For a new hospital, complete implementation of Planetree will likely require two to three years.
Planetree, Inc. provides an organizational assessment to assist hospitals wishing to adopt the model. The assessment consists of a series of on-site interviews led by members of Planetree, Inc. or leaders from Planetree affiliates with the organization’s leadership, physicians, employees and patients. The assessment process identifies the organization’s strengths, weaknesses, and readiness for adoption.
Planetree utilizes a formal contract with hospitals that join the Planetree Alliance. While the ten key components of the Planetree model (see Key Elements) form the model’s infrastructure, the organizational contract has only a select number of non-negotiable requirements, listed below.
- Development and support of a internal Planetree Steering Team to coordinate implementation
- Designation of a Planetree Coordinator (.5-1.0 FTE)
- Training of the Coordinator by Planetree (at national headquarters) within 3 months
- A minimum of 8 hours of Planetree instruction/orientation for every member of the organization’s workforce during implementation
- Representation at the annual Planetree conference
- Participation in an annual evaluation of progress
- Annual reporting of patient satisfaction scores
The key to rapid adoption and replication has been flexibility with respect to specific components and timing. Planetree, Inc. provides expertise (consultation and training services), encouragement and support, and a robust alliance that thrives on sharing innovations and welcoming new members.
Griffin Hospital had over 7100 applicants for 160 positions in 2006 and 6908 applicants for 173 positions in 2007. The majority of new hires are aware of the Planetree Patient-Centered Care model and have sought employment because of the established reputation. Griffin Hospital consistently develops and offers employee development, recognition and incentive programs and has been the recipient of prestigious workplace awards (see Results).
The internally designed WinFit wellness program offers all employees and their family members health risk assessments, free access to the hospital’s fitness center, individual counseling, and preventive screenings. Registered nurses are eligible for a Clinical Ladder program and specialty certification differential. All employees are eligible for tuition reimbursement with accredited colleges or universities.
All staff are considered caregivers: from nurses to pharmacists, food service to housekeepers, maintenance workers to parking valets. Every staff member attends an all expense paid two-day overnight Planetree retreat at an off-site location. Sharing a room with a co-worker, staff learn about the Planetree model and experience the world through the eyes of the patient. Employees take turns feeding each other in silence or being led blindfolded through unfamiliar corridors. More than 1600 Griffin Hospital employees, volunteers, physicians, interns, and residents have attended the two-day overnight retreats. By developing an understanding of how frightening and intimidating a hospital stay can be, each staff member identifies what they can personally do to create a healing and nurturing environment.
An Advanced Level Planetree Retreat (mandatory and compensated) was introduced in July 2007 to serve as a forum to review accomplishments and develop new ideas to enhance the model. Currently being offered on an invitational rotating basis to a cross section of hospital employees, the Advanced Level Retreat is considered both an honor and an opportunity to converse and innovate with leaders. In addition, Griffin Hospital provides a broad array of education and training classes to employees annually to promote individual professional development.
Griffin Hospital has hosted over 600 site visits since 1992. The Planetree Patient-Centered Care model has been replicated in 130 sites in the US, Canada and Europe. For a complete listing of Planetree Affiliates, please see www.planetree.org
Most Planetree affiliates support their implementation efforts with operational resources, in some cases reallocating existing dollars to patient-centered initiatives (e.g. using staff education funds for the retreat). However, many have been quite successful at leveraging their use of the model to increase donor support of facility enhancements that create a more healing environment. Some of the most successful examples can be found at Valley View Hospital in Colorado and Fauquier Hospital in Virginia, both of whom based successful capital campaigns on the Planetree model.
Leadership buy-in and support of the model is necessary for successful implementation of the Planetree model. Ensuring the readiness of executive members through visits to other Planetree member hospitals to meet with peers, as well as facilitated leadership readiness sessions during which leaders determine what their contribution and commitment will be to culture change, assists in this process.
In addition, physician acceptance and support are deemed critical to success. The “adopt-a-doc” program designed by members of the nursing staff to engage physicians in the design and implementation process resulted in additional ideas, ownership and enhanced professional and personal relationships.
Finally, engagement at the staff level is key to success, and this is achieved by establishing internal structures, such as steering teams and patient-centered action teams, that include broad representation of front-line staff.