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Dyad model increasing staff-physician collaboration

27 Oct 2019

Collaboration, care improves on two nursing units

By: Dinah Loa, MD, Sarat K. Velivela, MD Brooke M. Kamm and Miranda A. Schotthoefer, IMCU nurse leaders Raven Layton and Hilary A. Zehr, Medical Telemetry Unit nurse leaders

We started a dyad model for physician engagement last year in the intermediate care and medical telemetry units — so now it’s time to share our progress. The dyad model — designed to open communication and build trust between physicians — has increased engagement among staff and providers in several ways.

The model is led in IMCU by Dr. Velivela, and in medical telemetry unit by Dr. Loa. We began with a staff-physician survey, which showed an ongoing gap in current engagement between these constituents. This model was chosen to help close that gap.

We have seen progress this past year with improving collaboration. In the IMCU, staff appreciated Dr. Velivela’s support with unit council work, such as in our high flow test of change (a project that evaluates whether patients can safely eat with a certain amount of oxygen via high flow). Dr. Velivela has attended many meetings; his support has made other staff projects possible. His engagement also increased camaraderie of other IMCU staff and other providers in SHMG.

The medical telemetry unit has also seen positive outcomes. Multidisciplinary rounding is mainly provider-led, with improved guidance on patient status and management plans. The value of this collaborative work is evidenced by the pre- and post-surveys by providers and staff. Projects in the med tele unit include the TOC hypoglycemia monitoring, which resulted in a 71% decrease in hypoglycemia in seven other units.

Another project involved the process method to reduce omitted medications ordered in the emergency department upon transfer to the floor though a standardized provider order. Other efforts include the antibiotic stewardship and mobility pause projects.

Both units continue working on ways to improve patient care. The dyad model is a good starting point to increase provider-staff engagement, social connection, and meaningful work. If expanded, we also hope to influence areas such as early patient discharges, patient safety and perhaps help mitigate burnout. Studies show that physician-staff engagement and collaboration reduce physician burnout.

All of these endeavors will greatly aid our success – and improve patient care. For more reading, see the following:

Journal of Healthcare Management, March 2016 - Volume 61 - Issue 2 - p 105–127 Articles Physician-Organization Collaboration Reduces Physician Burnout and Promotes Engagement: The Mayo Clinic Experience. Swensen, Stephen MD; Kabcenell, Andrea RN; Shanafelt, Tait MD