9/9/2013. Aurora Health Care. The Magic of Milwaukee

Transcription

1 ANCC National Magnet Conference October 4, 2013 Orlando, Florida Is Your Professional Development Model Enough? The Evolution of a Novice to Expert Model Session C728 Deborah L. Gentile, PhD, RN-BC Becky A. Pogacar, MSN, RN, NEA-BC Kathleen A. Becker, PhD, RN Aurora Health Care Private, not-for-profit integrated health care provider 31 counties, 90 communities 15 hospitals 185 clinic sites 1,516 employed physicians Largest homecare organization in the state More than 70 pharmacies 30,000 caregivers 1.2 million individual patients treated annually 91,000 inpatient discharges 2 million hospital and outpatient visits 4 million ambulatory care visits $4.3 billion in annual revenue The Magic of Milwaukee 1

2 The shortest way to do many things is to do only one thing at once. Poet, Richard Cecil COMING TO CONSENSUS Existing Model Descriptions No Advancement Model Aurora Development and Advancement Model RN RN Career Ladders A Call for Consensus Career framework to achieve organizational purpose Evidenced based Consistent with the market With standardized components and valid and reliable measures 2

3 Work Group Membership Chair: Dr. Gentile Executive Sponsor: Mary Beth Kingston Shared Governance President Chair of the Nursing Professional Development Council Compensation and Benefits representative Human Resources representative Clinical Nurse Specialists Chief Nursing Officers Ambulatory care representatives Issue Based Information System (IBIS Analysis) A method of organizing vital information to collaboratively solve complex problems and document why certain actions were taken Ensures that informal or unstructured information is not lost during large projects IBIS Analysis: Steps Identify alternate courses of action Record supporting and opposing arguments for each course of action Note what questions of fact are required to prioritize each course of action Create a decision tree Call for consensus should we include? 3

4 Example: BSN Required? If your actions inspire others to dream more, learn more, do more and become more, you are a leader. John Quincy Adams THE CNO ROLE CNO Commitment: Why support a new model? Previous model issues Need for stronger reflective practice Support for professional accomplishments No ease of transfer between hospital sites Variation in advancement expectations between hospital sites 4

5 CNO Commitment: Resources Dedicating financial resources Support for staff work group members Training costs Model costs Dedicating CNO time Model development as a priority Preparing Leadership Engaged leadership for financial support Chief Nursing officer and Director of Human Resources met with nursing Had numerous Professional Advancement Model meetings over the course of two weeks Objective of the meetings was to describe our new model, ask for questions, barriers, etc. Explanation of the pilot, length of pilot and expectations from nursing team Preparing Staff Shared the vision with Shared Governance Committee, nursing leadership, educators and staff nurses Barriers included surprise around mandate to advance to accomplished level identified a clinical nurse champion and invited her to be a member of the ANPAM steering committee 5

6 Change Management Handling transition Prepare Manage Reinforce Retired old model June 2013 Developed pilot- July, 2013 through December, 2013 I have just got a new theory of eternity. Albert Einstein THE NEW MODEL New Model Elements Rationale for elements The clinical narrative Professional accomplishments Maintenance criteria 6

7 Clinical Narrative Allow exploration of decisions, thoughts, and feelings that inform practice Build the skills of reflection Window to critical thinking Domains of practice Characteristics of practice Professional Accomplishments Encourage and verify professional activity beyond direct patient care Reflect what nurses are doing Reflect organizational expectations Categorized by Magnet model components Point system Weighting Maintenance Criteria Every 2 years Review by manager, CNS, Educator Categories aligned with recertification categories Continuing education + professional accomplishments at each level 7

8 The single biggest problem in communication is the illusion that it has taken place. George Bernard Shaw THE COMMUNICATION PLAN Communication Plan Who What Where When How Who: Communication Plan Pilot Sites Nurse Managers and Executives Clinical Nurses Human Resources Non-pilot Sites Nurse Managers and Executives 8

9 What: Pilot Sites / Nurse Executives / Human Resources Model Purpose Advancement Process Model Elements Maintenance Criteria Process Algorithms What: Non-Pilot Sites Background Talking Points When and How? Introduction to the system Chief Nursing Officers Introduction to Human Resources Introduction to the pilot units Introduction to the nonpilot units 9

10 One of the great mistakes is to judge policies and programs by their intentions rather than their results. Milton Friedman THE EVALUATION PLAN Evaluation Plan Pilot evaluation at end of 2013 Ongoing model evaluation after full implementation Warts and all LESSONS LEARNED 10

11 Challenges Work group woes Pilot site issues Compensation and HR issues Managers back in the process Letting go issues Judge a man by his questions rather than by his answers. Voltaire Q & A Contact Information Deborah L. Gentile, PhD, RN-BC Senior Research Scientist Center for Nursing Research and Practice deborah.gentile@aurora.org Becky A. Pogacar, MSN, RN, NEA-BC Director, Center for Nursing Practice and Research Director, Nursing Operations becky.pogacar@aurora.org Kathleen A. Becker, PhD, RN Chief Nurse Executive and Vice President of Nursing Aurora West Allis Medical Center kathya.becker@aurora.org 11