly represent their magis values.

"Knowing what we believe in made it much easier to adopt this than to adopt someone else's model and try to implement it in full," says Hindle.
 
Putting patients at the center

After designing the model, it was put into practice in May in Loyola's cardiovascular surgery and interventional cardiology unit and the general surgery unit. The model's aim is to put patients and their needs at the core of everything:

  • Patients and family members are encouraged to become active in treatment decisions and are consulted by physicians and nurses for treatment decisions and education sessions
  • Designated family members have unrestricted visiting hours with the option of staying overnight in the patient's room
  • Patient preferences are respected under the magis values, including religious and cultural traditions

With patient and family needs and comforts at the forefront, the new units were designed with all private rooms, and featuring a nurse pod outside the rooms instead of a centralized nursing station.

Developing and strengthening staff

The model required some staff adjustments as well, which included the development of a new position, called a clinical resource nurse. The medical center hired two clinical resource nurses who assist with:

  • Staff competency: Making sure newly-hired staff nurses have skill sets needed to work at the bedside
  • Quality outcomes: Monitoring quality of patient care
  • Education: Running necessary educational conferences

And under the new model, staff nurses carry out new practices such as:

  • Making hourly rounds to check patients for pain, positioning, and bathroom needs
  • Asking patients probing questions to determine levels of pain and other symptoms so they can be resolved
  • Asking patients for their goals each day so the nurses can help patients meet them
  • Following the four Ps (pause, ponder, plan, and pray) to reflect on each patient's care, which is practice by both nurses and physicians

Jasovsky says the model also focuses on developing nurse's communication skills to help them build better relationships with other staff and with their patients. This includes honing better listening skills for therapeutic conversations to get them more comfortable when communicating with patients.

"We are really excited that the nurses are responding," says Hindle.

And Loyola's patients are reaping the benefits as well. Satisfaction scores have gone up for the first three months since implementing the model.

"We think we are going in the right direction," says Hindle.