Team slashes conference time with focus on issues
Staff have more time to spend with patients
The staff at MossRehab have cut their patient conference time to as little as eight minutes for some diagnoses by focusing on critical issues.
"Team conferences can take a lot of time, but if they are managed carefully, they can take less time," says John Melvin, MD, vice president of medical affairs for the Philadelphia facility.
Shortening the team conferences makes more efficient use of professional staff time, giving therapists and physicians more time to spend treating patients, Melvin adds.
"In the team conferences, we cut out a lot of the narrative reporting of the various therapies. They were giving a lot of broad information that could be gleaned from reviewing the charts and notes," he says.
In the past, some therapists tended to just read their notes. Staff decided to cut out reporting information other team members could get from reviewing the chart and the notes. "In the team conference, what is really important are the patient goals and what is needed to achieve the goals," Melvin says.
The joint replacement program staff have reduced their team conference from an average of 20 minutes to eight minutes, he says.
Staff began by analyzing what happened in the team conferences and deciding what was most important. The major issues are how patients are functioning and what else needs to be done before discharge. "If the conference is focused, the team is able to reduce the time," Melvin says.
However, he points out that joint replacement patients present fewer issues and complications than others, such as stroke patients. In the case of patients with more complicated issues, the hospital has continued to schedule a longer time for the team conferences. "We focus on the things that are needed to meet the goal. We use discussion by exception, rather than broad input," he says.
In today's health care market, patients move through the continuum so fast there is by necessity a lot of team interaction during rounds or in the hallways. "Physicians and therapists interact constantly, but not necessarily sitting down and doing it formally," Melvin says.
Instead, the treatment team takes care of many issues outside the formal conference, making it possible to cut the time. "We've incorporated some communication into the general rounds and the work of the therapists and doctors, rather than spending a lot of time in separate conferences," he says. The new plan gives staff extra time to spend with their patients, he adds.
Other disciplines are applying the same time-saving principles to their team meetings, but their results have not been as dramatic as the joint replacement time reductions, Melvin says. "The joint replacement team was able to be so aggressive because the cases are more focused and are not likely to have co-morbidities and psychosocial issues to deal with."
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