Shared Governance Redesigned by the Frontline Presented by:

Transcription

1 Shared Governance Redesigned by the Frontline Presented by: Tina V. Lindig, MSN, RN, NE-BC David Bates, BSN, RN, CCRN Rosie Friend, BSN, RN T RUMAN M E D ICAL C ENTERS 1

2 Truman Medical Centers Two hospital system serving Jackson County, MO Hospital Hill & Lakewood Academic medical center & safety net hospital Primary teaching hospital for UMKC School of Medicine Level I Trauma Center & Level III NICU 413 licensed acute care beds 226 average daily census 107,328 ED visits 333,076 outpatient visits $130,982,738 uncompensated care Magnet aspiring hospital

3 Nursing Demographics CY 2013 Employees 4,225 Registered Nurses: 1207 Direct Care RNs 904 Direct Care RN with BSN % 514 = 57% Direct Care RN with Certification 116 Licensed Practical Nurses 67 RN Turnover 9.8%

4 TMC Professional Practice Model (PPM) T RUMAN M EDICAL C ENTERS 4

5 Objective Describe the redesign process for shared governance at Truman Medical Centers T RUMAN M E D ICAL C ENTERS 5

6 TMC Shared Governance - Original Model NURSING PRACTICE Policy & Protocol Clinical Ladder Transformation of Care IBPR PPC NURSING QUALITY Falls Wound Care Pain Breastfeeding NEC & COORDINATING COUNCIL NURSING PROFESSIONAL DEVELOPMENT Recruitment & Retention ADVANCED PRACTICE NURSE COUNCIL EVIDENCE BASED PRACTICE & RESEARCH T RUMAN M EDICAL C ENTERS 6

7 Over time. Interest waned Participation fluctuated Staff leadership as chairs - minimal T RUMAN M E D ICAL C ENTERS 7

8 Why Change? Too many meetings Timing of meetings Low staff nurse participation Desire to focus on campus specific issues Information meetings vs. working meetings Desire to really work on real time practice issues Nursing leaders still leading meetings T RUMAN M E D ICAL C ENTERS 8

9 Your Shared Governance Redesign Team T RUMAN M E D ICAL C ENTERS 9

10 Redesign Seven (7) off site meetings Right people should create new model One-size does not fit all Corporate structure Hospital structure Staff driven decisions Evidence-based practice Bylaws Leaders facilitate T RUMAN M E D ICAL C ENTERS 10

11 3 Layered Shared Governance Unit Based Councils (UBC) Hospital Based Councils (HBC) Corporate Coordinating Council (CCC) T RUMAN M E D ICAL C ENTERS 11

12 Information & Communication Flow Original Drawing 2012 T RUMAN M EDICAL C ENTERS 12

13 Meeting Framework based on the 5 domains from TMC PPPM Hospital Based Councils (HBC): Hospital Hill & Lakewood Care Delivery Quality Professional Relationships Professional Development Shared Governance Frontline RNs from all clinical areas attend the HBC 2012 T RUMAN M EDICAL C ENTERS 13

14 Corporate Coordinating Council (CCC) 2012 T RUMAN M EDICAL C ENTERS 14

15 2012 T RUMAN M EDICAL C ENTERS 15

16 What s New? Streamlined meeting structure Designed by frontline nurses PPM driving force Working Meetings Hospital-based councils (HBC) focus on campus specific issues Coordinating council has the right number and mix of clinical nurses from both campuses Access to CNO during Coordinating Council T RUMAN M E D ICAL C ENTERS 16

17 Living in the new model: My experience as chair T RUMAN M EDICAL C ENTERS 17

18 Communication T RUMAN M EDICAL C ENTERS 18

19 Initial Outcomes Communication Tools Recognition & Retention Survey Oct 2013 Top 10 suggestions Implementation Certification Focus Group Certified Nurses Day Recognition Campaigns Leadership development for current SG members Teamwork Group Dynamics T RUMAN M E D ICAL C ENTERS 19

20 In Summary T RUMAN M E D ICAL C ENTERS 20

21 References Ballard, N. (2010). Factors associated with success and breakdown of shared governance. The Journal of Nursing Administration, 40 (10), Dunbar, B., et al (2007). Shared governance: Making the transition in practice and perception. The Journal of Nursing Administration, 37(4), George, V. & Haag-Heitman, B. (2010). Beginning the design. Guide for establishing shared governance, (pp ). Silver Spring, MD: ANCC. T RUMAN M E D ICAL C ENTERS 21