Whidbey General Hospital: First Things First
Hospitals
Written by Jill Rose   
Saturday, 01 December 2007
Whidbey General Hospital’s dedication to patient comfort is apparent—quite literally—right from the start. CEO Scott Rhine said the organization’s Patients First philosophy starts with check-in and encompasses every aspect of a patient’s stay.

Patients First is not a new campaign dreamed up to motivate overworked employees. The program started in 1999, and Rhine said he and his team are still improving it. The overall goal of the program is to help everyone at the hospital, and its satellite facilities, focus on what’s best for the patient. “We want every decision to be made based on what’s best for the patient, and we want to individualize and personalize the care we give each patient,” said Rhine. “We also want the family to be involved and feel supported.”

At the everyday level, that translates into things like a welcoming attitude at patient check-in, more explanations to family members and patients about procedures, and less jargon from caregivers when explaining clinical matters. Rhine said patients are encouraged to bring family members with them to help lessen their apprehension about being in a hospital. “We encourage our staff to talk with the family members, to explain what is happening and why. We also try to take the mystery out of medical delivery. Our goal is to create a healing environment where patients feel safe, have their decisions respected, and have confidence in our care.”

To that end, every employee hired at Whidbey General goes through a two-day orientation on the Patients First philosophy. The training is conducted by staff members and managers, and at the end of the two days, new employees have a much better understanding of what patients and families experience during a hospital stay.

They also understand the emphasis Rhine and his leadership team put on communication. “If there’s going to be a problem, it’s when communication breaks down between departments,” he said. “During orientation, we introduce each new staff member to all the departments of the hospital, including those outside the hospital walls. They learn about the key functions of each department and the skills and/or education required to work there.”

Hospitalists and e-documents
Located on beautiful Whidbey Island off the coast of Washington state, the hospital was built in 1970 to provide local care for islanders. Rhine, who had worked as a hospital administrator for 11 years in Southern California, joined Whidbey General as CEO in 1998 when the hospital’s CEO of 28 years retired. “I had the fortunate opportunity to follow him,” said Rhine.

Whidbey General’s main facility includes a busy ED, outpatient clinics, a medical/surgical unit, a critical care unit, and a family birth center. Because the island is 55 miles long, each end has its own rural health clinic. The 650-employee organization also provides the ambulance service, plus a home health and hospice service.

Over the past several years, Rhine and his team have done two things that are somewhat unusual for a rural healthcare organization. First, they started a hospitalist program; second, they became a beta site for electronic clinical systems.
The hospitalist program actually began seven years ago, but at that time it was staffed by physicians with practices in the community who would take a seven-day rotation in the hospital. In late 2006, Rhine and his team revamped the program, hiring two full-time hospitalists. The day-shift physician is accompanied by either a nurse practitioner or physician’s assistant.

“We’re still tweaking the program, but our staff have said they appreciate having the physicians in the facility and feel communication is much better with the hospitalist program,” said Rhine. He noted that although a few patients have expressed a desire to go back to the days when their physician treated them in both the office and in the hospital, most understand the benefit of the program.

Each day at 11:00, the hospitalists meet with representatives from each clinical department for a brief case review. Included in the meeting, in addition to nursing, are the clinical dietitian, physical therapist, respiratory therapist, care manager, and pharmacist. “That may sound somewhat burdensome,” said Rhine, “but the people I’ve talked to say it’s not only a real benefit for the patient, but also for those providing care.”

 

Making connections
Recognizing that it would be difficult to raise the amount of capital needed to buy a complete EMR, Rhine and Whidbey General’s CIO decided to partner with software vendor McKesson to become a beta site for electronic systems designed for smaller hospitals.

A nursing documentation system went live in June of last year, and last month, a test group of physicians began using a Web-based portal that will allow them access to nursing documentation, diagnostic images, lab reports, dictated reports, and digital mammography tests.

The hospital has also received a $1.5 million grant from the state to participate in a project that will tie three Western Washington hospitals, including Whidbey General, to the Harborview trauma center. “The first thing will be to develop the interfaces to connect with one another—we each use a different vendor’s system. The next step, about 12 months from now, will be connecting all of us to Harborview,” Rhine said.

Another piece of technology is used to connect patients in the community with the hospital. Whidbey General partners with Lifeline, a national company providing alert systems for the elderly. Working with community volunteers, the hospital has placed about 450 Lifeline units in homes throughout the island to help elderly persons remain independent.

A Whidbey General staff member goes to the home to set up the system and train the recipient on its use, and volunteers respond when an alarm is triggered. A scholarship program has been set up by community organizations to fund the monthly monitoring fee for those who cannot afford it.

Although that type of community outreach, combined with the Patients First program, mean that Whidbey General receives Press Ganey scores in the 85th percentile and higher, Rhine and his team are not willing to rest on their laurels. For example, Rhine said the Patients First program is reevaluated every year in a discussion led by the hospital’s HR director and assisted by the staff in charge of community relations. “We try to analyze and improve it each year. We ask ourselves what needs to be changed or freshened. We don’t want to be stale.”

 
< Previous Story   Next Story >