Why A Rounding System?
Patient care means delivering care in the best possible system.
Don’t our patients deserve the same standards of quality as our championship athletic teams and our symphony orchestras?
- The systems of care and the physician are seen as one.
- “We want to create a healthcare delivery system that our coaches can be proud of.” -Dr. James McGuigan, Chairman of Medicine, University of Florida, 1976-1997
The Gatorounds system applies the same principles used by our National Championship University of Florida Athletic Teams and our University Symphony. Just as in athletics and in music, no health care environment is perfect, and learning from our failures is the key to achieving our goals of efficient, error free, patient-centered care.
Flawed healthcare delivery systems expose our patients to increased risk, and create working conditions that make it impossible to practice without error. Poor delivery systems disrespect both providers and patients, and lead to unnecessary burnout (nurses and doctors can’t keep up with constantly making due).
- The Institute of Medicine has pointed out that Preventable Adverse Drug Events (ADEs) cause 45,000 – 98,000 deaths per year in the United States, and cost an estimated $29 billion per year. More recent studies warn that the incidence is 220,000-440,000/year. Preventable Medical Errors are now estimated to be the 3rd Leading Cause of Death in the U.S.
- Internet websites are tracking quality measures of individual hospitals, specific care teams and soon will be able to drill down to individual physicians (Example: http://www.healthgrades.com). Consumer organizations are now keeping score.
- Why are there so many errors in Medicine? Medicine has grown increasingly complex, some estimate by 20 fold in the last 15 years. The ratio of caregivers to patients is often as high as 16:1. It is impossible for a single person to orchestrate this complexity.
Systems of care must to be perfected that incorporate teamwork to coordinate care.
Conditions that increase the risk of failure:
- Independence (“I want to be me.”)
- Resistance to change (“If it ain’t broke, don’t fix it”)
- Individual Silos (“We’re the best Department. Those other Departments are weak.”)
- Lack of trust (“Only I have the answers.”)
- Adversarial communication (“I like to intimidate others to achieve unanimity.”)
- Ambiguity everywhere (“Everyone knows their job, right?”)
- Defective or nonexistent handoffs (“Oops, lost to follow up, oh well.”)
These conditions reflect self-centered care, not patient-centered care. How do we counteract these common tendencies? We need a rounding system that encourages teamwork and patient centered care.