Graduate Nursing Education (GNE): Duke University Hospital Demonstration Project

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1 Graduate Nursing Education (GNE): Duke University Hospital Demonstration Project

2 Concept: Professionalism The Duke Nurse demonstrates integrity in nursing practice through self-knowing, nurturing students, and mentoring colleagues to provide exemplary professional practice every day, every patient, every setting. We support patient needs, changes in practice, and the nursing profession through active dialogue and partnership. A commitment to continual learning and developing expertise is critical to advancing nursing practice.

3 Project Oversight Senior Leadership Oversight from Mary Ann Fuchs, DNP, RN, FAAN and Catherine Gilliss, PhD, RN, FAAN Day-to-day operations: Pamela Edwards, EdD, MSN, RN-BC, FABC, CNE; Associate Chief Nursing Officer; Education, DUHS Barbara Turner, PhD, RN, FAAN; Director, Doctor of Nursing Practice Program, DUSON

4 Duke: Transformation Requires Growth Innovating in clinical growth DMP & Cancer Center Continued investment in Duke Primary Care network expansion; affiliation models Outpatient/inpatient access initiatives expanding patient volumes Strategic network/partnerships; business development Local, statewide, & regional strategic marketing; national promotion & marketing of Programs of Distinction

5 Transforming Our Future Innovating in Clinical Growth DMP & Cancer Center growth drivers; meeting demand Primary care network expansion Outpatient/inpatient access initiatives expanding volumes Strategic clinical partnerships and network development Targeted and strategic marketing locally, regionally, etc. Revolutionizing Care Delivery Patient centered care; focus on patient experience Maestro Care (electronic health record) Right patient, right place, right time - full spectrum of care settings; better integration/alignment across DUHS Length of stay efficiencies; reduce unnecessary readmissions Reinventing Care Design & Payer Strategy Population health management strategies Creation of Clinically Integrated Network (CIN) Care bundles Pricing and contracting strategies with payers

6 LEADING HEALTHCARE DELIVERY SYSTEM IN THE NATION Revolutionizing Care Delivery Patient-Centered Care Maestro Care Right patient, right place, right time Innovating in Clinical Growth Primary/Specialty Network Development Access Improvement DMP & Cancer Center Reinventing care design Population health management Clinically Integrated Network Care bundles Cost Improvements Reduce costs for episodes of care Expense management Competitive pricing Performance Excellence Quality & Pa+ent Safety Pa+ent Experience Finance & Growth Work Culture Physicians, Providers & Direct Care Staff Deliver great, compassionate patient care efficiently and effectively; constantly seek innovations in safety and quality Support Care Staff Improve the patient experience; support optimal care delivery; excellence in operational execution DUHS Values All Physicians, Staff, Volunteers Demonstrate values-based behaviors and decision-making Caring for Our Pa+ents, Their Loved Ones, & Each Other Excellence Safety Integrity Diversity Teamwork

7 Duke GNE Goals Prepares APRN learners to play a greater leadership role in the health system, both in delivering care and in decision making about care Provides APRNs more involvement in the development and evolution of a regional care infrastructure that is more accessible, cost-effective, and responsive to the needs of our region Provides direct support to develop, institute, and require new preceptors to participate in a comprehensive preceptor education program further improving preceptor training already in place

8 Project Partners Half of clinical training occurs in non-hospital settings, which strengthens nurses skills in handling preventive services, chronic disease management and other primary care needs School Partner: The Duke University School of Nursing Clinical Partners: Private Diagnostic Clinic (PDC) Duke Primary Care; 32 locations across the region Healing with CAARE, Inc., a non-profit community clinic that provides free health services in Durham

9 Project Partners The Division of Community Health in Duke s Department of Community and Family Medicine, in partnership with: Lincoln Community Health Center Lyon Park Community Center Walltown Neighborhood Clinic Holton Wellness Center Northern Piedmont Community Care Duke LifePoint: N.C. community hospitals at Maria Parham Medical Center in Henderson Person Memorial Hospital in Roxboro Danville Regional Medical Center in Danville, Va.

10 Preceptor Planning & Development During the Fall, Spring, and Summer terms of Year 1 - a formal training program for preceptors was launched. This program includes face-to-face seminars and online learning modules for preceptors to develop skills in working with students in clinical settings. The online modules will be advised for all new clinical preceptors. Face-to-face preceptor training seminars will be delivered on a bi-annual basis through the end of the project and will include the use of standardized patients. These sessions will be digitally captured to enable preceptors to review them in the future.

11 # of APRN Students APRN Student Placements In Duke Primary Care APRN Students Duke Primary Care Year 1 0 Fall '12 Spring '13 Summer '13

12 % Increase in Duke Primary Care APRN Preceptors % APRN Preceptors 50 DPC Provider Preceptors 25 0 Fall '12 Spring '13 Summer '13

13 Increase in Duke Primary Care APRN Preceptors # of APRN Preceptors 20 Duke Primary Care APRN Preceptors 10 0 Fall '12 Spring '13 Summer '13

14 Accomplishments in Year 1 Relationship Building Began ENTICE (Enlisting New Teachers In Clinical Environments) initiative to increase number of preceptors by learning What Motivates Providers To Precept Created Preceptor Development Workshop to help providers become better preceptors upcoming on May 4, 2013 Delivered on-site presentations to Primary Care Clinics throughout Duke Medicine and Research Triangle Park Communities to explain objectives of the Graduate Nursing Education Demonstration Project

15 Preceptor Champions Emerging: It s interesting how teaching can make you a better provider, especially with the really good questions they ask, such as why did you do that or why did you prescribe that? Comment from a preceptor

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