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JANUARY / FEBRUARY 2006

FEATURES

As hospital network grows, Acibadem Healthcare Group takes multidisciplinary approach

Since 2003, Acibadem Healthcare Group has teamed with HMI to develop high-level educational programs for its internal staff, the regional medical community, and the general public. Acibadem has made significant progress in the development of Kozyatagi Hospital, a center for cancer and neuroscience, and supported an intensive nursing professional development initiative. The organization’s leadership are committed to providing opportunities for professional development for its staff. The group continues to expand its network, and in recent months has worked with HMI on a broad array of professional development and continuing education programs.

At present Acibadem operates three hospitals and outpatient clinics, as well as a central laboratory and specialized medical center. Acibadem Hospital Bursa, the first of its facilities to be located outside Istanbul, will open this year, and more hospitals are in the planning stages.

Fostering continuous quality improvement
Patient safety was the focus of a two-day program held at Acibadem in October. Patricia Folcarelli, PhD, RN and Kenneth Sands, MD, MPH, both of Beth Israel Deaconess Medical Center (BIDMC), led a workshop on root cause analysis (RCA) and failure modes effects analysis (FMEA). Metin Cakmakci, MD, FACS, FACPE, medical director at Acibadem, and Hasan Kus, MD, MA, Acibadem’s director of quality, also served as faculty.

Dr. Kenneth Sands helped introduce new methods designed to enhance patient safety.

RCA and FMEA are a pair of separate but complimentary tools used by health care teams to gain a systematic understanding of events and processes in the hospital that produce or have the potential to produce impacts on patient safety. “In the hospital setting, RCA is a retrospective review of an event that occurred and is designed to help identify what, how, and why something happened,” explained Sands, who is vice president of health care quality at BIDMC. “The ultimate goal of RCA is to prevent the recurrence of events through the implementation of workable corrective measures.”

FMEA, on the other hand, is a proactive method for evaluating steps in the process for possible failures, the relative impact of failures, and identifying the most important areas for improvement. “FMEA asks three important questions: What could go wrong? Why would the failure happen? What are the consequences of each failure?” said Folcarelli.

The workshop’s overarching objective was to help the participants—a multidisciplinary group of approximately 30 physicians, nurses, operations managers, and pharmacists—understand the hospital as a system, and see how the design of this system impacts patient safety.

Nursing: Clinical practice, leadership, and education
The development of its nursing staff remains a top priority for Acibadem. Elizabeth Brown, HMI director of clinical services, and Saliha Koc, RN, Acibadem’s director of nursing, have developed a series of programs aimed at enhancing both the clinical and leadership skills of Acibadem’s nurses.

In September, Georgie Cusack, RN, MSN, a clinical nurse specialist with the National Institutes of Health, continued her efforts to help Acibadem’s nurses further develop their skills in the care of oncology patients and the training of new staff, leading workshops on topics such as the long-term side effects of chemotherapy, care at the end of life, phone triage, and critical thinking.

Two nurses from BIDMC—Jacqueline Riley, RN, BSN, of the emergency department, and Mary Francis Cedorchuck, RN, BSN, CONR, nurse manager of the operating room—spent two weeks in the Acibadem hospital system as visiting faculty and consultants, splitting their time between Kadiköy Hospital, Bakirkoy Hospital, and Kozyatagi Hospital. Their goal was to help nurses in these hospitals evaluate and improve clinical practice in the domains of emergency room nursing and operating theatre nursing.

“The leadership at Acibadem was pleased with the clinical practice program, both with the content and the interactive format that sparked some great discussions,” said Brown.

In October, Brown was joined in Istanbul by Patricia Folcarelli, PhD, RN and Joanne Ayoub of Beth Israel Deaconess Medical Center for the second part of a leadership program for charge nurses and nurse managers. The first half, held last April, focused on the development of a competency model for charge nurses as the foundation for building further leadership work. During the second set of workshops, the HMI faculty and Acibadem nurses finalized the competency model, practiced communication skills, and began work on developing an orientation program for charge nurses.

In November, Kathleen Scoble, RN, EdD, senior associate and director of the International Nursing Studies Collaborative for the Institute for Nursing Healthcare Leadership, joined nurse educators at Acibadem for a series of discussions designed to assess the current nursing professional development, review their current and desired approach to orientation and ongoing training and recognition, and identify challenges and opportunities. “The goal of the visit was to produce recommendations for improving the structure for Acibadem’s department of nursing education, the role of the educators, the education and training of new and current staff, and how nurses are recognized and advanced,” said Brown. “This work builds upon and is connected to the nursing clinical practice development and leadership development.”

Dr. Metin Cakmakci: Medical education programs organized by HMI and Acibadem Healthcare Group “have reached effectively into the external medical community” of Istanbul.

CME programs focus on women’s health

Two recent continuing medical education (CME) programs led by faculty from Harvard Medical School focused on women’s health issues. In October, Beverly Woo, MD of Brigham and Women’s Hospital and Marcie Richardson, MD of Harvard Vanguard Medical Associates joined HMI’s Harvey Makadon, MD for a three-day program on women’s wellness. In November, Annekathryn Goodman, MD of Massachusetts General Hospital led a two-day program focused on gynecological oncology.

Metin Cakmakci, the medical director at Acibadem, said that the CME programs have been well received and appreciated by faculty and staff in the network. He added, “The programs have reached effectively into the external medical community as well and the sessions organized for the lay public have been well attended.”