Yale Union-Management Partnership

Yale Union-Management Partnership | Human Resources & Administration

Profiles in Collaboration:
University Health Services

Union members: Gloria Lopez, Adam Marchand, Maureen Polizzi
Management members: Sandy Dinneen, Paul Genecin, Judy Madeux
Facilitator: Michele Potter

Broadening decision making improves patient care

Yale University Health Services (YUHS), a division of University Health Services, where Yale faculty, staff, and students get medical care, is relying on input from front-line staff to improve the patient care experience. Patients encounter doctors, nurses, medical assistants, receptionists, and many others in the course of getting health care. That’s why those YUHS staff members have had a hands-on role in designing a critical piece of the new facility that is scheduled to open in 2010. A Joint Departmental Committee (JDC) at Yale University Health Services worked as a committee to advise the architects on designing user-friendly examination rooms for the patients as well as for clinical staff. The JDC looked at details such as where the exam table is positioned, how the privacy curtains ought to work, where cabinets and supplies ought to be, and how nurses, doctors, and patients would interact with one another and with new tools such as the electronic health record.

Based on advice from the JDC, the architects built two life-size model examination rooms inside the current building at 17 Hillhouse Avenue. The JDC invited every employee to walk through and test out the rooms from his or her individual perspective. The JDC members observed how staff and patients would experience the exam rooms, and from this exercise, they made specific recommendations to the architects.

health services

Sandy Dinneen and Gloria Lopez

Katie Kelly, Manager of Member Services and Communications and the co-chair of that JDC, says “we were looking for an exam room design that makes sense for everyone – patients and staff alike. The senior YUHS administration felt it was very important to have those staff members who provide care involved in the process of room design, including setup and features. The feeling from the very beginning [of the new facility project] has been that this is an opportunity to get everyone involved in the decision-making.”

“For instance,” Kelly says, “everyone was sensitive to patient privacy and how curtain dividers should provide privacy when clinical staff members enter and leave examination rooms and at other times as well.” One of the early ideas was to put supply cabinets and the computer outside of the privacy curtain so staff members could remain in the exam room and keep working while patients changed clothes. In many ways, the JDC found creative ways to fine tune the room set-up in order to enhance the patient experience.

Another JDC project at YUHS focused on improving appointment access for patients with orthopedic problems. Waiting times were too long, and Maureen Polizzi, a Licensed Practical Nurse and the other co-chair of the JDC, says, “We felt that was unacceptable. Usually with a musculoskeletal injury, physical therapy is going to be involved, and the sooner you start it, the better off you are. So we needed to find a way to get them in sooner and get their program started sooner.”

YUHS is implementing a variety of solutions to improve service to patients with orthopedic problems, including better referral guidelines, improved use of physical therapy, and numerous ways to shorten wait times for new patients. They are even developing DVDs that demonstrate exercises for patients with selected chronic problems to use at home. Kelly says that soon they hope to show measurable results like quicker service times and improved YUHS member satisfaction.

“The whole point of all our projects is service excellence for our patients,” Polizzi says. “When we started we surveyed all the staff in the building asking ‘What helps you to give the best service?’ And people wrote a lot. We sat in our meeting and read every comment out loud, and that was a real eye opener. We really heard them. When you actually heard someone read it, it had a much greater impact. Communication was the big thread connecting it all.”

YUHS staff members look forward to new JDC projects to improve the work culture and enhance patient care. Management and union leadership are forming new best practices task forces to enhance the new employee orientation program in YUHS and to institute an improved performance appraisal process for C&T staff. And YUHS will soon follow the University Library in piloting a program to resolve workplace problems and disputes through interest-based problem solving. Stay tuned!


Last Updated: April 14, 2009 (kp).