In this modern age, we have become used to thinking about innovation as the domain of the iterative tinkerer, the weapon of choice for wizards who stay up late to make smaller, faster, cooler circuits and systems. But for Tami Minnier, chief quality officer for the University of Pittsburgh Medical Center, life-saving innovation was as easy as picking up the phone. “It was so simple, it’s almost embarrassing to say it out loud,” she told me. “But I knew it could save lives.”
She is talking about Condition Help, a program she helped create that allows a patient or their family to summon a “rapid-response team” of medical personnel, at any time throughout their hospital stay. In most hospitals, these alarms–the ‘codes and crashes’ that we know from television shows–can only be called in by staff. Crazy, right? “You can sit on your couch at home and call 911 and someone will help you,” Minnier says.
But head to the hospital, when you’re already in tough shape, and that authority is taken away. For anyone who has sat by a loved one’s bedside and couldn’t get even the most basic question answered, let alone a serious one, the very notion of being given the power to get medical attention is remarkable. “For people who are at their wit’s end, how can it not be the right thing to do?”
The insight came, as these things often do, after a terrible tragedy. The tragedy belonged to Sorrel King, a grieving mom turned patient safety advocate. In 2001, Josie King was an 18-month-old toddler recovering in the hospital after she was burned in a home bathtub accident. She died suddenly after a series of preventable medication and treatment errors. Her mother now tells the wrenching story on her Web site and to audiences throughout the country. Her simple point: She knew something was going seriously, albeit slowly, wrong with her daughter, and if she’d been able to get someone’s attention, Josie would be alive today. Minnier heard King speak at a medical conference in 2004, talking about rapid-response teams organized around patient needs. It got her attention. “I knew it was the right thing for us to do.”
Patient-centered care is the new ‘new thing’ for in health. For all its positive vibe, it’s tougher than it sounds. “Health care has historically been an individual profession, not a team sport,” says Minnier. “We have empowered the physician to be the smart person, the one who has all the knowledge. Frankly, the more you feel you have to deliver everything, the more self-centered you become.”
She cites the explosion of technology as another barrier. “We rely on technology and machines more and more,” she says. “The simple act of listening and diagnosing a patient, of using intuition to piece together their condition, we do that less and less.” Putting the patient at the center of their own care means taking their feedback seriously–even when they are frightened, confused, or simply overwhelmed. But it’s also giving them effective tools to be more in charge of their own health. Letting them hit a panic button and dispatch teams of doctors? Visions of litigious hypochondriacs danced in the heads of UPMC leadership. “There were some concerns that the system would be abused,” she admits.
The program allows patients to use the same emergency line that nurses and doctors do. (Just pick up the phone and hit 111.) Immediately, a team is paged and dispatched to the scene in minutes, for anything from a full cardiac arrest to any spiraling health condition. No screaming in vain for a duty nurse, no paging invisible doctors, no fretting while a patient struggles. “It’s a fresh set of eyes and ears and completely unbiased,” says Minnier. Patients are taught how to use the system when they’re admitted and are reminded by stickers on the phone and posters everywhere. “We have pictures of Josie King on some of the materials to help us tell the story,” says Minnier. “None of this is rocket science.”
But the results have been remarkable. “We now know that 69% of the patients who have used that line would have been harmed if they hadn’t called,” she said. And they’ve made significant strides in pain management, the most common patient complaint in hospitals, and the most measured component of patient satisfaction in the data collected by Medicare.
Condition Help was introduced in 2005; it is now being used in all 20 hospitals in the UPMC system and inspiring similar programs around the country. And as hospitals are increasingly being asked to measure things like patient satisfaction and pain management, programs like this are becoming important ways that health systems can differentiate and market themselves.
For Minnier, that only goes so far. “I spend a lot of time asking how we can change the work process to make things safer and less painful for the patient,” she says. “Even if I couldn’t measure it, it’s the right thing to do.”
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