It’s difficult enough to coordinate patient care across departments or hospitals, but what happens when the care process takes place on two different islands?
That was just one of the challenges tackled by an interdisciplinary team from Spaulding Rehabilitation Network (SRN) and Partners HealthCare International (PHI) that recently traveled to the VGH Karin Grech Hospital (KGH) in Malta for the opening of a newly renovated, 28-bed stroke rehabilitation unit.
Part of the Vitals Global Healthcare (VGH) network, the unit’s launch is the first step in a comprehensive plan to improve the care for stroke patients and one of a series of initiatives taking place as part of a multiyear agreement between PHI and VGH, explains Betsy Cox, Director of Global Nursing Programs for PHI.
Other initiatives include programs to improve quality and safety, strengthen the program infrastructure, information technology, nursing, and clinical rehabilitation care, Cox says. “We are working on quality and safety with them, moving toward international accreditation, and working closely with nursing leadership development.”
Malta is an archipelago in the Mediterranean Sea that includes the larger island of Malta and the smaller island of Gozo and sparsely populated island of Comino. It is located about 50 miles south of Italy. Approximately 700 patients on the two islands suffer strokes each year. Stroke patients receive care on either island and the goal is to define a stroke pathway across the continuum of care for patients across Gozo and Malta to provide the right level of care at the right time to improve outcomes, satisfaction and efficiency.
“In Malta patients who have suffered a stroke are admitted to Mater Dei Hospital for acute care management. What the patient needs next is dedicated rehabilitation care to start relearning skills,” explained Stephen Zammit, MD, CEO of VGH’s Karin Grech Hospital. “Through our collaboration with Partners and Spaulding Rehabilitation Network we are now able to offer our patients this specialized rehabilitation.”
The new rehabilitation unit at Karin Grech Hospital is located within an existing area of the hospital. The newly opened unit was refurbished to focus exclusively on stroke rehabilitation and features an updated gymnasium and new technologies to assist in the recovery process.
In addition to the facility updates, the teams collaborated on new strategies for educating staff, scheduling patients, conducting case discussions, setting goals for patients, involving families in the care process, and preparing for the next transition of care.
“We’ve delivered some of the work and we will continue to work with KGH remotely as they implement these changes and review targeted performance measures to see how well they are improving care in stroke rehabilitation,” Cox explains.
Cox was quick to highlight the critical role played by the team from SRN, which included physicians, nurses, speech language pathologists, physical therapists, and occupational therapists. “They worked hand in hand, shoulder to shoulder to help our colleagues in Malta through this process.”
PHI, the international arm of Partners HealthCare, has been collaborating with hospitals and health care organizations across the globe for more than two decades. The PHI team merged with Partners Innovation in 2016. The unique model of international collaboration is based on a two-way exchange of ideas rather than exporting a single approach or methodology. In this case, the goal was not for VGH to do everything the same way that the Spaulding team does it, but to combine global best practices with local considerations and identify solutions that work best for this country.
While the advisory teams from Partners have a lot to offer their international colleagues, there is much to gain as well.
“You always learn how our international colleagues do things differently,” Cox says. “Maybe they are using protocols from the European Union or have different cultural practices. You are always extracting ideas from each other and being able to say, ‘Hey, I didn’t think about it that way—we might be able to implement that.’”
For Cox, one of the most gratifying parts of the collaboration is watching the spirit of teamwork develop as the project moves along, not only between the PHI/Spaulding and VGH teams but within VGH as well.
“I think it’s always extremely rewarding to see how these teams that have come from across the globe, and there locally, across two islands, are able to work together and have this impact when so many of them didn’t even know each other beforehand.”
“They come from the same hospital or the same country. Now, not only do they know each other, but they are standardizing care in a way that will have an impact on the patient.”