Providence CMO Bets Big on Co-Caring Model

Providence is expanding the health system's Co-Caring Model at inpatient units and working to improve patient care progression in the inpatient setting.

The chief clinical officer of the Providence health system is shepherding a pair of inpatient care initiatives aimed at improving the patient's journey.

Hoda Asmar, MD, MBA, is supporting a quality improvement initiative called the Co-Caring Model. Under the Co-Caring Model, bedside teams in the inpatient setting are supported by a team of nurses, social workers, case managers, and other staff members who work in a virtual role 24/7.

The Co-Caring Model was launched as a pilot last year on one acute-care unit. By the end of 2024, Providence will have 33 acute-care units using the Co-Caring Model.

Staff satisfaction with the Co-Caring Model has been high and it has the potential to help address workforce shortages, Asmar says. In the first seven months of the pilot for the Co-Caring Model, there was 100% retention of staff on the inpatient unit that adopted the model.

Patients have also been receptive to the Co-Caring Model, says Asmar, who has been executive vice president and chief clinical officer of Providence since October 2021. Previously, she served as executive vice president and chief clinical officer of Adventist Health and chief medical officer of system clinical improvement at Baptist Memorial Health Care.

"We tell the patient there will be a virtual team supporting the bedside team that they interact with in-person," she says. "None of our patients have opted out of the Co-Caring Model. When we looked at patient satisfaction and experience scores for patients and their families who were engaged in the Co-Caring Model, there were great results."

The Co-Caring Model gives the patients and staff more choices, which supports growth, Asmar says.

"In healthcare right now, there is a challenge in having enough caregivers joining the workforce," she says. "By creating choices, efficiency, and a positive culture, the Co-Caring Model is helping us to recruit and retain staff members, which is helping us to serve more patients."

Providence considers the Co-Caring Model to be a learning opportunity, Asmar says.

"As we are implementing the model at acute-care units, we customize elements for the local context, and we keep refining the model as we go based on the results and what we are learning," she says.

Hoda Asmar, MD, MBA, is executive vice president and chief clinical officer of Providence. Photo courtesy of Providence.

Improving patient care progression

Asmar is also involved in efforts to improve patient care progression. Patient care progression is measured by operational efficiencies in the acute-care space and hospital length of stay, she says.

Providence started working on patient care progression about three years ago to address some of the challenges that occurred during the pandemic—long lengths of stay, difficulty in discharging patients, and lack of access to enough post-acute care.The work began with the goal that every patient deserves a safe and timely discharge from acute care, Asmar says.

"We created a multidisciplinary team from across the organization and implemented a back-to-basics approach," she says. "We adopted more than a dozen basics that hardwired and established critical processes and workflows. We also worked on the connection to post-acute care such as home care and skilled nursing facilities in addition to access to primary care after discharge."

The work is paying off. In the first quarter of 2024, the health system is seeing a trend in the right direction for length of stay in acute care.

What happens before and after an acute-care stay is part of the patient care progression work, Asmar says.

"We are looking at hard-wiring standardized workflows, promoting automation, having safe and timely discharge from an acute-care stay, and addressing some of the chronic and repetitive issues with access to primary care as well as access to post-acute care," she says.

As is the case with the Co-Caring Model, patient care progression work is supporting growth at the health system, Asmar says.

"The ability to create operational efficiencies, reduce length of stay, and improve access in primary care gives us more capacity to serve patients in our emergency departments and have the beds ready for patients who need acute care," she says.