In Georgia, Veterans, employees benefit from use of relationship-based care, part 2 - Charlie Norwood VA Medical Center
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Charlie Norwood VA Medical Center


In Georgia, Veterans, employees benefit from use of relationship-based care, part 2

July 26, 2017

 The realtionship-based care wheel used by Charlie Norwood VA Medical Center. (Graphic used with permission)

AUGUSTA, Georgia (July 26, 2017) -- At Augusta’s Charlie Norwood VA Medical Center, two care delivery processes are evolving the ways employees deliver health care to Veterans: Relationship-Based Care, or RBC, and Patient-Centered Care, known as PCC. Together, they are expanding throughout the CSRA’s VA system, including its two main hospitals, and three outpatient clinics.

Anna Corulli, who leads the charge for RBC at the Augusta VA, said that RBC has two vital relationship-based components for employees to master before they can fully realize their potential as caregivers: their relationship with themselves, and their relationships with their colleagues.

One of the fundamental tenets of Patient-Centered Care ensures patients are at the heart of their treatment; that by changing some behaviors, they can improve their health care experience. Relationship-Based Care’s “self-care” aspect seeks to do the same thing, but with employees.

“[Relationship-Based Care] looks at the Patient-Centered Care wheel and asks, and asks ‘how can you apply that to yourself?’ Patient-Centered Care doesn’t talk about that for health care professionals. So, we talk a lot about self-care. I probably didn’t give it [self-care] as much credit as I should have at first, until I saw how it changed people; how they showed up for work, mentally, emotionally.”

The second tenet of Relationship-Based Care in centered on staff members’ relationships with one other. It concentrates on building camaraderie between groups, eschewing any baggage that may come with being part of a certain group. Engineers, doctors, nurses, maintenance staff, administrative staff, and anyone in-between all have the opportunity to participate in meaningful ways.

“Relationship-Based Care started as a nursing model but can be applied to any practice,” Corulli said.

RBC is currently undergoing its fourth of 11 planned expansions into new departments at Charlie Norwood. Goals include adding RBC to six new departments on a six-month schedule until every service line in the hospital joins. Corulli said once established, RBC it will require far less time and energy to sustain.

Leadership and staff charged with keeping the RBC torch burning have other methods to sustain the flame. Among them is the Relationship-Based Care Steering Committee, which provides oversight to the smaller unit-based councils. The committee directs the RBC agenda, and presides over disputes the individual unit-based councils might have.

“It offers the structure to bring Patient-Centered Care in as more than a suggestion,” Corulli said.

Another tool to keep staff engaged with RBC are monthly seminars on “Reigniting the Spirit of Caring.” These events are open to all staff, and concentrated on encouraging employees to have vital, healthy relationships with their patients, coworkers, and themselves.

For some, these seminars may serve merely as a reminder of what Relationship-Based Care already does in their departments, but for staff in practices where RBC has not yet been rolled out, it serves as an introduction to the principles—both practice and theory—they will eventually be immersed.

Kelsey Shull, seminar facilitator and PCC trainer, said this all adds up to success. “They come, and they learn, and they really understand the philosophy—the concepts, and then they take it back.”

'They come, and they learn, and they really understand the philosophy—the concepts, and then they take it back.'

“It helps all of those ideas gel. People can stand there, having never heard of Relationship-Based Care and go, ‘Wow that was powerful,’” Corulli added.

RBC stresses the importance of data when measuring results. One study used pedometers to demonstrate to nursing staff that when they walked through their wards at consistent intervals, they actually received fewer calls for assistance from Veterans. Consequently, nursing staff members exerted themselves less, and patients were more satisfied.

RBC can also help patients pick their hospital. The American Nurses Credentialing Center awards certain hospitals with Magnet Recognition if they meet certain criteria for care, collaborative thresholds between coworkers, and employ critical analysis when developing policy. This certification is difficult to achieve, and demonstrates publicly that the preeminent national association for nursing has endorsed that facility.

According to Corulli, when assessing a hospital for recognition as a Magnet facility, one of the major contributing factors is successful use of Relationship-Based Care.

“This is the most common model used to achieve Magnet status, is Relationship-Based Care. It’s hard to get. It’s through the American Nurse Association. They come in and survey you, and there are all sorts of standards you have to meet … People may choose to have their family member admitted there, or have their surgery there because it’s a Magnet-accredited facility,” Corulli said.

Patient-Centered Care and Relationship-Based Care serve complimentary roles at Charlie Norwood VA Medical Center. The program for implementing RBC provides new mechanisms for the completion of PCC; and together they serve vital roles towards improving Veteran care and building a better environment to both heal and to work.

Corulli said, “Through more effective evidence based policy, improved interpersonal skills, and developing democratic bodies, Relationship-Based Care adds to the tools healthcare providers have to ensure quality care.”

(Story by Mark Karmin, a volunteer staff writer for the Charlie Norwood VA Medical Center public affairs office.)