The Accountable Care Unit six-month pilot project started accepting patients in late February. The Regina Qu’Appelle Health Region (RQHR) is supporting the implementation of this project through existing resources and $305,000 of funding from the Ministry of Health’s Emergency Waits and Patient Flow initiative.

The unit’s model of care is aimed at ensuring patients receive the safest, highest quality care possible, through a unique interdisciplinary team-based model. This model improves communication and accountability among patients, families, and clinicians to reach patient care goals.

“It’s encouraging to see shorter stays and reduced wait times for patients during the initial phase of the Accountable Care Unit,” Rural and Remote Health Minister Greg Ottenbreit said. “We look forward to the results of this pilot project.”

The Accountable Care Unit ensures clinicians are better connected to their patients and one another, with the responsibility to ensure that patients receive the safest, highest quality care possible. The care provided is different from that in other units in a number of ways, including:

• patients and their families are included as part of daily interdisciplinary bedside rounds, so that they are fully informed and involved in their care;
• physicians are hospitalists, who, for the pilot, focus only on the patients within the unit; and
• through the use of improved and standardized communication tools and specific educational training, unit staff ensure they are more fully informed about their patients’ care needs and goals. This involves the patient’s input to plan their health care journey, including expected outcomes and recovery plans.
  

“We are being told through survey responses of patients, staff and physicians that this model of care is delivering greater benefits to patients and staff, through improved communication and accountability for patient care,” said John Ash, RQHR’s Executive Director of Patient Flow.

“The next step is to continue our research pilot and determine the longer-term benefits of this approach, and potential to expand its use in the region,” he said.

To ensure data-based decision-making, the region is conducting qualitative and quantitative research to analyze the success of the unit’s approach in many areas, including:

• patient, staff and physician experience surveys;
• patient length of stay;
• reduction in care complications;
• care costs, including drug, laboratory, staff sick time and overtime costs; and
• number of patient/family complaints.

The unit leaders, Sherilyn Bray, RN and Dr. Ron Taylor say: “The research results, coupled with our implementation experience, will help us to determine how and where we can apply these principles to provide maximum benefits to our patients, staff, and physicians, while creating a more sustainable system in future. The implementation challenge is tremendous, as this degree of change faces significant resistance. Yet, we engage in this work because we believe in the Accountable Care Unit model, the paradigm change surrounding patient care, and the opportunities it has the potential to create.”

“This project is a key strategy for the region this year,” said Dr. David McCutcheon, Vice President Physician and Integrated Health Services. “It aligns completely with our three goals of improving the quality and safety of our care, enhancing patient flow through our system by avoiding delays in care and decision making, and contributing to a sustainable future.”

The pilot’s funding continues into August; once the pilot is completed, it is anticipated that accountable care principles will continue to be delivered on Unit 4A while research results are analyzed.

“Based on results to date, we expect that the new care principles and practices will extend to other hospital units throughout our region – and in fact, another unit not involved in the project has already adopted these principles, and other units have incorporated some of them with their own patients,” McCutcheon said.