Relationship-based Care: Beyond Nursing

The Problem

In 2004, Faxton Hospital and St. Luke's-Memorial Hospital merged. The leaders of the new system were concerned about integrating the clinical cultures of two formerly independent hospitals while improving staff morale. That year, only 2 percent of respondents to the company's employee satisfaction survey made positive remarks.

The Solution

Following admission, new patients are assigned to specific nurses to guide their journey from admission to discharge. The nurse then receives a card with detailed information about the patient—including medications, medical history and their primary care provider—that is collected at admission. Each primary nurse is responsible for coordinating the patients' needs with other areas of the system, and is expected to build relationships with the patient and their family. During their stay, patients are also visited by staffers from support services, who consult about their food preferences, temperature comfort and other issues.

The relationship-based care concept is also used to manage internal relationships. Liaisons from each department are assigned to work with specific staff members in other departments to coordinate everything from linen dispersal to pharmacy orders. Unit practice councils, elected by each department, meet monthly to share best practices. Regular, organization-wide meetings of all of the unit practice councils are held to discuss systemic challenges and opportunities.