Inside Duke Medicine

Clinical teamwork energizes focus on common values

DUHS Values provide the foundation to support the change to a patient-centered, team-oriented approach to care.

The rapidly changing health care environment will likely lead to a significant increase in the number of patients receiving care within DUHS in the years ahead.  The increasing caseload will make collaborative team performance even more critical to deliver medical excellence and preserve a careful focus on the patient and their loved ones.

While more practices are moving away from a physician-centric model and utilizing a team-oriented approach to patient care, this model will eventually become the standard and the DUHS values will provide a foundation to support this change.

“We are being forced to do things differently,” said Carl E. Ravin, MD, and president of the Private Diagnostic Clinic (PDC). “We are going to have to care for more patients and do so in new ways that involve a team of providers. As we undergo this transition, it will be more important than ever for physicians to reinforce with their teams the importance of our values and the preeminence of the patient experience.”

Ravin emphasized that the consolidated health system values reflect behaviors that physicians and staff within DUHS have traditionally held but which crystallize and unify those beliefs into a common set of behaviors that we all share and for which everyone will be accountable to model.

“The technical medicine you get here is excellent and that will not change,” Ravin said. “But the patient experience should change. We are in a service organization and everybody needs to understand their role and their importance in creating a positive experience for the patient, from receiving great care, to being made to feel special at registration, or in any of the many other touch points in the process.”

A renewed emphasis on teamwork in the clinical environment, Ravin and others said, should improve the patient experience. “It will be a positive experience if we make the changes in a comprehensive way and continue to strive to put the patient at the heart of everything we do,” Ravin said.

Paul Newman, executive director of the PDC and the Duke Patient Revenue Management Organization (PRMO), predicted that physicians will welcome and eventually benefit as a result of the renewed focus on common values.

“It will be important for both physicians and employees to embrace these values and demonstrate team-based leadership skills,” Newman said. “The teamwork value will be key in the clinical environment because it contributes to related values such as safety and excellence.”

When teams manage care, all clinicians, in collaboration with physicians, will play more significant roles in daily decision making. Pamela Sutton-Wallace, senior vice president of Duke Hospital Operations, said the collaborative approach will help translate values from language to action. The result will produce a more caring culture for patients and reinforce a sense of community and purpose among Duke caregivers.

“When we bring the values to life, everyone will see the benefits,” said Sutton-Wallace.

The clinical environment will present an important opportunity for this demonstration. “We all need to get beyond the value-laden language and ask ourselves how we make these changes real so we can change behaviors,” added Sutton-Wallace. “That’s what our leaders must do. They must make it real for everyone and model the ways in which we are all accountable for these changes.”
Ravin and other leaders make clear that the commitment to excellence has been traditionally well established within the DUHS culture. But the opportunity presented by the new values should strengthen the collaborative environment.

“You can’t be part of the community if you don’t believe in these values,” Ravin said. “If all of our employees, and faculty, would embrace and live these values, we would be a much more effective, functional organization. But more importantly to me, the patients and their loved ones would have a much better experience here.”

View the complete pdf of the  Sept. 2011 Inside Duke Medicine or click through the articles online.