Philip Anderson, MD (far left) of BIDMC and Korhan Taviloglu, MD, Acibadem Healthcare Group (far right) work with physicians and nurses from emergency departments in the Acibadem network.

Acibadem focuses on enhancing emergency medicine throughout its growing network

Thursday, November 20, 2008

For the past five years, Acibadem Healthcare Group has been working with Partners Harvard Medical International to provide high-quality education and training programs for its physicians, nursing leadership, management teams, and support services. The most recent collaboration with PHMI was a three-day professional development program on emergency medicine for the physician and nursing staff of the emergency departments and urgent care clinics throughout the Acibadem network.

PHMI engaged a faculty team from the Department of Emergency Medicine at Beth Israel Deaconess Medical Center (BIDMC) to work with Prof. Dr. Korhan Taviloglu, Acibadem’s Emergency Services Coordinator, to develop the program. The BIDMC team was comprised of the following:

• Philip Anderson, MD, Assistant Professor of Medicine at Harvard Medical School
• Jason Tracy, MD, Clinical Instructor of Medicine at Harvard Medical School
• Shelley Calder, MSN, RN, CEN, Clinical Nurse Specialist at BIDMC

Acibadem began in 1991 with a 50-bed hospital and second-hand equipment. Since then the organization has been focused on developing new facilities and improving existing hospitals in order to become a leading health care network in Turkey. Its rapid growth has challenged the organization to develop key strategies around organization and staff development, clinical program development and training, and quality and performance improvement.

As the Acibadem network has grown to include nearly a dozen hospitals, it has become critical to determine how best to implement system-wide processes in several areas, including emergency care. Most hospital emergency departments in Turkey, including those in the Acibadem network, are staffed by a mix of physicians who have received emergency medicine training, and those that have not. This is a reality of the Turkish health care system, where emergency medicine is a relatively new specialty. This is one reason, said Anderson, that the medical leadership at Acibadem are “looking at ways to increase the standardization of how emergency care is delivered.”

The emergency medicine program was based on the main Acibadem campus in the Kadikoy section of Istanbul. The first day was dedicated to a series of discussions on the respective emergency care delivery systems of Acibadem and BIDMC. “This was a rare opportunity to bring together the emergency medical leadership and personnel from throughout the hospital network for a system-wide meeting to engage in collective thinking and planning,” said Anderson.

On the second day the BIDMC team conducted a tour of the Kozyatagi Hospital, an 80-bed facility with a special focus on oncology and neurological sciences. The team visited the emergency department, radiology departments, and several inpatient wards, and held discussions with members of the physician and nursing staffs.

The information and impressions collected during the two days’ activities formed the basis of a set of recommendations for how Acibadem can enhance emergency care at Kozyatagi Hospital and throughout the network. These activities also set the stage for an interactive third day. During the morning session the BIDMC faculty presented their perspectives on the design and configuration of emergency department facilities, staffing considerations for the ideal emergency service (including health care provider roles and responsibilities and optimum skillsets for the given patient population), and guidelines for improving care. The program concluded with a breakout exercise in which the BIDMC team guiding groups of participants representing different Acibadem hospitals through the initial planning necessary to develop clinical guidelines and protocols.

Clinical practice guidelines are the standardized frameworks for provider decision-making. They set clear expectations with providers, define standards of care, and help to decrease variation in care. In emergency medicine, which encompasses a broad scope of practice, a standardized approach to care helps the provider to organize his or her thoughts and potentially reduce errors. Clinical protocols are the specific steps or actions for specific scenarios.

Following the program, Dr. Taviloglu noted that it “has been stressed that the use of standard guidelines in the emergency services of multi-center institutions has proved particularly successful and the patient satisfaction measurements have contributed a great deal to such guidelines.” He thanked the PHMI/BIDMC team and noted that the active participation of emergency medicine leaders from the various Acibadem hospitals demonstrated the network’s dedication to enhancing emergency care. He concluded, “The brainstorming meeting held on the final day has greatly improved the creativity and motivation of the participants.”