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Dome - A Shared Journey

Dome December 2013

A Shared Journey

Date: December 2, 2013


Toby Levin, center, talks to a Suburban Hospital patient about to be transferred to the Hebrew Home in Rockville, Md., about her father’s positive experience at the home as the patient’s daughter looks on. At left is oncology nurse Jennifer Simon.
Toby Levin, center, talks to a Suburban Hospital patient about to be transferred to the Hebrew Home in Rockville, Md., about her father’s positive experience at the home as the patient’s daughter looks on. At left is oncology nurse Jennifer Simon.

“At some point in your life,” Toby Levin reminds a group of new hires at Suburban Hospital, “you or someone in your family will be a patient.” Then the co-chair of the Patient and Family Advisory Council (PFAC) asks them to leave their professional roles aside as she shares a personal story.

Four years ago, her 96-year-old father was hospitalized for aspirational pneumonia at Suburban. As he was a Holocaust survivor who spoke broken English and had some dementia as well as hearing loss, Levin served as “his voice.” After spending two nights at his bedside and anticipating his imminent discharge, she went home, leaving instructions to call, should he have any difficulties.

The next morning she learned that her father had fallen and suffered a head injury in the middle of the night. Instead of calling her when he awoke confused, the nurse gave him an anti-anxiety drug—one Levin had specifically warned against because it had caused him to hallucinate when he took it previously.

Following this incident, Levin discussed various ways to improve communication between staff, patients and family members with a Suburban nursing director. And after her father was discharged, Levin was invited to join the newly formed Patient and Family Advisory Council, a group that includes hospital leadership, staff, patients and families.

At the first meeting, it was announced that Levin’s experience with her father had inspired the purchase of a white board for every room. Had her phone number been posted on a message board near her father, Levin says, a caregiver might have called about her father’s behavior and saved him from unnecessary medication.

Now retired as a senior adviser at the U.S. Department of Homeland Security’s Office of Privacy, Levin is directing Suburban’s 17-member PFAC with Barbara Jacobs, one of Suburban’s nursing directors. The two women also speak every month at employee orientation to increase awareness about patient and family concerns.

Currently, the council is helping to pilot shift change reporting at the bedside that includes patients and families. Starting in Suburban’s progressive cardiac care unit, this practice will become the norm for all units. “We recognize that not every family will want to be involved at the same level,” says Levin, “but we want to give them the opportunity to participate.”

Such collaboration extends beyond the hospital’s walls. Last year, a multidisciplinary group from Suburban began meeting regularly with Hebrew Home of Rockville representatives to streamline processes and move patients safely from one health care setting to another. Levin, whose late father was a Hebrew Home resident, founded that facility’s family council and serves as a bridge between the two institutions.

Thanks to such efforts, discharge forms at Suburban and the Hebrew Home now include more relevant patient data that reduce the risk of readmissions, notes Jacky Schultz, Suburban’s executive vice president and chief operating officer.

Jacobs applauds greater participation by patients and their families, claiming that this cultural shift has already improved safety and communication. “The family shares nuances about loved ones that may not be evident from the chart,” she says. “The real change here is that we are moving from a culture of providing care to patients to one where we are partnering with them for their care.”

—Judy F. Minkove

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