Bellevue Medical Center had a vision for delivering healthcare differently. Planetree Certification offered the plan to achieve it.
Located on the outskirts of Beirut in a green valley, Bellevue Medical Center is a state-of-the-art, tertiary care hospital that opened in 2009 with a vision of being a truly healing hospital. From the onset, planning efforts emphasized patient safety as a core value that was embedded into the hospital’s design, systems, procedures and practices. This non-negotiable insistence on quality and patient safety earned Bellevue Medical Center Joint Commission International Accreditation for patient safety and quality just three years after it opened. At the time, it was one of only three Lebanese hospitals to meet the rigorous JCI standards.
The hospital’s patient satisfaction exceeded 90%. Patient safety and infection control indicators were consistently best in class, and the hospital had earned a reputation as a hospital and employer of choice.
And yet, the Bellevue team was eager to hold itself to a new standard: to do more than keep patients safe and satisfied, but to also keep them (and their loved ones) informed, involved and engaged.
“The JCI standards that focus on systems and processes for patient safety and to ensure clinical quality are important, but they are not enough. On their own, they will not increase doctors’ satisfaction. They will not look at how well our staff is doing or look at wellness programs or how we are involving staff in task forces. The added value of Planetree has been the partnerships with patients and staff, and engaging with them to make this hospital better." Rémie Maalouf, Executive Manager and Planetree and Person Centered Care Coordinator
A Path Forward
Planetree provided a clear path forward to achieving that vision in the Person-Centered Care Certification framework. The criteria offered up concrete markers of what to expect in a person-centered hospital: shared medical records, bedside shift report, accommodations for family caregivers, patient-directed visitation, complementary therapies and more.
Importantly, though, the criteria also established expectations for planning and executing these hallmark person-centered practices not just for patients and families, but with them.
“We consider accreditations and certifications the best learning methodologies. For somebody who wants to build a person-centered care culture, the Person-Centered Care Certification helps to train staff and build the culture in a fast period of time. If we didn’t have the Certification, we would go about it at our own pace and rhythm. It would have taken us more time." - Nayef Maalouf, President & CEO, Bellevue Medical Center
Change from the Inside Out
Guided by the Certification standards, this change would occur from the inside out — starting with engaging leadership and frontline caregivers, listening to patients and staff to better understand their experiences, and finally bringing all these distinct points of view together to partner in ongoing quality improvement.
A New Normal for Patient Care
These behind-the-scenes processes soon gave way to noticeable changes in patient care. Family caregivers — who culturally had long been expected to accompany their loved one at the hospital — were formally enlisted as Care Partners and generalized visiting hours were eliminated to better accommodate families’ needs. Today, care partners’ names are posted on communication boards in patient rooms and they are included in patient education and discharge planning in far more intentional ways.
Nurses’ shift-to-shift report was relocated to the bedside, providing the opportunity for the patient and family caregiver to participate. And a system was enacted to provide patients real-time access to their medical record while in the hospital.
As the first hospital in Lebanon to enact such changes, Bellevue did not have any local examples to model their effort on. Instead, the Bellevue team consulted with Planetree for best practices from around the world that could be adapted to accommodate specific cultural nuances.
“Planetree changed our management approach. Before implementing any system or big project like complementary therapies, opening up visiting or giving patients access to the medical record, we conduct a focus group, we consult our Patient and Family advisory council (PFAC) who truly help us in understanding patient needs, and we do an assessment and ask patients and their families how they see us implementing it. The feedback of patients has pushed us to do more. And it helped with staff — especially those who were resistant at first — because this is what our patients want. Planetree may require it, but we do it because it is what our patients want.” - Rémie Maalouf, Executive Manager and Planetree and Person Centered Care Coordinator
When a Culture of Safety Meets A Culture of Person-Centered Care
Introducing these person-centered practices had far-reaching effects. Patients quickly began commenting about how their experience at Bellevue differed from other hospitals. Family members reported feeling more confident in their caregiving role.
When they were invited to actively participate in their care by signing off on an integrated care plan and sharing their own assessment of their progress during shift report, patients and families began speaking up more. They communicated their preferences and concerns. They asked questions. They corrected misinformation. The result? Patient safety and quality got even better as staff accepted greater accountability for communicating effectively, for coordinating care and promoting continuity.
A Hospital Poised to Thrive While Others are Trying to Survive
Despite a challenging economic environment, Bellevue Medical Center has thrived. Leaders attribute this, in part, to the adoption of Planetree. Though it is nearly impossible to quantify, the medical center’s leaders are positive they have avoided what could have been costly mis-steps because of their person-centered management approaches. Designing initiatives in partnership with patients and families from the onset takes the guess work out of what patients and families will want and what will be of most value to them. It has accelerated Bellevue’s ability to create change that can be sustained over time — while reducing the costs many hospitals incur when they need to double-back and re-engineer a process discovered retroactively to be flawed.
In addition, the hospital’s reputation for providing best in class patient experience has attracted patient from all over the country and the region. In recent years, Bellevue Medical Center has experienced a surge in the demand for healthcare services during the peak of the touristic season of Lebanon.
A Culture that Attracts Top Talent
The hospital’s ability to recruit and retain top talent further positions it for success. Knowing that ultimately staff are the embodiments of the organization’s values and culture, the hospital developed a customized screening tool was developed to vet candidates for their fit with the Bellevue culture. Indeed, Bellevue is uncompromising when it comes to finding the right staff who not only possess the necessary technical skills, but also meet the requirements for kindness, customer service and teamwork.
“Many hospitals may use the terminology ‘person-centered care,’ but this Certification tells the world that we are really and truly implementing it." - Rémie Maalouf, Executive Manager and Planetree and Person Centered Care Coordinator