Back Page | Care Center Model Allows Integrated Patient Care

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 - Laurie Mulgrew, RT
Laurie Mulgrew, RT, vice president of clinical services, Cardiovascular Care Center & Imaging, Southcoast Hospitals Group, New Bedford, Mass.

In June 2011, Southcoast Hospitals Group, a three-hospital healthcare system in southeast Massachusetts, formed care centers and service lines. Since then, in my role as vice president of clinical services, I have had the opportunity to be part of a team effort that seeks to improve healthcare services of patients in the community we serve. The gains are tangible and many.

By definition, the management of the care centers and service lines serves to align clinical staff and resources according to disease state. It takes traditional hospital hierarchy and reshapes it according to clinical function, resources and purpose. Physicians become integral to the leadership team and a dyad is formed of the administrative leader and the physician leader. Typical care centers are categorized by systems of care which include cardiovascular, medicine, maternal fetal medicine, oncology, orthopedics, surgery and neurosciences.

Typically, a senior administrator, in the role of vice president or service line executive, leads the care center administratively. This level of leadership is key because the role of the administrator is to mesh the strategic plan of the hospital with operations of each service line. Understanding the interdependencies of the strategic plan and hospital operations is the fundamental platform for all communication among members of the care center. The physician leader's main role is to partner with administration, oversee quality, assure that evidence-based medicine is practiced and collaborate with medical staff to develop and execute the operating goals of the organization.

The integration of services within the care center affords efficiencies of resources, including clinical staffing and supplies, but it also reaches support services, medical information systems, marketing and finance. Support services are crucial to the delivery of everyday care, but they become even more significant when planning new programs and services. A dedicated group of support service members lends another layer of depth to the team.

While each service line remains clinically demarcated according to a disease or bodily system, it is supported by a consistent leadership team where the focus remains on quality of care, patient experience and cost of the delivery of care.

The benefits of creating a care center and aligning clinical services are many, including a reinvigorated team, greater accountability, better patient care and staff satisfaction. Leadership re-organization often accompanies the creation a care center or service line structure. The creation of a new leadership team in and of itself creates a palpable level of excitement and engagement.

With engagement, comes the sharing of clear goals. Once the goals are well disseminated to the team and routine meaningful communication begins, leadership accountability skyrockets. There is a new-found purpose for each leader and a revitalization of the team.

With the care center creation, the clinical services that are available to the patient now are considered in total. We no longer operate in silos, the team understands service integration and the patient ultimately benefits. We can now consider shared medical appointments, detailed medical hand-offs among providers and more robust sharing of medical data.

As a team, we become ambassadors for our organization; we understand that every interaction with a patient is an opportunity to market the care center and its service lines. The integration of services now becomes so clearly evident to the leadership, that they share it in every message to the bedside caregivers. The bedside caregivers are then able to speak to patients about the entire care continuum. Patients know what to expect after their discharge from the hospital and understand the importance and necessity of hand-off between caregivers. The patient continuum comes alive and what was once a barrier is now an opportunity to care for the patient at any access point.

Laurie Mulgrew, RT, is vice president of clinical services, Cardiovascular Care Center & Imaging at Southcoast Hospitals Group in New Bedford, Mass.