Profiles of Change
MCGHealth (MCG Medical Center and MCG Children's Medical Center), Augusta, Georgia
MCG Children's Medical Center
The MCG Medical Center and the MCG Children's Medical Center are academic health centers in Augusta, Georgia, affiliated with five schools at the Medical College of Georgia-medical, nursing, dental, allied health, and graduate studies. During the past 13 years, MCG has systematically integrated patients' and families' perspectives and involvement into all areas of operations.
The Foundation for Transformation
The transformation of MCG's organizational culture began in 1993, during discussions about the development of a new children's hospital facility. At that same time, a group of pediatric nurses suggested to the administrator that family-centered care be considered as a new approach for the delivery of inpatient pediatric services.
An assessment revealed that the care delivered, while excellent in many ways, reflected the needs of providers and did not adequately respond to patients' and families' needs and concerns. At this point, the hospital made a commitment to family-centered care for the pediatric units.
MCG began by establishing a Family-Centered Care Steering Committee. Training sessions were held to help staff and families learn how to work collaboratively.
The following initiatives were essential to family-centered pediatric care at MCG:
- Defining core values. In 1993, hospital leaders convened a visioning retreat, where participants developed a philosophy and values statement for the new MCG Children's Medical Center and built a consensus for family-centered concepts and priorities. Attendees included hospital- and community-based physicians, other clinical staff, administrators, and families.
- Expanding family involvement. Following the retreat, families were appointed to all the design planning committees. A Family-Centered Services Committee, which included staff, faculty, and families, was charged with exploring ways to integrate family-centered concepts and strategies into all aspects of the MCG Children's Medical Center. That committee evolved into the Family Advisory Council which continues to provide guidance for policy and program development.
- Children's Advisory Council. In 1996, the Children's Advisory Council, known as Kids' ART (Architectural and Recreational Team), was created. The members, past and current pediatric patients, have provided invaluable suggestions and ideas to the MCG Children's Medical Center (CMC), having an effect upon design, policy, and ways of thinking among staff. They assisted in the selection of the CMC logo, created new hospital menus, raised money to purchase new toys for outpatient clinics, and wrote articles for several different hospital publications reflecting upon their health care experiences.
Children's Advisory Council
Extending to Adult Services
In 1997, MCG created a strategic plan to implement patient- and family-centered care throughout the institution. An Adult Family Forum was created that later evolved into the MCGHealth Partners Advisory Council. The 35-member council consists of patients, families, staff, and senior hospital leaders. It meets monthly.
In 1998, the hospital created the position of Director of Family Services Development and hired Julie Moretz, a mother of a child with special health care needs. Julie served for nine years as part of MCG's senior management team; she was responsible for ensuring that patient and family perspectives were represented in all aspects of the health care experience for children and adults. Bernard Roberson, the current Director, continues to develop and maintain patient and family advisory councils. He involves patients and families in hospital operations to support a patient- and family-centered healing environment.
In 2000, MCGHealth made the major transition from a state-operated institution to a private nonprofit organization, and its commitment to patient- and family-centered care continues.
Patient Care Services
Patient- and family-centered care initiatives in adult services include the following:
- The Augusta Multiple Sclerosis Center. MCGHealth worked with the Walton Rehabilitation Hospital to create the Augusta Regional Multiple Sclerosis Center. The Multiple Sclerosis Patient and Family Advisory Council was created to ensure patient and family input in the development of this center.
- The MCG Neurosciences Center of Excellence. Three members of the MCGHealth Partners Council who have neurological conditions had key roles in the development of this center, which was created to serve as a model for patient- and family-centered care within the hospital. Along with other patients and families, they contributed to the design process, assisted in the development of the philosophy for the unit, and participated in interviewing center staff and physicians prior to the unit's opening.
- Breast Health Suite. A woman with breast cancer served on the planning committee to design and build a new mammography suite. Her participation dramatically changed the way health care professionals viewed this center, shaping it into a place for women's health and wellness, rather than just a diagnostic and treatment center.
- Patient and Family Advisors. There are currently 130 patient and family advisors. During the past year they have served on 45 hospital committees or task forces. In 2006, several new patient and family advisory councils were developed, one for Behavioral Health and one for the Family Medicine Clinic.
The Patient and Family Advisory
Council for the Augusta Multiple
The new MCG Neurosciences
Center opened in December 2003.
A new campaign designed by the
Patient Safety Committee
Three members of the MCGHealth Partners Advisory Council are members of the hospital's Patient Safety Committee. They participated in the design of a campaign (known as "Speak Up!") to encourage patients and families to become active and informed members of the health care team. Patient members of this committee worked with staff to develop MCGHealth patient safety goals in order to meet new JCAHO standards. The family leader who serves as the Director of Family Services Development has chaired a subcommittee of the Georgia Hospital Association's Partnership for Health and Accountability.
Family Involvement in Professional Education
'Adopt-A-Unit': A team of hospital administrative leaders, unit managers, staff, patients, and families 'adopt-a-unit' within the hospital, and work together on improvement. It is a process of mutual learning. Senior administrators learn about the real issues for patients, families, and front-line staff; managers learn new skills from the administrative leaders; and patients and families help all see the issues as viewed through the eyes of a patient and family member.
With the encouragement of the leadership of the medical centers and the deans of the five schools on the MCG campus, a Patient and Family Faculty Program was developed in 2003. A Directory of Families profiles 25 families who have agreed to share their stories with students and trainees to help further their understanding of patient- and family-centered care and to help staff learn how to collaborate with patients and families. Family faculty members have participated in a variety of educational sessions, including the opening day lecture for the first-year medical students. Members of the academic faculty participate on hospital committees to enhance the practice of patient- and family-centered care. In the last two years, the patient and family faculty members have given over 120 presentations to students and hospital staff and faculty.
Monitoring Patient Satisfaction
MCGHealth leaders have linked the efforts to advance patient- and family-centered practice with the hospital's ongoing efforts to improve customer service. The Director of Family Services has served as a member of the MCG Customer Satisfaction Steering Team (CSST), and patient and family leaders have participated on various customer service committees and subcommittees. In 2003, behavioral standards for patient- and family-centered care were developed that parallel and build on the previously developed customer service behavioral standards.
Through the patient and family councils, the efforts of the Director of Family Services Development, and programs such as "Speak Up!" leaders regularly receive patient and family input on the experience of care. MCG solicits patient feedback through more formal means as well. Since measuring of patient satisfaction through a national research corporation began, MCG Children's Medical Center has consistently ranked in the 90th percentile or higher compared to more than 50 children's hospitals on a national measurement of patient satisfaction.
Patient satisfaction scores are also increasing for the new Neuroscience Center. This nursing unit recently enjoyed some of its highest scores since tracking began over three years ago. Results are being closely monitored to determine the full impact of the new unit that opened December 2003. Three years of quality improvement data for MCG Adult Center for Excellence in Neuroscience reveal the following:
- Patient satisfaction increased from 10th to 95th percentile.
- Neurosurgery length of stay decreased by 50%.
- Reduction in medical error by 62%.
- Number of patients discharged increased by 15.5%.
- Staff vacancy rate decreased from 7.5% to 0%; have waiting list of 5 RNs.
- Increased skills and commitment of staff and faculty for continuous improvement.
- Positive change in perceptions of the unit by doctors, staff, and house staff.
- Staff owns and protects the new culture.
Patient- and family-centered care, now the business model for the organization, has had a positive impact on each one of MCG's business metrics: finances, quality, safety, satisfaction, and market share.
MCG Center for Patient- and Family-Centered Care
Families assisted in the
development of the Family Resource
Center for the Children's Medical
In July 2004, the President of the Medical College of Georgia and the President of the Health System established the MCG Center for Patient- and Family-Centered Care. The Center's purpose is to advance cultural change in health care delivery toward models which serve as strong examples of patient, family, and provider partnerships. The Center will influence the curriculum of the health sciences university, conduct research, and build upon more than a decade of work integrating patient- and family-centered care into the health system.
Crucial Factors to Program Success
MCG's success in advancing the practice of patient- and family-centered care throughout its organization illustrates the importance of several key components. Of them, none is more important than the commitment and participation of senior leadership.
During her tenure as Senior Vice President for Patient- and Family-Centered Care at MCG, Pat Sodomka, FACHE, said, "Leaders are the guardians of the ideals related to the patient experience of care." Listening to patients and families is key to enhancing that experience. Modeling this behavior for staff and encouraging patient and family involvement in policy and program development will result in improved satisfaction, better outcomes, a safer system, and, ultimately improved financial performance.
For more information about patient- and family-centered care at MCGHealth, please contact Bernard Roberson at 706-721-3924.