December Nursing Strategic Goal Focus: Innovation

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1 December 2009 Nursing Strategic Goal Focus: Innovation Last month, we introduced you to our nursing strategic plan and our plan to highlight each of our five strategic goals in this year s editions of enursingnow. A graphic of our five strategic goals and their link to the new Northwestern Medicine strategic goals is shown below. Plan for Advancing Nursing Excellence at Northwestern Memorial Deliver Exceptional Care Nursing Strategic Goal: Innovation 1. We aspire to develop and implement innovations patient and family-centered care that foster quality, safety and effectiveness and serve as a model for nursing care nationally. Advance Science and Knowledge Nursing Strategic Goal: Research and Evidence-Based Practice 2. We aspire to develop a culture of inquiry that encourages and supports nurses in advancing evidence-based practice and building new nursing knowledge. Nursing Strategic Goal: Workforce Supply and Performance 3. We aspire to attract, develop and retain exceptional nurses and provide them with an environment that fosters excellence through continuous learning. Nursing Strategic Goal: Healthy Practice Environment 4. We aspire to provide our nurses with an environment that supports their professional practice, health and well being. Nursing Strategic Goal: Leadership 5. We aspire to develop transformational leaders who can positively impact the nursing profession at NMH as well as locally, nationally and internationally. This month, we are focusing on our nursing strategic goal of Innovation, which states: We aspire to develop and implement innovations in patient and family centered care that foster quality, safety and effectiveness and serve as a model for nursing care nationally. Innovation links to our new Northwestern Memorial strategic goal to Deliver Exceptional Care. Our Patient Centered Care Model (PCCM) is one of the ways that we accomplish our strategic goal of innovation. Our stories this month focus on how the model is being embedded across Northwestern Memorial. Implementation of the Patient Centered Care Model in the Radiology and Professional Services Departments By Tara Campanella, RN, MSN The Patient Centered Care Model for the Departments of Radiology and Professional Services was designed to provide an environment centered around three core components; safety, communication and education. Consistently focusing on these three core components provides trusting and compassionate patient and caregiver relationships to meet both patient and clinical needs. The model was created through the collaborative efforts of the members of the Departmental Shared Leadership Committees from both departments. Team members defined safety, communication and education within the daily practice of each area. Diverse examples were explored, and the team collaborated to further develop each core component to fit the differing work flows within the departments.

2 These core components include: Safety: Patient identification, completion of pre-procedure checklists and assessments, sedation recovery, and performing safety checks for all equipment. Communication: huddles, use of handoffs and SBAR, multi-disciplinary collaboration, and communication via various electronic information system applications. Education: interdisciplinary and staff to staff education as well as patient education pre- and post-procedure. The model has been implemented throughout Radiology and Professional Services through the leadership of the Departmental Shared Leadership Committees (DSLCs). Each DSLC member used large laminated posters along with hot sheets to lead group discussions with their departmental colleagues to provide education and deepen their ability to articulate and apply the model. The posters were then displayed throughout the departments. Departmental Shared Leadership Committee members continue to reinforce the core components in implementing practice standards and providing patient care. Measures of success include the fall rate and compliance with handoff procedures. The Antepartum Model of Care By Heidi Close RN, BSN, MS, CNA, BC The design and implementation of the Patient Centered Care Model on Prentice 9, the Antepartum Unit was developed in November, 2008 in response to a root cause analysis done to identify opportunities for improvement. The process included looking at the way nursing care was delivered on the unit as well as the communication process between MDs and RNs. The concept of a nursing model of care that involved bedside report, whiteboard documentation, serial rounding and safety huddles was introduced. Several staff members: Diane Pokrovac, RNC, BSN; Lisa Bieze, RNC, BSN; and Carol Burke, APN, RNC worked together to refine the model specifically for the antepartum unit. In addition, through the support of the medical staff, a model for interdisciplinary rounds was also introduced. The first interdisciplinary rounds were rolled out in January, They proved to be an overwhelming success. Rounds were scheduled each day of the week so that nurses and physicians could come together to discuss the plan of care for each patient on the unit. Not one day of rounds has been missed since the roll out. The antepartum nursing model of care was developed following a literature review to provide support that the model was evidence based. It rolled out in early March, 2009 after the staff was educated on all aspects of the model. For the first 5 months monthly audits were performed by the clinical coordinators and the staff educator to ensure compliance and give feedback to staff as needed. The unit has demonstrated consistent compliance with the audits and will now move to a quarterly tool. In addition, since the roll out, the antepartum unit has seen an increase in patient satisfaction from 59% to current 75% Very good responses on the patient satisfaction survey. The success of the model stems from an emphasis on ensuring that nurses understood why practice was changed utilizing an evidenced based practice model. In addition, the consistency of interdisciplinary rounds has enhanced nursing and medical collaboration in the plan of care for each patient. Patients have truly benefitted from the implementation of the model and appreciate knowing how staff work together on their behalf. 2

3 Nurse Leaders This month, we are showcasing three leaders from the Department of Medicine Nursing: Kate O Brien, RN BSN; Margaret Mensing RN, BSN, CMSRN; and Megan Ethington RN, BSN. These three nurses were awarded Best Poster in the Clinical Category at the 2009 AMSN conference in Washington DC. Kate has been employed at NMH for the past 4 years and is currently working as an education coordinator in the division of Medicine. She is currently pursuing an MBA. Mary Alice Ackerman, RN, BSN, CCRN Karen Campbell, Emily Sosnowski, Amanda Ray, Certifications CTICU Critical Care Registered Nurse Margaret has been employed at NMH for 3½ years. She started as a student nurse extern and later transitioned to a PCT role. Margaret obtained her certification in Medical Surgical Nursing in November Megan has worked at NMH for the past 2½ years. She is a preceptor in 16W Feinberg. All three of these nurses are charter members of the Academy of Medical Surgical Nursing chapter at NMH. Their poster titled Putting the Patient at the Center of Care: Using Theory in Practice is based on the patient centered care model and the impact it has had in their unit. In the poster they describe how the PCCM has focused on enhancing communication between the care team and the patient and how it has created an environment where care delivery is individualized and outcomes are attainable. The implementation of the PCCM has led to a decreased fall rate and increased patient satisfaction. A copy of their poster is shown on the next page. 3

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5 November Poll Question Results Which of the following initiatives would be the most helpful to raise awareness and prevention of injuries in your unit/department? 23% 32% 31% 14% Total number of respondents: 366 Debriefing after an injury happens in the unit Posting a monthly injury report in the report room Having a work related injuries discussion in monthly unit/departmental meetings Posting safety reminders (signage) in strategic areas such as the medication rooms, soiled utility rooms, and by the lift equipment, etc. Thanks to those of you who responded to our November Poll Question. This information will be shared with our Nursing Best People and Professional Excellence Committee. It will also be shared with managers and unit quality committees and discussed at unit/department meetings. 5