8.3 Describe the organization s relationships with educational institutions (including schools of nursing) for consultation and building a collaborative/professional nursing community. The mission of Massachusetts General Hospital (MGH) is Guided by the needs of our patients and their families, we deliver the very best health care in a safe, compassionate environment; we advance that care through innovative research and education; and, we improve the health and well-being of the diverse communities we serve. The dedication to preparing future clinicians through education manifests itself through affiliations with colleges and universities in Boston, and throughout Massachusetts and New England. MGH is a teaching affiliate of Harvard Medical School and is its oldest and largest teaching hospital. Nearly all of the hospital s active staff physicians are part of the Harvard Medical School faculty. MGH is equally committed to preparing future nurses through formal affiliations with a number of institutions. In 2006, MGH was a clinical placement site for 28 schools of nursing and 1,231 nursing students (attachment 8.3.a). The Clinical Affiliation Program is managed through The Norman Knight Nursing Center for Clinical & Professional Development and exemplifies the Department of Nursing philosophy to educate ourselves and to educate others. Students may enter the organization either through group placement with faculty or through precepted clinical placement in which the student is placed with a Staff Nurse, an Advanced Practice Nurse, a Nursing Director, an Associate Chief Nurse, the Chief Nurse, or with a Primary Care Physician. Preceptors may be rewarded and recognized for their precepting activities through vouchers for payment of courses or continuing education programs at the affiliating school of nursing. As with the physician relationships with Harvard Medical School, many members of the MGH nursing and allied health staff hold faculty appointments at local colleges and universities, teaching in both graduate and undergraduate nursing programs. Staff who serve as clinical faculty of MGH bring a unique value to the teaching/learning experience, bridging the gap between what is taught in the academic setting and the realities of the complex patient care environment. Staff are also invited to be guest lecturers or visiting scholars. As the number of affiliations with nursing programs continued to grow, it became evident that it would be beneficial to develop a BSN Advisory Group charged with improving and strengthening relationships with affiliating colleges and universities with baccalaureate programs. The first group convened in February 2005 with representatives from staff and leadership of MGH and representatives from the six colleges and universities with the greatest volume of student placements. The overarching goal of this collaborative group is to advance a culture that fosters and 219
supports baccalaureate education. The Advisory Group meets quarterly to share concerns, thoughts, and ideas for improving student, faculty, staff and patient experiences. Initial meetings focused on the student and faculty experience as well as the resources that MGH had to offer them in the face of rising faculty shortages and growing resource needs. As the group has matured, the focus expanded to allow the Massachusetts General Hospital Department of Nursing to access the expertise of faculty (attachment 8.3.b). One outcome is a collaborative effort between the MGH and academic institutions to host a seminar twice a year for staff who may be interested in serving as instructors or may be currently acting as clinical instructors. Through the Carol Ghiloni Oncology Nursing Fellowship, each year a faculty member from a College of Nursing is selected annually to serve as the Oncology Faculty Fellow. This 10-week rotation exposes the faculty member to the variety of oncologic services throughout the MGH to better inform classroom instruction MGH has also used its affiliations with Schools of Nursing to provide opportunities for staff of MGH to pursue on-site learning through the MGH Institute for Health Professions and Northeastern University or through distance learning through St. Joseph s College in Maine. 220
Attachment 8.3.a CLINICAL AFFILIATION PROGRAM Annual Report 2005 2006 Submitted by: Rosalie A. Tyrrell RN, MS 221
TABLE OF CONTENTS Executive Summary 3 Academic Year 2005-2006 4 Table 1: 5 Utilization of Patient Care Units by Clinical Groups with Instructors (Fall 2005) Table 2: 6, 7 Schools Utilizing Patient Care Units for Precepted Experiences (Fall 2005) Table 3 7 Utilization of Patient Care Units by Clinical Groups with Instructors (Spring 2006) Table 4 8, 9 Schools Utilizing Patient Care Units for Precepted Experiences (Spring 2006) Table 5, 6 10 Utilization of Patient Care Units by Clinical Groups with Instructors (Summer 2006) Schools Utilizing Patient Care Units for Precepted Experiences (Summer 2006) 222
EXECUTIVE SUMMARY: This academic year, we have continued to accommodate most requests for clinical placements. There was an increase in the number of students placed at MGH this year. A total of 1,231 students (for an estimated 86,267 hours) were placed during AY 2005-2006. Associated Activities: BSN Education Advisory Group:] o Meeting quarterly o Recommendation: course coordinators to meet with unit leadership prior to the end of group clinical rotations o Discussion re: strategies to support interested and present new instructors o HR Recruitment Event in January 2007 for internal candidates. Event for internal and external candidates will be planned for end of January 2008. Contract Management Proposal o Developed proposal with recommendations for a more efficient, cost-effective process. Resubmitted for consideration in March 2007 Database Pilot o Boston College, Simmons and Curry were pilot schools. Issues included: The initial entry of requests for clinical placements to an Excel spreadsheet was considered to be very labor intensive by the schools. There were changes in individuals at the schools who submitted the requests and therefore, the spreadsheet was not used. The Database Manager in the Knight Nursing Center, to whom the data on the spreadsheets was sent for entry into a database transferred into another department. Given increased requests for student placements, capacity management, as it relates to students, will be an increasingly important issue to monitor and address. Issues to consider/explore: Criteria for increasing capacity Additional areas for student placement How students might be spread out to maximize optimal capacity for students, staff and patients Presently, student placements from the four Associate Degree Programs have been suspended for the AY 2007-2008. A decision will be made at that time as to our ability to accommodate these students. This difficult decision was made in response to the increase in requests for placements from BSN and Accelerated Bachelors and Masters Programs. 223
ACADEMIC YEAR 2005-2006 Number of Schools of Nursing That Utilized MGH for Clinical Placements: 28 Number and Type of Program: Number Type of Program 12 Graduate and NP 17 BSN 3 AD 2 PCA Number of Schools Utilizing Patient Care Units For Clinical Experiences With Instructors: 12 (Table 1, 3, & 5) Number of Students Per Unit with Instructors: 6-9 Number of Schools Utilizing Patient Care Units for Precepted Clinical Experiences: Total: 23 Units Providing Preceptors: (Table 2, 4, & 6) Number of Precepted Students (Estimate): ( 149 Undergraduate students, 82 graduate students and 3 PCA students) Total: 234 students Number of Students Placed in Groups with Instructors: 997 Total number of students placed for 2005-2006 (estimate): 1, 231 SUMMARY of AY 2005-2006: Students with instructors: Hours: Precepted students: Hours: Fall 2005: 494 22, 747 81 11, 799 Spring 2006: 420 21, 114 143 22, 663 Summer 2006: 83 1, 474 10 1, 470 Sub-totals: 997 50, 335 234 35, 932 TOTAL # OF STUDENTS PLACED: 1, 231 TOTAL # OF HOURS: 86, 267 (estimate) 224
Table 1 Utilization of Patient Care Units by Clinical Groups with Instructors Fall 2005 School Units # of Students Hours IHP: MSN (generalist) See attachment. 113 11, 493 Boston College: BSN + Accel. Masters Entry Pgm. Northeastern: BSN Wh. 8, Ellison 16, 19 Big. 14, Blake 13/14 Blake 13/14, PH22, Big. 11, White 10 56 892 37 252 Simmons: BSN White 7, 9, 11, Ell 12, Big. 7, 13, 14 65 1200 Salem State: BSN Ell. 18 13 156 U Mass Boston: BSN PH 20, Ell. 17, 6 30 588 Curry College: BSN PH 22, White 10 14 168 LMH: ASN Wh. 8, 12, Ell. 7, 12, 18 81 6, 355 Quincy College: AD White 8 11 172 Roxbury CC: AD White 9 24 (2 189 groups) Rox CC + SRH Ellison 6 15 174 Regis: Generic Masters + BSN PH 22, Ell. 18 35 216 Total: 494 22, 747 225
Table 2 Schools Utilizing Patient Care Units for Precepted Experiences Fall 2005 Schools Students Unit Hours Boston College 6 BSN 720 NICU,Ell. 14, 17. 18, OR, White 12 3 NP MBG. Big. 14, Community HC 240 5 MSN/CNS Ell. 13, 12, White 9, 11, Big. 11, PH 20, 930 U Mass Boston 13 BSN 3 MSN PH 22, Ell. 8, 12, 14, 9, Wh.6, 7, Blake 7, ED Blake 8, PICU, SICU 1820 120 1 NP Women s Health 225 Regis 1 NP E. Boston HC 120 Simmons 4 Accel. Masters 4 BSN White 7, 10, Blake 14, Ellison 18 Big. 11, 13, Blake 7 1344 Northeastern 7 Direct Entry Masters White 7, ED, Ellison 9, 16, Blake 8, 13 1008 6 NP Ell. 11, NICU, Cardiol., Wound Clinic, Wht. 8 & 10 984 IHP 18 NP See attachment 2308 226
U of New Hampshire 4 Direct Entry Masters 1 NP Big. 14, Ell. 12, Cardiac Rehab, Blake 13 Ellison 11 736 112 U of Southern Maine 1 BSN Blake 7 154 U Mass Worcester 3 MSN Blake 7, 8, Ell. 810 10 U of Wisconsin 1 Accel BSN on line White 10 168 Total: 81 11, 799 Table 3 Utilization of Patient Care Units by Clinical Groups With Instructors Winter/Spring 2006 School Units # of Students Hours IHP: MSN (generalist) See attachment. 77 9, 702 Boston College: BSN + Accelerated Masters Prog. Simmons: BSN + Accelerated students Wh. 8, Big. 7, 14, Ell. 16, 17, 18, 19, Blake 13/14 Big. 7, 12, White 6, 11, 9, Ell. 12, 18 57 1, 020 54 1288 Salem State: BSN Ellison 18 13 320 U Mass Boston: BSN PH 20, Ellison 17, Blake 11, Ell. 6 34 594 Curry College: BSN & Acccel PH 22, White 10 29 458 Northeastersn: BSN Ell. 16, Big. 11, PH 21, Blake 13/14 40 624 Regis: BSN + Generic Masters White 6, 9, PH 22 20 438 LMH: ASN Wh. 12, Ell. 7, 12, 17 70 6, 210 227
Roxbury CC: AD Big. 7 14 210 Quincy: AD White 8 12 172 Total: 423 26, 114 Table 4 Schools Utilizing Patient Care Units For Precepted Experiences Winter/Spring 2006 Schools Students Unit Hours Boston College 7 BSN 840 6 Accel. Masters Blake 14, ED, Ell. 6, 17, 18, 19, Blake 11 Blake 11, 7, Ell. 7, 11, 13, 14 672 6 NP 4 MSN/CNS BMG, Ell. 11, Wound Clinic, Chelsea HC, Pedi Surg, Big. 11, Oncology, surgery, Gillette Ctr., Ell andwhite 12, Ell 16 Big. 11, Oncology, Ell/Wh. 12, Ell. 16 852 781 Northeastern 27 BSN ED. PICU, El. 9, 10, 13, 17, 18, 19, 11, Blake 7, SICU, White 8, Blake 4, Big. 11, PACU, Glake 14, 12, 8, NICU, Big. 13 4860 1 RN to BSN 7 NP 1 MSN/ Admin. Blake 8 Hospitalist Team, Trauma, El. 11, Blake 8, IMA White 8/10 40 802 120 IHP 15 NP See attached. 1916 U Mass Boston 10 BSN Big. 11, El. 11, 12, 16, PH 21, White 6, 7 1400 2 MSN/CNS Blake 7, 11, Ellison 12 118 228
U Mass Lowell 5 BSN Blake 7, 14, El. 7, 10, 17 1080 Curry 4 BSN Wh. 8, 11, El. 12 640 Simmons 9 BSN Ell. 8, 9. 17, 18, 1344 19, 12, ED, 6 NP Big.13 704 MGH Downtown, Cancer Ctr., Revere HC, Breast Ct., Walk-In, Thoracic Oncol. U Mass Worcester 1 NP Blake 8 270 U Mass Amherst 5 2 nd Bachelors El. 7, 11, 9, 18 1600 U Mass Dartmouth 5 BSN Ell. 11, 12, 18, SICU, Blake 8 480 St. Anselm 2 BSN SICU, PH 22 392 Boston University 1 Nurse Midwifery OB 900 229
U of Vermont 3 BSN ED. Blake 12, Wht. 13 Endicott 4 BSN Big. 11, El. 11, 12, Blake 8 378 704 Regis 1 MSN Pedi CNS 80 Salem State 2 MSN ED, Knight Nsg. Ctr 240 Emmanuel 1 RN to BSN Neuro Out-Pt. 96 U of New Hampshire 3 BSN 1 MSN Ell. 16, Blake 14 Blake 14 882 112 Yale University 2 NP Gillette Ctr., GI Cancer Ctr. 360 Total: 140 22, 663 Table 5 Utilization of Patient Care Units by Clinical Groups With Instructors Summer 2006 School Units # of Students Hours Regis: Generic MSN Ellison 17 18 262 Simmons: BSN + Direct Entry Ellison 18 22 288 Curry: Accel. BSN Pgm PH 22, White 10, Ell. 17 15 324 Roxbury CC: AD Ellison 6 16 420 Quincy: AD White 8 12 180 Total: 83 1474 230
Table 6 Schools Utilizing Patient Care Units For Precepted Experiences Summer 2006 Schools Students Unit Hours Fitchburg State 1 MSN PATA 60 IHP 3 NP See attached 322 Simmons 1 NP OB/GYN 48 U Mass Boston 2 NP NE Health Ctr, Hematology 130 U of Southern Maine 1 BSN Ell. 14 154 Johns Hopkins 2 BSN Ell. 12, 19 420 BHCC 3 PCA Wh. 7, Big. 7, Ell. 7 336 Total: 13 1470 231
Attachment 8.3.b Massachusetts General Hospital The Norman Knight Nursing Center for Clinical and Professional Development BSN Education Advisory Group April 2007 Background: The college relations subgroup of the BSN Nursing Operations Committee recommended the development of an Advisory Group with the overall goal of improving and strengthening relationships with affiliating colleges with baccalaureate (BSN) programs. Membership: MGH: Keith Perleberg, Nursing Director PH 20 & 21 Marita Prater, Nursing Director White 8 Marian Jeffries, CNS Ellison 19 Mary Lou Kelleher, CNS Ellison 17 & 18, Pedi Denise Morelli, Staff Nurse PH 22 Ann Eastman, Staff Nurse Bigelow 14 Michele Andrews, Human Resources David Pattison, Human Resources Rosalie Tyrrell, Professional Development Coordinator, Chair School representatives: Karen Hall, Placement Coordinator Boston College Emily Olmstead, Placement Coordinator Simmons College Terry Buttaro, Instructor Simmons College Patricia Ciarleglio, Placement Coordinator Regis College Steve Alves, Placement Coordinator Northeastern University Linda Tenofsky, Placement Coordinator Curry College Heidi Wallace, Placement Coordinator U Massachusetts Boston Meetings: Quarterly Summary of activities to date: In the first meeting on February 17, 2005 the following goal and charges were developed: o Overarching Goal: Advance the culture that fosters and supports baccalaurerate nursing education. o Charges: 1. To insure quality and safety of the clinical practice learning environment 2. To establish recommendations for recruitment of BSN student graduates 232
Attachment 8.3.b continued Best practices: Denise Morelli brought this issue to the Staff Nurse Advisory Group; examples of best practices were shared by staff: o One unit puts up a large Welcome sign to welcome students to the unit o Some staff receive an e-mail informing them when student groups will be coming to their unit o Welcome breakfasts held with staff and the hosted student groups o Students receive orientation welcome packets Evaluation of student and faculty experiences: suggestion that course coordinators meet with unit leadership prior to the end of the clinical rotation for a mutual discussion of what worked, ideas for improvement, etc. Welcoming and orienting students (i.e.: Ellison 19: New Student Information Packet (shared with CNS group), PH 20 & 21: Welcome and feedback meetings with students and faculty) Support for new instructors at MGH: o Strategies to make teaching/faculty opportunities known to staff o Seminar in Clinical Instruction to be collaboratively developed and offered starting in Fall 2007 Recruitment Events: o HR sponsored a career workshop for MGH employees enrolled in a nursing program and plan to graduate in May 2007. Held in January 2007. o HR will hold a similar event for external candidates at the end of January 2008 System for granting students/faculty access to locked areas on units: in discussion with Police and Security Up-dated school affiliates to new system of students/faculty obtaining computer access directly on units via Password Self Help Rosalie Tyrrell, RN, MS Chair, BSN Advisory Group April 2007 233
Attachment 8.3.b 234
Attachment 8.3.b continued 235