Mitigating Risk with Advanced Practice Strategies
Phoebe Putney Health System (Phoebe Putney), headquartered in Albany, GA, is a network of hospitals, family medicine clinics, rehab facilities, auxiliary services, and medical education training facilities. Founded in 1911, Phoebe Putney Memorial Hospital (Phoebe) is one of Georgia’s largest and most comprehensive regional medical centers. The 443-bed teaching hospital holds one of only six designated perinatal centers across the state of Georgia and is the region’s only provider of neonatal intensive care. Outside of obstetrics, Phoebe offers medical and surgical care, emergency treatment, pediatrics, wound care, and much more. Nationally recognized for clinical excellence, the hospital is constantly reinvesting in the health of Southwest Georgia through innovative programs in prevention, education, and research that go beyond the bounds of traditional medicine. In fact, Phoebe is a five time recipient of the prestigious VHA Leadership Award.
A Close Look at Risk
Frank Middleton, MD, Senior Vice President of Physician Practices at Phoebe Putney Health System and Risk Management Consultant took a long hard look at risk across the system in early 2012. Understanding that a large portion of risk at any hospital comes from Labor & Delivery, he delved deeper to understand how Phoebe Putney could intervene. What he found was that the nursing staff, who he calls the eyes and ears of the department, would benefit from a formal educational program to support their daily needs, which required an offering that would be timely, flexible to their schedules, and clinically excellent. Upon deeper examination, he found two particular needs around Electronic Fetal Monitoring (EFM): consistent use of industry-approved language as well as a common communication platform between physicians and nurses to discuss EFM. With communication at the root of many instances of risk, an intervention for both doctors and nurses was needed.
Selecting an Intervention
Phoebe Putney decided on perinatal content from APS, citing the web-based delivery, quality of information, and referrals from other APS clients as reasons for the selection. In addition, they were intrigued by the opportunity to deploy a Personal Proficiency Module (PPM) to identify where doctors and nurses needed support the most. The APS PPM uses a unique clinical approach, in that it measures both knowledge and judgment, ensuring a real-world clinical experience. In every day medicine, answers are not always black and white – so a truly useful assessment must consider this aspect of care. “The proficiency assessment is really uniquely designed,” explained Dr. Middleton. “The fact that judgment questions have no exact answer is true to every day clinical life and this helps us measure areas of risk above and beyond the medical facts. The assessment has illuminated opportunities for us to focus our improvement efforts and that is really valuable.” An example of this he said was seen in the actions of a Nurse Educator – who viewed her nursing group’s strengths and weaknesses and knew exactly where to direct her additional educational efforts. Middleton continued to call out other important features of the APS content, including layout and presentation, comprehensive graphics, inclusion of expert opinions, and the current nature of the content aimed at keeping clinicians up to date.
Getting to the Next Level
Phoebe Putney is now in process of evaluating APS’ newest innovation GNOSIS™, which pairs assessments with segmented content, in 2-5 minute segments for today’s busy clinician who is almost always on-the-go. GNOSIS takes the PPM a step further to customization: Based on the individual clinician’s assessment, GNOSIS prioritizes user content and delivers a Learning Path focused on the clinician’s needs. This prioritization, along with the brevity of content segments, maximizes clinician time and focuses learning even more.