Nebraska Medicine’s Transformational Thinking

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A proactive approach to medicine has kept Nebraska Medicine at the forefront of healthcare in the U.S.

Being innovative doesn’t necessarily mean inventing or using the latest technology, applications, or gadgets. Innovative ideas, practices, and leadership styles go a long way to defining business strategies.

When you can combine innovative technology with transformational thinking, the only way to go is up.

That’s why Nebraska Medicine exists today.

The combination of The Nebraska Medical Center, Bellevue Medical Center, and University of Nebraska Medical Center Physicians (UNMCP), Nebraska Medicine—a cofounder of the National Comprehensive Cancer Network—came together in July of 2014 to provide the people of the state a better option for healthcare.

The two hospitals—The Nebraska Medical Center and Bellevue Medical Center—were acute care oriented before joining together. When UNMCP was acquired, however, 40 ambulatory clinics and a physician’s practice were added to the mix.

“Usually this type of collaboration and integration is driven by market pressures,” shared Daniel DeBehnke, MD, MBA, Chief Executive Officer. “This organization had the foresight to do the hard work to restructure itself to deliver on the brand promise of serious medicine—­extraordinary care”

The integration of these three organizations into one began three years ago, and came together in a proactive way, instead of a reaction to the current climate. Since becoming Nebraska Medicine officially, the organization is aligned with the same goals and objectives to serve its patient base.

It’s innovation, transformational thinking, and a proactive outlook that’s driving its strategy today, resulted in several new facilities and better ways to treat the community.

New Outpatient Center: A True Patient Experience Facility

The four-level Lauritzen Outpatient Center and Fritch Surgery Center opened at the end of November last year. The 168,000 square foot facility is a multi-specialty outpatient facility, offering services ranging from ear, nose, and throat and oral surgery to facial prosthetics, urology, and orthopedics.

Its designated ophthalmology suites will be connected to Nebraska Medicine’s Stanley M. Truhlsen Eye Institute via a skywalk early in 2017.

Support services including labs, therapy space, a pharmacy, and radiology have also found a home in the new location. Seven of the operating rooms (ORs) are functional, with three more shelled out and ready for expansion when the time comes.

The research space, however, is where Nebraska Medicine truly shines. The dedicated space for innovative orthopedic research and education allows for stress testing on orthopedic implants. From this to its space supporting telemedicine training programs, it’s truly a remarkable building.

“It was designed to be a patient experience facility,” said DeBehnke. “This might sound strange. Aren’t all facilities supposed to be geared towards the patients? In theory they are, but in practicality it doesn’t work sometimes.”

“By building the facility around care processes, we’ve constructed a building that can truly provide a seamless experience to our patients.”

Patient access was a key consideration at Lauritzen, with parking and patient drop-off located close by: in some cases, just a few steps from the front desk. And no matter where patients or visitors end up in the facility, the staff will help them get to the right place.

“It doesn’t matter if you end up on the wrong floor, our staff will get you checked in and direct you to the correct location. You can even check in for multiple appointments at once.”

Nebraska Medicine is also utilizing a pager system—similar to what restaurants use when there is a wait time—to alert patients of doctor availability, or patients’ families when a procedure has been completed.

Other amenities are available to the patients’ families as well. There are lounges as well as collaborative areas and working spaces set up throughout the facility.

“Some procedures take a while, so our new lounges and workspace allow families to congregate in comfort, or get work done while waiting,” shared DeBehnke.

To make sure that these gathering spaces were as comfortable—and comforting—as possible, DeBehnke and the leadership team enlisted the help of Nebraska Medicine’s patient advisory council. The furniture package in this building was identified for its ease and warmth, and was so well-liked it will be appearing in the campus’s new cancer center as well.

Cancer Center: Collaboration Between Clinicians & Researchers
Both Nebraska Medicine and its academic partner, University of Nebraska Medical Center, are known for their transformational thinking. Instead of being set in the moment, these two organizations are constantly thinking about what is possible.

This approach has led Nebraska Medicine to design and construct a facility unlike any other in the U.S.

“We had been thinking for a long time about what it would look like to co-locate research and clinical staff together in one state-of-the-art facility,” DeBehnke commented, “to facilitate daily interaction between pure clinicians and researchers in the same environment.”

The design of the building will enable a level of collaboration healthcare facilities have yet to see. DeBehnke spoke of a “knowledge transfer zone” in the corner of the L-shaped building that will contain faculty offices, the perfect meeting place for sharing research and providing feedback to treatment.

If breast cancer treatment is on the fourth floor, breast cancer researchers will be just a few doors away.

“What we really wanted was to create a sense of urgency,” DeBehnke said. “Every day when researchers and clinicians come in to go to their lab or patient care areas, they’ll be sharing the space with patients and their families. This just highlights the importance that this is a disease that we have to conquer, and we have to do it together.”

While integration is the innovation of note with the new cancer center, its technology and healing arts program are just as innovative when it comes to the patient experience.

Currently, Nebraska Medicine is piloting bedside tablets with the patients in the current bone marrow transplant unit. The organization’s app—One Chart Patient Bedside—is preloaded and ready to make the patient’s visit a little easier to understand.

They can view the medication that is currently being administered, read their most recent set of vitals, review lab tests and get explanations for what it means, as well as see what is scheduled for them that day.

Non-urgent requests can be made for more linens or towels, for example, and patients can leave themselves virtual sticky notes. This way, when a patient’s family member wants to know the answer to something, the patient won’t forget to ask the doctor.

Other significant tech is abound. Technology enabled conference rooms will allow tumor boards from across the state to connect with one another. There’s cutting-edge radiation tech in the form of four linear accelerators and as many operating rooms. A 24/7 infusion center will ensure patients are getting treated when it is convenient for them.Biocontainment Unit
As the cancer center was under construction, and in the middle of Nebraska Medicine’s clinical integration process, the healthcare group applied its transformational thinking in another area.

There was no Ebola crisis in 2005, but Nebraska Medicine had the foresight to build the largest infectious disease unit in the nation.

“What if there was a significant, highly contagious agent that entered the U.S.?” asked DeBehnke. “No one was thinking in terms of this, and very few hospitals would be able to handle this level of crisis. We were proactive.”

The organization built all of the components needed to treat highly infectious diseases, including double pass through antechambers, an autoclave to decontaminate waste linen, and negative-pressure patient rooms.

During the Ebola outbreak of 2014, Nebraska Medicine was one of three centers in the country designated to treat Americans who had contracted the virus in Africa. Three patients were treated in Nebraska’s biocontainment unit and the staff became an international resource for information on safety procedures and patient care.

Today, healthcare practitioners fly in from all over the world to use Nebraska Medicine’s biocontainment unit for simulation. The hospital staff trains these workers in how to deal with highly infectious diseases.

“We just did a drill a couple of weeks ago that simulated a 747 from Africa bringing multiple infected patients,” he said. “We worked through ambulance transport, moving throughout the hospital and to the biocontainment unit.”

These training opportunities inspired the leadership at Nebraska Medicine to pursue another facility for its campus: something akin to a biocontainment hotel.

Based on the success of the partnership with the University of Nebraska Medical Center, Nebraska Medicine was able to apply for and win a $20 million grant from the U.S. Department of Health and Human Services. This money will go to fund a training, simulation, and quarantine center to teach federal healthcare personnel how to care for patients with infectious diseases such as Ebola. It will also operate as a place for people who are exposed, but have not yet shown symptoms.

“One of the problems that we came across during the Ebola outbreak was that many people had been exposed but were not symptomatic. We needed to quarantine for observation, but not treat.”

This new facility will reside inside UNMC’s Interprofessional Experiential Center for Enduring Learning, or iEXCEL which is due to be completed in September of 2018.

Why Nebraska Medicine?
The facilities are impressive. The leadership is committed. But why should residents of Nebraska choose Nebraska Medicine for their healthcare needs?

“It’s not the buildings, it’s what happens inside the buildings,” said DeBehnke. “We research and bring on board top-notch research and physician scientists and clinicians. Our oncologists are the ones who researched, spearheaded, and brought to market bone marrow transplantation.

“Our researchers, and how we are building our facilities right now, could help us develop a novel and ground-breaking treatment. Our best asset is our staff. When the Ebola outbreak occurred, other organizations had panic run through them. This community stepped up and had more volunteers than could help.

“It’s a testament to the culture of this organization. When the nation needed us, we were there and ready to go. And we always will be.”