At Nebraska Health System, physicians and nurses teach transplant patients how to manage their own care and treatment. Using a "cooperative-care" concept, organ and bone-marrow transplant patients and their chosen care partner-a friend or a relative-spend part of their recovery time at Lied Transplant Center learning basic nursing skills such as monitoring vital signs, administering medicine and changing dressings.
"They feel accountable and responsible and involved in the healthcare team," says Theresa Franco, director of oncology services and cooperative care at the 543-bed, Omaha-based system.
"We put patients and family members at the center of the healthcare team rather than on the periphery looking in when we make decisions," she says.
For its creation of Lied Transplant Center and use of cooperative care, Nebraska Health received this year's Sodexho Marriott service award for vision.
In partnership with Sodexho Marriott, the system also made the hospital environment more homelike. Patients and partners stay in suites with two beds, a kitchenette and a sitting area that includes a love seat, a couch, a television and a VCR. They wear their own clothes, have keys to their rooms and can move freely around the property, which includes a restaurant, a patient resource center with Internet access and play areas. Sodexho manages all the hospitality services for the center.
"We provide a level of amenities or comfort that you don't get in a traditional hospital environment," Franco says. "Part of that is necessary if you're going to break this mind-set about giving them accountability for their own care."
The Lied center opened in February at a cost of $65 million, funded mostly from private donations. It contains 88 rooms, half used for cooperative care and half sold as hotel rooms to other visiting family members and friends. The center also has space for research, office administration and education.
The facility employs a concierge, who can arrange for dry cleaning, schedule transportation to and from the airport and make dinner reservations.
"There are a lot of similarities that have always existed between a hospital and a hotel, but the difference was that in one setting there are patients, and at the other, people are healthy," says Richard McLaughlin, hospitality services manager at Lied Transplant Center. "There's no reason why the two couldn't have the same outlook on comfort and satisfaction. That's starting to happen. Our goal is to make patients feel good, comfortable and cared for."
Cooperative care has been used successfully in hospital cancer programs, and Nebraska Health managers decided it was suitable for transplant patients. That's because patients who have organ failure have been sick awhile, and families have already learned to deal with chronic illness, says Byers Shaw Jr., M.D, professor and chairman of the surgery department at University of Nebraska Medical Center, part of Nebraska Health. In addition, hospital stays for transplant recoveries are often weeks, not days. Surgeries are still performed at the hospital, and patients stay in the traditional setting for a few days before being moved to the Lied center.
The cooperative-care model provides clinical benefits in addition to creature comforts. The hospital is still gathering data and analyzing the cost savings and clinical outcomes of cooperative care, but doctors and nurses say they believe recovery rates are faster, stays are shorter, medication errors are less common and readmission rates are lower.
"It gives patients a sense of control over their recovery, creates a positive feeling of getting better," Shaw says. "If you involve them early enough, you don't have to keep them in the cooperative-care room as long. They are more confident, willing and able to return to their homes earlier. And when they become an outpatient, they normally have already prepared for some of the possible complications, such as coincidental illnesses like the flu or strange blood pressure readings."