ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Sunday, April 28, 1996 TAG: 9604300039
SECTION: NURSES PAGE: 3 EDITION: METRO
SOURCE: SARAH COX
In a new approach to hospital management, Carilion Health Systems has formed service lines that cut across its hospital boundaries. Service lines link departments, such as cardiology, in most of Carilion's health care facilities.
These service lines are designed to streamline service, improve quality and reduce repetition. According to Helen Butler, vice president of the medical-surgical service line, this concept has been around for a long time, but it's new to health care management in this part of the country.
Butler said service lines integrate all areas - financial, marketing and nursing - within each medical specialty to better meet the needs of the customers. Currently there are 10 service lines.
She said that forming the service lines has forced them to evaluate their services. Andy Cochrane, vice president of oncology and orthopedic services, added that doing this is helping them make sure that patients are getting the best quality service.
The program has had its growing pains. Beth Cullum, vice president of nursing for Carilion Health System, said they are crossing over eight facilities. These facilities all have diverse cultures and, of course, loyalties, as well as particular ways of performing duties.
Each service line will now have its own medical director, and part of the function of this streamlining is to evaluate cost as well as quality. But Cochrane said the whole point to this team approach is to bring the best ideas to the table - and those ideas will be coming from all sectors. Cullum said there already are great examples of people working together, ``because people want to improve the care process."
Fourth-level managers are responsible for the day-to-day service line practices across the facilities. One of the results, said Butler, is that approved ideas and practices will be brought to the bedside quickly. Changes, once made, will be made right away because these managers have direct access to patient-care services.
This can be done by removing the barriers which once existed between hospitals, and making more people instrumental in the decision-making process.
Cullum said nursing staff is involved on all of the different design teams for the in-patient care re-engineering initiative, ``to make sure decisions have been given the litmus test. We're teaching the nurses to be decision-makers. They've always had responsibility and authority. They can coordinate care, and manage patients across the continuum."
As part of this re-engineering process, there are nurse care managers that will plan for patients' entire length of stay.
``This requires a lot higher level of thinking and coordinating," Cullum said. She added that along with this increased responsibility comes accountability, and Cochrane added that there will also be increased emphasis on staff education.
The bottom line, indicated Cullum, is that those at the bedside can make the best decisions. And those at the bedside are most often the nurses. So these service lines will not only affect their roles in the Carilion hospitals, but they will be instrumental in making the very changes that change their roles.
She said those nurses who have already become involved, those who ``have really begun to feel it and touch it and practice it," understand it better. It's not a matter of presentation, said Cochrane, but of getting them to the table and getting them involved.
It's a new world and a new way, he said. But they're pushing forward because in the end, the result of improving patient care is what matters and what will be affected.
LENGTH: Medium: 69 linesby CNB