We are commencing work this week with the Naval Hospital – Jacksonville on a number of fronts to enhance the patient experience throughout their system as well as identify ways to improve patient safety. In many ways it’s a classic example of the way we approach to culture change. We are beginning with extensive interviews of all of the leadership within the organization, both civilian and Navy. Following these interviews we will “embed” ourselves in the system—interviewing patients to discover their stories, extensively interviewing clinical and non-clinical staff to increase our understanding of the Naval Hospital’s culture vis-à-vis its impact on patients’ experience and the degree to which it supports various safety initiatives which have become fairly universal features of most hospitals’ attempts to improve their delivery of care.
The Naval Hospital is in many respects like any other community hospital, but it also has some unique challenges. At any one time 10 to 15 percent of their doctors and nurses rotate out of the hospital to medical facilities in Iraq and Afghanistan. This destabilizing factor is not new to the military, but it tests the organization’s resilience and complicates the institutionalization of initiatives such as TeamSTEPPS—a program with its roots in the aviation industry that focuses on communication and teamwork, especially in the operating room. We will be examining how the Naval Hospital can continue to improve, ensuring that these initiatives remain viable and effective.
We’ll also be looking at how new staff are on-boarded. They currently have a 4-day orientation program, and they recognize that in addition to not being totally engaging, it’s not as effective a tool for quickly integrating these new staff into the fabric of the organization.
We’ll also be taking a hard look at the physical plant with regard to how it impacts the patient experience. It often comes down to simple things, like being sure that patients and family can find their way around – more in a few weeks as we learn more.