Nurses Ownership of Outcomes through Shared Governance

Transcription

1 Nurses Ownership of Outcomes through Shared Governance Lisa Lokken, MSN, RNC-OB, C-EFM, CNS-BC Clinical Nurse Specialist Wheaton Franciscan St. Joseph

2 Identify at least one approach to integrate shared governance into your local culture. Give at least two examples of how the clinical nurse can become engaged in making sense of evidence-based data. Relate one or more strategies which can be used to leverage outcomes improvements through shared governance.

3 Tim Porter-O'Grady: o A professional practice model, founded on the cornerstone principles of partnership, equity, accountability, & ownership o that form a culturally sensitive & empowering framework, o enabling sustainable & accountability-based decisions o to support an interdisciplinary design for excellent patient care.

4 Vanderbilt: o A dynamic staff-leader partnership that promotes collaboration, shared decision making and accountability for improving quality of care, safety, and enhancing work life.

5 Charter - boundaries of decision-making Collaboration - between clinical nurses and nurse leaders Regular meetings and formal means of communication to all staff Agendas - mutually planned, and distributed before meetings Ground rules - how to work together, accountability for presence at in-person or online meetings Consensus decisions - everyone agrees to support decisions after having discussed the options

6 Unit and Clinic Boards are the point-of-service decision-making, problem-solving forums for staff, managers, and other key stakeholders. The boards consider issues related to: local concerns of the unit/clinic staff and patient education quality of care patient and staff safety clinical practice other topics aligned with VUMC s pillar goals The local boards are typically chaired and facilitated by a team comprised of two elected staff co-chairpersons partnered with the manager of the inpatient unit, outpatient clinic, procedural or peri-operative area.

7 Shared governance may look different in different settings Outcomes are the same: o A feeling of having been heard and included in decisions that directly impact nurses and their patients.

8 Make participation meaningful. Managers and leaders must be clear about boundaries for shared governance councils o Prevents unrealistic expectations which lead to frustration.

9 ANCC definition o Overarching conceptual framework for nurses, nursing care, and interprofessional patient care. o It is a schematic description of a system, theory, or phenomenon that depicts how nurses: practice, collaborate, and develop professionally o to provide the highest-quality care for those they serve.

10 Various models can be developed depending on the culture of the organization. Can and should be evaluated and revised as the need arises.

11 Sometimes when a door closes, a window opens..

12 What makes sense to nurses working in direct care? Given their time constraints, what gives them (and the organization) the biggest bang for their buck? Take a look at the following when might each of these be useful?

13 Executive summary o High level o Tells a story at a glance o Snapshot Dashboard o Unit or area-specific o Lots of information to keep an eye on Run charts o Change over time o Easy for eye to track changes

14 A team relies on data to make in-game course corrections How does this same principle apply at the clinical level? Where should we be placing our priorities?

15 Real time Point of service Sharing with others Partnering with resources We not they

16 Professional Practice Models o Teamwork and collaboration o Autonomy o Professional Development o Leadership access and responsiveness o Interprofessional relationships o Fundamental of quality nursing care o Adequacy of resources and staffing o RN-RN teamwork and collaboration

17 Patient outcomes influenced by nursing care o Falls with injury o HAPU Stage 2 and above o CLABSI o CAUTI o NSI from core measure set o NSI from primary or specialty OP services

18 Patient engagement/patient-center care Care coordination Safety Service recovery Courtesy and respect Responsiveness Patient education Pain Careful listening

19 Helping nurses to understand what they are, and how to make sure they are implemented.

20 How do you incorporate this into the work that is done every day?

21 Use some type of checkdown process to organize thinking o At the individual patient level o At the unit level o At the organization level

22 Shared accountability helps with ownership We all have a role in excellent patient outcomes Swimming solo, you can get stung

23 Taking Your Ideas Back Home

24 Journal of Nursing Administration official journal for Magnet. American Nurses Credentialing Center. (2013) Magnet Application Manual. Author: Silver Spring, MD. %20Governance. Accessed 03/14/14. Accessed 03/14/14.