May 30, 2012

Bring in the Patients

- Ginny Combs,  RNC-MN, BSN, IBCLC  Graduate Nursing Student at Worcester State University, Maternal Newborn Nurse at UMass Memorial Hospital

Confessions: Even though I have been a maternal-newborn nurse for more than 20 years, I have little knowledge about the process of improvement and creating change. I have the passion, but not the know-how. The word “improvement” was never uttered when I went to school. Every day, I see how evidence-based practice does not reach our patients. Every conference continues to highlight the evidence, but the conversation ends there. It seems as if the research sits in books and journals waiting for us to unwrap it and “birth” it with the patients.

Notice I wrote “with.” My first instinct was to write “for the patients,” but after my IHI time, my lens has changed. Soon, I think you’ll understand why.

In my search for answers and knowledge about process improvement, my Worcester State University nursing department director introduced me to the IHI Open School and I felt as though I’d landed on a new and fabulous planet. And last week, I was fortunate to attend a deeply inspirational and transforming event as an IHI Open School student in New Orleans..

The IHI Perinatal Improvement Collaborative all-team meeting gathered for three days of powerful discussions regarding improvement in perinatal systems and how to actually work on creating change!  My mind was pleasantly overwhelmed and racing with ideas. I felt like I was on fire with a “new way” that truly changed how I see health care.

Witnessing this team of committed change agents work with perinatal groups from around the United States was one of the most empowering experiences I’ve had as a nurse and student. The IHI team, led by the inspiring Sue Gullo, walks the talk. The conference included a patient panel of mothers sharing heartfelt stories about their births and birth losses. In that large room of more than 100 people, I could feel a tilt happen. In our own ways, we all committed to putting the patient at the table with us — and always at the center of what we do.
The mothers spoke through tears as they described what mattered to them while in the hospital. One mother shared how “it’s not what you do or say, but it is how you make us feel that matters.” Another mother bravely discussed the loss of her infant and how important the staff was to her healing. “Patience is so important, don’t rush; some things can’t ever be pushed” as she told of her need to have just one more ultrasound to know she had lost her baby girl. This mother wanted to “pay it forward” and now works with other mothers on this hospital unit who are experiencing a loss.

The audience was tearing up and we embraced this sacred chance to learn from — and really tune into — the experience of patients and how our own actions can support or deter healing. Many in the audience nodded their heads and spoke of how those in health care can get desensitized and how vital it is to our work to bring the patient into the health care discussions. We all have either been a patient or will be one!  How different would our health care would be if patients contributed at all levels, offering wisdom through their own experience?

As we move from students to clinical work, I’ll pass on the challenge the IHI Perinatal Team put forward at the conference: Bring in the patients. Not just as a side note, but as a real contributor for change. It got me thinking of how we can include patients in our own IHI Open School Chapter meetings. How can patients inform students regarding innovative health care ideas and healing? How might hearing the story of a mother needing just one more discussion, more time, and more compassion color our thoughts when we  often move too quickly through our tasks as health care workers? We can “birth” new health care WITH patients, not for them. Take the challenge, bring in the patients, and be ready for the change!