Geographic Wards
In January 2019 we re-designed our ward structures at University Hospital around a geographic ward model that co-locates providers on a single unit to achieve the following goals:
| Instead of… | …Imagine if |
|---|---|
Little or no connection between team members | Personal connections between team members |
Lack of interprofessional teamwork | Daily interprofessional team huddles/meetings |
Waste in travel time between units | Economy of movement on one unit |
Constant multitasking | Focus |
Lack of defined leadership presence | Effective and well-known unit-based leadership |
Lack of improvement infrastructure | Improvement work included in daily flow |
Lack of team specific data | Unit-based data to drive team performance |
Idiosyncratic rounding strategies | Structured interdisciplinary bedside rounding |
Uncoordinated scheduling | Coordinating scheduling |
Emphasis on process | Emphasis on outcomes |
We saw early successes with geographic wards. Teams had new opportunities to get to know nurses better and have in person discussions with consultants on rounds. We developed standardized interdisciplinary communication and workflow including daily interprofessional team huddles.
And as expected, we also experienced significant challenges in work, including an increased amount of patient handoffs.
However, we are not afraid to tackle difficult problems. Changes like this are considered complex service interventions requiring continuous improvement science to get it right.
If you are interested in more detail in how we improve, watch the videos below, parts of a grand rounds given by our Geographic Wards leader and associate program director Danielle Weber:
You will be encouraged to join our improvement groups to learn and contribute teams and system science.
The opportunities are endless but here are some goals for the future:
- Improve interdisciplinary communication related to patients not on our geographic wards (“rover patients”)
- Develop a system for residents to receive data related to ongoing quality improvement projects
- Participate in the Acute Care Pathway for residents that includes education related to specific inpatient systems-based care topics
Contact Us
Department of Internal Medicine
231 Albert Sabin Way
Medical Sciences Building Room 6058
PO Box 670557
Cincinnati, OH 45267-0557
Fax: 513-558-3878
Email: ucintmed@ucmail.uc.edu