Engaging Nurses in Practice WHA Nurse Leader Forum May 2010

Transcription

1 Engaging Nurses in Practice WHA Nurse Leader Forum May 2010 Ruth Risley-Gray, RN, BSN, MHA, CPHQ Director Patient Services & Quality Chief Nursing Officer Langlade Hospital

2 About Langlade Religious Hospitallers of St. Joseph - Montreal, Canada Critical Access Hospital An Aspirus Partner Modern Healthcare Top 100 Best Places to Work 2009 Inpatient services- ICU, Medsurg, OB, Surgery Outpatient services Primary Care and Specialty clinics, Cancer center, Dialysis center Professional Union

3 Intent for Engagement Emotional involvement/commitment to a common purpose----- to each other, one s job, and workplace Pride as a Profession Innovation and passion for professional practice ownership Innovation and passion for delivering safe, high quality patient care Without commitment Innovation and Passion are not evident

4 Catalyst for Engagement Shared Governance Model effective strategy for improving work environment and patient outcomes while engaging staff in the process and ownership of these improvements Nursing Strategic Plan Vision, Mission, and Values, Goals and Actions; strengthens a sense of belonging and purpose, woven into communications and staff meetings Opportunity to Refresh/Revise/Reclaim/Reorganize the Professional Practice Environment

5 The Model PARTNERS In PRACTICE Shared Governance Interdisciplinary Councils Practice Education Leadership/Coordinating Patient Care interdisciplinary sunset Unit based Quality to be established May/June 2010

6 The Journey steps and missteps Moved too quickly good structure and defined process but---- soil fertilization was weak Assumptions : Front line staff understanding Management readiness /role transition Prevailing organizational culture /sub cultures (culture eats strategy for lunch) Symptoms: Poor attendance at councils- unfilled representation Few decisions made by staff/management tweaking Discomfort in leading and staff frustration

7 Re- Tooling Listen Listen - Listen Solicited feedback from all nursing staff at annual symposium The good the bad and the ugly Re-education ---far reaching /strengthened support - resources Involved informal leaders and naysayers Assigned work teams to revise/redefine roles, structures and processes in the SG model CNO town halls --- Create a safe environment to express opinion Encouraged all nurses to challenge the status quo Nurses to lead and drive change /minimize hierarchy

8 Re-Tooling Model enhancement Work Group contribution Shared Governance definition clarified and strengthened Nursing Philosophy- Values and Goals Model of Care Bylaws revisions Education and on going support Like changing a tire while the car is moving trying to design a structure to empower and engage nursing staff while being coached to become leaders at the bedside.

9 Lessons Learned Assessing the culture organization, nursing, medical staff Importance of medical staff partnership and meaningful collaborative relationships CNO as role model for this Communication plan and strategy audience specific Use of nurse champions/informal leaders Use of the informal grapevine for communication Changing role of nurse managers under a SG model letting go and getting out of the way

10 Lessons Learned Importance of continued support and development of clinical nurses in leadership roles ---- {reminiscent of advancing good clinicians to managers} Progress communications to staff Council interface to maximize synergy Leaders required to budget time and resources for council participation and modeling behaviors that support SG

11 Engagement Outcomes Union leaders active participation on councils advocates Increased number of clinical nurse initiated QI projects letting them follow their passion/special interest; work on things that make a difference in real work Idea capture great Idea forms..unit based and house wide Team Huddles pt safety, quality and operations Beginning Nursing Grand Rounds TCAB initiatives implemented// EMR transition

12 Engagement Outcomes Council snapshots PIP newsletter and web page Collegial performance review / 360 s Preceptor Program and competency evaluation re-design Staff meeting standing agenda for SG Introduced at orientation >>>shift to council chair/rep New Q council awesome response

13 Recognition Great Catch recognition Teamwork rewards Annual Nurse Excellence award Nurses Week Nurse specialty certification

14 Next Steps Clinical Advancement Program ANCC Pathway to Excellence Program Healthy Work Environment Strengthen Interdisciplinary Collaboration Nurse /Physician Collaboration Nurse peer review

15 Thank You