The "silo effect" can be very damaging to a hospital system. It occurs when hospital staff members strictly focus on their function (e.g., social work, discharge planning, utilization management) and forget how their function influences other healthcare professionals. When this happens, communication between disciplines becomes very difficult.
When Grace Dotson, RN, MS, CMAC, CPUR, joined Greenville Hospital System (SC) as the director of outcomes management, the first matter she wanted to address was improving communication and eliminating the facility silos.
One example of the problem Dotson saw was that case managers spent their valuable time playing phone tag, waiting for e-mails, and searching the halls for coworkers. As a result, efficiency suffered. The average length of stay (LOS) at Greenville was high, and avoidable days were numerous.
Greenville needed a better system for communicating with staff members in other departments, so Dotson came up with a daily flash rounds meeting.
Not your typical meeting
The daily flash rounds meeting structure is simple: There is no structure. Dotson feels that the informal nature of the meeting makes it more likely people will attend and also makes the meeting quicker.
Keeping with the informal attitude, Dotson tells staff members to come to the meeting "with their sense of humor and their census."
Staff members who can attend include some of the following:
The meeting is early—10:30 a.m.—and quick, only lasting 15 minutes. "I like to compare it to speed dating," Dotson says.
Once in the meeting, attendees are free to roam around the room and mingle. They typically make small talk before asking for information about one of their patients. After a case manager tells a utilization nurse about a potential discharge, he or she can head over to the Well Vista staff member to talk about that patient's medications.