Innovation units aim to improve patient care inside and outside the hospital

Members of the innovation units steering committee are overseeing efforts to redesign care to ensure patients receive coordinated, safe, high-quality and high-value care and treatment in the hospital and community.

Yale New Haven Hospital is launching six "innovation units" that will not only target care and treatment for their specific patient populations, but will work to improve patients' overall quality outcomes before, during and after their hospital stays.

The first group of innovation units includes the Musculoskeletal Center Unit (Verdi 4 North) and Surgical Intensive Care Unit at the Saint Raphael Campus, general medicine units (EP 9-7 and 4-7) at the York Street Campus and Medical Intensive Care Units at both campuses. Additional innovation units will be rolled out by the end of this fiscal year in September across other service lines.

On these units, advanced practice, master's-prepared providers such as APRNs or clinical nurse leaders will lead teams of physicians, nurses and staff from Pharmacy, Social Work, Care Management, Psychiatry and other disciplines at the unit level. Each team will implement practices that target care and outcomes to their unit's specific patient population. The teams will also develop protocols and/or monitor existing pathways to pinpoint and prevent medical or surgical complications that could affect patient safety and outcomes.

"The main goals of the innovation units are to improve the quality, safety and value of care," said Diane Vorio, RN, vice president, Patient Services, and associate chief nursing officer. "Specifically, they'll be working to eliminate unnecessary lengths of stay, optimize the use of resources and reduce hospital-acquired conditions and hospital readmissions."

For example, medical intensive care innovation units will explore the best ways to keep patients on ventilators mobile to maintain their strength and function. They will also implement protocols for weaning patients off ventilators and pathways to reduce incidents of sepsis.

As part of clinical redesign, the practices, procedures and protocols innovation units develop will be standardized for similar units throughout the hospital, to ensure that any unit caring for the same type of patient is using best practices proven to yield optimal patient outcomes, said Kathleen Kenyon, RN, director of Nursing, General Medicine and Geriatric Services.

In addition to focusing on patients' care in the hospital, the innovation unit teams will move toward population health management — ensuring that patients are receiving the care they need in the community to promote health and reduce hospital readmissions, ensuring a seamless handoff to the right providers.

One example of an existing innovation unit is the Sickle Cell/General Medicine unit, which has implemented a number of procedures and protocols for the care of sickle cell patients. These include standardized order sets for tests, procedures and medications, patient-controlled pain medication and more frequent outpatient appointments to catch risk issues early, treat patients and prevent readmissions. APRNs care for sickle cell patients across the continuum, inside and outside the hospital. The care team also includes Social Work and Psychiatry staff, who help patients deal with other aspects of their chronic illness. As a result of the changes, the unit has reduced patients' length of stay, readmission rates and emergency department visits, and lowered costs.

"The innovation units provide a tremendous opportunity to redesign care by promoting prevention, quality, safety and care coordination strategies that extend beyond the four walls of the hospital," Kenyon said. "The patients and their families are central to this value-based care team model."