Over the last decade there has been much discussion about the creation of Centers of Excellence to provide quality care to patients with specific health problems. Since then, the term has been used by many but also has become the new "buzzword" for hospital and specialty group administrators to help achieve a greater market share by utilizing a term that sets their specific facility apart from the rest. More than a "buzzword," it should represent an organizational wide commitment to excellence in patient care for a specific population of patients. A Center of Excellence can either represent an entire specialty such as orthopaedics or a particular program within the specialty. For example, the joint program may be the cornerstone for a particular facility.
What does it really mean to be a Center of Excellence? An orthopaedic Center of Excellence should include a well-designed program consisting of people, facilities, and programs that provide the components that are necessary to create such a center. Professionals with excellent clinical competence who possess advanced treatment techniques and the available technology to produce high quality outcomes is imperative. Oftentimes, the attention focuses on the physician competencies. However, these same excellent competencies must also be present in any healthcare provider that interacts with the patient and family. This would include nursing, physical and occupational therapy, radiology, pain management, and rehabilitation specialists.
In addition to the term Center of Excellence, other terms that are used to describe an organized initiative to create excellent patient care outcomes are product lines, small business units or as Porter (2006) discusses, Integrated Practice Units (IPUs).
In this issue of Orthopaedic Nursing, Dr. Patterson (page 12) revisits the concept of orthopaedic service lines. While the concept has been used in healthcare for over 25 years, it has changed over time. This excellent discussion reviews the past but shares the current state of orthopaedic service lines as it is utilized today.
The development of specific areas of expertise within the Center of Excellence is necessary. The commitment to not only measure outcomes but to react and make changes if the data indicates are necessary. Remaining current not only in surgical techniques but also in patient care management creates the 'cutting edge' or 'state of the art' philosophy necessary for success.
All of the above is important; however, I believe the most important aspect of creating a Center of Excellence is the people that stand behind these kinds of programs. Every individual, from the person working in the sterile processing department, to the transport personnel, to the attending surgeon, to the staff nurse, to the service line director, to the hospital administrator, must completely believe in the concept of creating an environment second to none. Creating a culture of excellence must be the first step in creating a Center of Excellence.
Davis (2005) in his book, Creating a Culture of Excellence: Changing the World of Work One Person at a Time, discusses the need to engage all people in the workplace to contribute to the success of the whole. This concept of developing a corporate culture of excellence may help drive our own programs into success. Instilling the notion that every person in the Center of Excellence contributes in some way to the success of the program, is essential.
At the same time, one person in the continuum may also diminish the success of the entirety. Providers and patients want and demand excellence in patient care. Finding the best way to accomplish this goal requires the inclusion of many different healthcare workers in the solution.
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