Patient Advisor Rounding
Vidant Medical Center
Kim Blanton
Patient & Family Advisor
Melissa Thomason
Patient & Family Advisor
What you will learn today
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What are Advisor Rounds?
Why are they important?
How do you do Advisor Rounds?
Tools to support successful rounding
Impact of Advisor Rounding
Lessons learned
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System of Care
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A Day in the Life of Vidant Health
 196 acute care
admissions
 136 surgeries
 118 critical care
patient
 822 ED visits
 1,377 outpatient visits
 2,000 VMG practice
visits
 7 medical air transports
 21 babies born
 184 patients with
central lines
 78 patients on
ventilators
 144 patients with
urinary catheters
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Patients & Families as
Team Members & Leaders
“Put Patients and Families on the Improvement
Team” is noted as the leverage point
with the greatest potential to drive the
long-term transformation of the entire system.”
IHI Seven Leadership Leverage Points
to Drive Organizational Improvement
2008 IHI innovation series
System Wide Advisor Structure
VIDANT HEALTH
PATIENT-FAMILY EXPERIENCE TEAM
Vidant Medical
Center
Advisory
Council
Vidant Medical
Center
Service Line
Advisory
Councils
Vidant Bertie
Hospital
Advisory
Council
Vidant Chowan
Hospital
Advisory
Council
Vidant
Employee
Health
Advisory
Council
Vidant Duplin
Hospital
Advisory
Council
Vidant
Home Health
And Hospice
Advisory
Council
Vidant
Edgecombe
Hospital
Advisory
Council
Vidant Medical
Group
Advisory
Councils
Vidant
RoanokeChowan
Hospital
Advisory
Council
Albermarle
Hospital
Advisory
Council
The Outer
Banks
Hospital
Advisory
Council
Vidant
SurgiCenter
Advisory
Council
Vidant
Pungo
Hospital
Advisory
Council
To be
developed
Vidant
Beaufort
Hospital
Advisory
Council
(To be
Developed)
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Vidant Medical Center
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Vidant Medical Center Advisor Structure
Vidant Health’s commitment is to have advisors at decision-making
tables and to view care through the eyes of the patient.
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Patient and Family Advisors
Any role or activity that
enables patients and families
to have direct input on
policies, programs, and
practices affecting health care.
What do VMC Patient Advisors do?
Board Presentations
“Experiences in Care”
Videos
Conferences
New Nurse Orientation
MyChart
Care
Coordination
Falls
UTI
Skin
CLABSI
VAP
Storytelling
Patient
Communication
& Transparency
Literature
Review
Education
Safety
Patient &
Family
Advisors
Quality &
Performance
Improvement
Teams
Hiring Committees
Strategic Planning
Vendor Selection
Rounding
System
Input
Facility
Design
Provider Education
Patient Education
Staff Education
REAL DEAL
training
Safety Summit
Safety Boot Camp
RCAs
FMEAs
*Unit Rounds
*Return to Care
Rounds
*Safety Liaisons
Children’s ED
Cancer Center
Children’s Hospital
Heart Institute
WHY Should Advisors do Rounds?
 A real-time pulse check
 Strengthens partnerships
 Some patients are more comfortable
sharing concerns with a “former patient”
 Introduces a fresh perspective
 Front line workers see PFCC in ACTION
 Drives results. Yields better outcomes.
Vidant Medical Center Safety Liaisons
 Patient & Family Advisors
who have completed risk
assessments, HIPPA training
and role orientation.
 Patients give consent in
advance.
 Liaisons focus on safety and
use a rounding tool.
 Findings are documented and
staff and advisors conduct
debriefs with safety manager.
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Pre – Safety Round
Patient Consent Form
Safety Liaison Rounds:
What we learned…
…. about Advisor Rounding
 Advisor Selection Important
 Builds Relationships
 Some patients more comfortable sharing with Patient
Advisors than with Staff
…. about our Care System
 Identified transition snags from acute to rehab
 Room nightlight preventive maintenance process missing
 Discharge instructions in bright envelope; being used
throughout the system
 Patient-family engagement in bedside shift report, hourly
rounds and communication boards
Return to Care Rounds
 Advisors rounded with
leaders from Office of Patient
& Family Experience
 Used separate rounding
tools and compared results
after each room
 Hospital – wide results
compiled by Office of Patient
& Family Experience
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Service Line Rounds
“ That’s what made a believer out
of me….”
Diane Hatfield
East Carolina Heart Institute
Quality Chair
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CVIU and CVIC
Unit Rounds
Cardiovascular
Intensive Care Unit
Cardiac
Intermediate Unit
Cardiac Intensive
Care Unit
Cardiovascular
Intermediate Unit
CVIC
CIU
CICU
CVIU
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HOW do we do Unit Rounds?
 Meet with Unit Manager
 Review Unit Scores
 Identify Unit’s Needs
(based on scores, manager’s needs & advisor’s input)
 Round with Managers
 Discuss Advisor Rounding Alone
 Report Findings to Unit Manager
 Act on Findings
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A Success Story: CVICU
Unit Needs:
Med Communication
Nurse Communication
From CVICU Rounds:
1. “Patient does not understand purpose behind
the only new med she has received since
admission”
2. “No staff member has ever removed the
“Commonly Used Meds” sheet from the boom for
any reason.”
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Act on Findings
One piece of the puzzle:
1. TEAM strategy session
2. Small tests of change
3. Round to assess
effectiveness
4. Make Improvements
5. Continue Rounding
RESULTS:
CVICU Med Communication
score rose from sub 10% to 98% within a year.
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A Success Story: CIU
“Wife stayed with
husband for entire
admission of 40+ days
and was overwhelmed
by the care she
received as a family
member. Nurses
offered her extra meal
plates at every meal
time and checked on
her regularly.”
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Act on Findings
1. Advisor and Wife
immediately recognized
nurse on duty
2. Advisor reported
findings to Unit Manager
at end of Rounds
3. Unit Manager and
Advisor gave Wife
Employee Recognition
form
4. Form copies added to
personnel files
5. Nurses received Staff
Reward Points
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Round, Round, Round …
1 West, Rounds - September 19, 2013, Patient Advisor Feedback
FOCUS: Pain Management and Quietness (Restfulness)
Patient 1:
Positive Feedback: Patient felt well-informed and well taken care of.
Needs Work: Patient’s largest complaint concerned restfulness. She felt as though staff
members were in and out of her room all night long. Patient finally requested that staff please
limit the times they come in during the night, and they made an effort to coordinate her care.
She did add though that nurses/care partners are still coming in and making her get out of bed
to weigh at 4am
Patient 2:
Positive Feedback: Pain is being managed well. Patient and husband both love that they always
feel well prepared for what’s coming next. Staff makes it a point to tell them both what to
expect ahead of time.
Needs Work: Communication Board not updated for current shift. (as of 4pm)
Patient 3:
Positive Feedback: Says that she’s had a perfect experience. Could not think of one thing that
needed work.
Needs Work:
Patient 4:
Positive Feedback:
Needs Work: Patient was in horrible pain while in the ED the night before. She felt like no one
was listening to her and ended up taking her own IV out. She offered no positive feedback. She
did say that 1West staff is doing a better job of managing her pain but seemed completely
unsettled by the ED experience.
VMC Outcomes
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58% reduction in hospital acquired infections
(HAI) since 2008
95% optimal care on core measures (up 17
percentage points since 2007)
90th percentile inpatient experience
Tripled number of patient-family advisors in
less than two years
Hardwired hourly rounding, bedside shift
report and communication boards
Nearly 90% of staff report organization
demonstrates commitment to patient-family
centered care
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Advisor Rounding: Impact
 Strengthened Partnerships
 Advisor impact no longer dependent on
presence of Patient Experience Team leaders
 Boosted Patient Morale
 Boosted front-line staff support
 Made managers more open to Advisor input
 Increased Advisor satisfaction
 Improved scores & outcomes
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Lessons Learned
 Not every manager is open to Advisor Rounding.
Start small.
 Not every Advisor will want to Round. Advisor
selection matters.
 Rounding requires mutual respect and open
communication between Advisors and Managers.
 Build on existing work. Don’t reinvent the wheel.
Keep it simple!
What can I do today?
Leader Rounds
+ Experienced Advisors
ADVISOR ROUNDING
“I love to round with
advisors. It is the best
thing a manager can do
for her unit.”
Elaine Clark
Manager, Women’s & Children’s
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Kim Blanton
Patient-Family Advisor, Vidant Medical Center
blakimsab@embarqmail.com
252.830.1794
Melissa Thomason
Patient-Family Advisor, Vidant Medical Center
mthomason@embarqmail.com
252.886.2864
for more information contact
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