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Consistent and Exceptional Patient Care, Always: Doctors Hospital of Manteca

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Doctors Hospital of Manteca has always had a longstanding commitment to serving Central Valley patients, employees, physicians and partners. Since the hospital opened in 1960, they have never lost sight of what it takes to be a leader in healthcare services while tirelessly implementing new systems that improve service delivery and patient outcomes.

Continuing their focus of concentrating on an exceptional patient experience, Doctors Hospital has several new programs and methodologies in place to assist the hospital in improving their processes. At the forefront is a national methodology that offers a simple and consistent approach for problem-solving; it’s one that can be embraced by leaders at all levels. Lean Daily Management has become a new road map for DHM that allows their leadership team to implement a cultural progression of units that lead to discrete and objectively measurable phases.

“Lean Daily Management, or LDM, is the system that allows us to deliver patient value through proper support and leadership to those who are closest to the process,” Dr. Simran Sethi, MD and Lean Manager, shared. “LDM also helps the hospital be consistent with care of our patients. It provides a framework so we can help them always know what to expect, and what’s going on with their care, at all times. This process is hardwired into every department from emergency services and nursing to environmental services and maintenance. It’s a very standardized, hands-on approach to consistently providing the best care possible for those who come through our doors.”

New Strategies for Excellence
Lean Daily Management was proposed by the leadership team in 2015 and was fully realized in March 2016. The Tenet Health Care family was one of the first healthcare systems to adopt the LDM methodology; since that time, all involved have noticed an uptick in patient satisfaction and rave reviews from families. A large part of the LDM process is a system of checks and balances that takes many shapes and consists of several unique initiatives.

“I’ve found that front-line employees and physicians are a great source of finding opportunities in hospitals. I brought LDM to DHM because I’ve seen it work in many hospitals; it truly engages and empowers front-line team members with tools to find the barriers to enhancing the value we offer to patients, and to test their ideas to overcome them. It’s already had a powerful impact on improving our processes for safe, high-quality care and an exceptional patient experience,” noted Ikenna Mmeje, CEO, Doctors Hospital of Manteca.

“We are adamant about always knowing that our staff is well trained and our patients are superbly cared for,” noted Antonio (Tony) Garcia, MNS, RN, NEA-BC, CEN, Chief Nursing Officer. “LDM allows us to focus on things that we may be struggling with, address concerns and take preventive measures. One of the highly reliable systems that’s part of the LDM system includes The Four Must Haves, four strategies to address patient needs while providing outstanding care.”

Hourly Rounding
Hourly rounding is a structured means of promoting patient-centered communication in a healthcare setting among staff, patients and their loved ones to ensure the best outcomes. During the nursing staff’s meaningful hourly rounding, the Four Ps are observed: pain, positioning, potty (bathroom needs) and personal belongings (whether that patient has what they need within reach).

Bedside Hand-Off Report
A key component is providing information and detail to patients at all times. “We know that patients who are informed in all aspects of their care find comfort in knowing what to expect,” Tony added. “This includes what we call a hand-off report between the outgoing shift nurse and the incoming one. This hand-off report happens with the patient present and all details, plan of care and requests of the day are shared at that time as well.”

Ask 3-Teach 3
In an effort to increase patient understanding of their care and reduce anxiety, DHM’s nursing staff has implemented a process called Ask 3-Teach 3. When medication is given, three important details are provided: what the medication is, what it is for and what the side effects may be. Nurses then ask their patient to repeat the information, which helps to eliminate confusion and uncertainty with their treatment.

Leadership Rounding
Every day, key members of the Doctors Hospital of Manteca leadership team set aside several hours in the morning to be on the front lines of patient care with meaningful rounds. These one-on-one interactions between patient and the leadership team are an opportunity for leaders to learn more about the patient’s experience and identify possible areas of improvement.

“At DHM, we aim to provide an environment for the provision of quality healthcare on both an inpatient and outpatient basis,” Tony concluded. “It’s our hope that when our patients leave here, they take with them the feeling that they received the best care possible and share that positive experience with others in the community. Our primary goals include exhibiting leadership in setting standards for excellent patient care, improving the care we provide, and treating all patients in a way we would want our own family to be treated.” ■

To learn more about Doctors Hospital of Manteca, visit