By Megan E. Doherty
A groundbreaking, nurse-led initiative is celebrating its first birthday at the University of Chicago Medicine.
The Advanced Practice Service Unit, a friendly hospital-within-the-hospital for short-stay patients, doubles as a learning lab. Experienced advanced practice nurses (APNs) work to improve and standardize care, charting progress with data-driven results.
“All other services are led by physicians,” said Emily Lowder, PhD, RN, NE-BC. “These nurses, who have advanced clinical training and degrees, embody both expertise and high-quality, high-touch, patient-centered care.”
Housed on Mitchell 3SE and 3SW, the unit is designed for inpatients expected to be discharged within 24 to 48 hours. Since APNs are on the floor around the clock, they see patients frequently and respond to their needs promptly.
The team works closely with referring and consulting physicians. Equally congenial is the APNs’ relationship with staff nurses, a warmth that translates to better patient outcomes.
“The nurses are able to come directly to the APN office to discuss any concerns; we are always available to the staff,” said Nurse Practitioner Manager Joseph Giannini, ANP-BC.
The year-old service has charted impressive growth. What began as a three-APN, two-patient service has expanded to a 10-APN team that sees up to 16 patients daily.
From a patient’s perspective, unique advantages of the unit include the APN-led multidisciplinary rounds. The rounds include the APN, the medical director, a staff nurse, nursing leadership, and a case manager. The whole team unites to update the patient – and include him – in his care plan.
“Patients become true members of the team, having direct input with all caregivers and providers present,” said Patient Care Manager Stephenie Blossomgame, RN, BSN. “It allows for real time feedback, recovery and recognition. It’s a win-win situation for everyone.”
The service has earned high patient satisfaction scores in the Mitchell Hospital, scoring 91 out of 100. Guest remarks culled from Press Ganey surveys and discharge calls praise caregivers by name as well as the impressive service and patient-centered focus.
The year-old unit has been a springboard for many hospital-wide initiatives. One is the sitter-reduction practice, which empowers unit leadership and bedside nurses to order one-to-one care for patients. APNs, not unit secretaries, also call patients within 24 to 48 hours after discharge to ensure they fill their prescriptions, understand aftercare guidelines and schedule follow-up appointments.
These check-in calls have prevented an estimated five readmissions.
Looking forward, APS team members plan to increase their focus on nursing scholarship, research and leadership opportunities – while helping their patients recover in safety and comfort.
The team hopes its hands-on, innovative care delivery model will grow, expanding to specialty services within the UChicago Medicine, then to other hospitals. “I see big things in our future,” Giannini predicted.