Changing a Culture
I've just gotten back from a day trip to London. My colleague, a nurse, and I presented for a panel of judges on why our service should be awarded the National Patient Safety Award for 2014. It went well, I think. It's based on the fact that our service succeeded at reducing falls by 81% in a cohort of 142 people for six months after discharge. The literature states a well-run service should be able to achieve 33%. I'd call that a real success.
The panel wanted to know what innovation we'd implemented to get those results. It is a simple thing actually; our assessments are joint evaluations with both physios and nurses working together in the same 90-minute assessment. It has improved our efficiency and patient outcomes. It also took a lot of convincing for management to accept this before we had the clinical outcomes stated above.
At the end of the week, I'm submitting a grant for another Trust, which is focused on changing culture between general practitioners and the public. We're including public health and pharmacists in the plans as well. This is based on a health needs assessment that determined prevention of falls was rarely, if ever, discussed between GPs and their patients. Once again I'm looking to change a longstanding culture. It won't be easy, even if we do get the grant! However it is what's necessary to improve patient outcomes and meet the demands of the future.
Change in the health culture of the USA is necessary now as well. The ACA has tried to do that. It may or may not be the solution, but who has offered up better ideas? Maybe it needs to happen first on small local levels first, like I'm doing, gathering evidence to support our ideas, and taking them forward to state and national levels. How have you helped changed culture that is no longer serving the needs of your patients?