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Back to the basics: Relationship and results oriented healthcare program transforms cultures

Nurse Leader Weekly, October 28, 2005

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Both nurses and nurse leaders want to feel they are making a difference in patients' lives. When an organization adopts a relationship and results oriented healthcare (RROHC) philosophy, the relationship with patients and the results the patients want to achieve become the catalyst for interdisciplinary team communication and individual action.

RROHC is a method of delivering care that requires care-team members to communicate with patients and patients' families about their plans for the direction of the patient's care.  It also incorporates patient goals and expectations in the planning and administration of care by the interdisciplinary team.

The method combines patient- and family-centered, outcomes-focused communication with high impact team practices to create optimal health in any type of care delivery setting. When healthcare team members understand what patients and families want, they operate from a common purpose to create a shared picture of success and an effective interdisciplinary care plan which clearly outlines the critical role of each member of the team.

"Stating that one must return to the basics of professionalism and teamwork may seem unsophisticated or too rudimentary to be useful," says Ruth Hansten, RN, MBA, PhD, FACHE, of Hansten Healthcare, a Port Ludlow, WA, consultant who has assisted in developing the RROHC philosophy. "However, healthcare workers must deconstruct the overwhelming complexity they face each day with a solid framework built on a shared purpose with the patient and clear plans for their team."

After adopting the principles of RROHC, Marion General Hospital in Marion, OH, created an RN peer coach role to allow staff experts to guide clinical practice back to the fundamentals of RN leadership and teamwork, and their efforts spread throughout the medical center. In 2002, the hospital had received scores of 69.57% in a physician satisfaction survey, but by 2005, the scores had risen to 76.50%. The hospital also noted a decreased use of restraints, better pain management, and healthier employee satisfaction.

Marion has also improved its ED throughput. In 2004, only 8.7% of ED patients were admitted within 60 minutes of the order to admit. Following a hospital-wide interdisciplinary effort, now 70% of patients are admitted within 60 minutes.

At MultiCare Health System in Tacoma, WA, RN retention has increased by 55%, and physician satisfaction with quality of nursing care advanced from 61% to 78% following introduction of the professional practice initiative.

Editor's note: For more information about Ruth Hansten's consulting and coaching services, visit www.hansten.com.

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