FORT KENT — It is not by chance, but by design, that Northern Maine Medical Center has been the beneficiary of numerous accolades for the quality of clinical, as well as non-clinical services, over the past three years. Many factors have affected the positive changes reported at NMMC with the implementation of best practices in patient care areas; these changes have also been implemented across the entire organization.
According to President and Chief Executive Officer, Peter Sirois, “One of the primary reasons for the levels of performance achieved is a direct result of our patients sharing their perspectives with us regarding their experiences.” He said that NMMC has focused on adding new and effective ways in which patients and the public may offer candid feedback.
The Lucien Leape Institute (LLI), established by the U.S. National Patient Safety Foundation, has identified five concepts that are fundamental to the endeavor of achieving meaningful improvement in healthcare safety and quality. The five concepts are: transparency, care integration, patient/consumer engagement, restoration of joy and meaning in work, and medical education reform. Historically, these types of changes, which are largely driven by an organization’s culture, do not change overnight but usually result, in part, from a healthcare organization’s obsession with incorporating improvements beginning at the patient’s bedside, and all the way up to the board room.
Since 2014, NMMC has focused strategically on the five concepts established by LLI by engaging in a dialogue with its workforce and with the public. Related to one of the concepts, the work to increase patient feedback has demonstrated higher patient engagement in response rates by seeking feedback in a number of ways, including but not limited to, home visits, patient rounds, and various forms of surveys, both formal and informal. Approached on multiple fronts, and dating back to February of 2015, when the We’re Listening campaign was launched, NMMC has embraced best practice policies to make more opportunities available for patients to offer feedback about their experience. Sue Devoe, RN, Chief Experience Officer said, “We need to make it as easy as possible for patients, family members and the public in general, to provide us with meaningful feedback. The more information we have available from the people we serve, the more we will learn about what our patients expect and the better the decisions we will make to improve our care.” Devoe and NMMC’s new Director of Quality, Jennifer J. Albert, together possess the experience, concepts and tools necessary to guide NMMC on its journey to high reliability.
According to the New England Journal of Medicine, “Transparency is increasingly considered necessary to improving the quality of health care. By being candid with both patients and clinicians, healthcare organizations can promote their leaders’ accountability for safer systems, better engage clinicians in improvement efforts, and engender greater patient trust.” In an effort to engage more members of the public in the evaluation of services to ensure greater transparency for the public, the NMMC Board of Trustees put into action the Liaison Committee of the Board whose purpose it is to be the eyes and ears of the hospital. Additionally, two members of the public were appointed to another high level committee at NMMC this year, the Performance Improvement Committee. Traditionally, in the healthcare industry, these types of committees have not been open to the public due to confidentiality reasons and the sensitive nature of the material discussed. NMMC has chosen to break from the ranks and change the makeup of the committee in order to support transparency initiatives and seek firsthand input from the public. In addition to the data obtained from patient satisfaction surveys, local community members, Becky Caron and Carl Theriault, both accepted active membership to the Performance Improvement Committee in January of this year.
Caron said, “The learning curve and the personal growth I have experienced in four meetings have been tremendous. It is impressive to see the accountability and transparency of employees when they report on quality monitoring at the meetings.” Theriault added, “We can see the hospital staff is taking it seriously and that this hospital is going places and doing great things.” Theriault further shared that as a father and caregiver, what he experienced at NMMC far surpassed encounters he has had at other hospitals.
As mentioned by Sirois, in addition to the critical need for patient feedback, employee engagement must exist at a high level in the organization in order to move the safety culture forward. NMMC has allocated other resources such as the addition of Courtney Deprey, Patient Experience Director, whose responsibilities include training and mentoring of employees in empathetic communication strategies and service recovery techniques. Part of the journey for employees is to have the skills and the tools necessary in order to contribute and to ensure that they feel valued as key members of the patient experience. For best practices to be sustainable, Deprey meets with all new employees at the time of employment to define what is expected of every NMMC employee as it relates to the patient experience, in addition to the ongoing education provided. As described by LLI, “Caregivers cannot meet the challenge of making healthcare safe unless they feel valued and find joy and meaning in their work.” Sirois echoes the LLI philosophy and emphasizes that the inclusion of the hospital employees in any and all strategic planning has been critical to continuous quality improvement and the journey to high reliability.
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