Cultivating Nurse Engagement With Shared Governance. American Hospital Association Annual Conference-2018

Transcription

1 Cultivating Nurse Engagement With Shared Governance American Hospital Association Annual Conference-2018

2 OBJECTIVES Each attendee will understand value and connection between Nurse Engagement and Shared Governance Each attendee will learn strategies for successfully implementing a Shared Governance structure in your rural organization Each attendee will leave with examples of nurse driven quality projects that spark enthusiasm

3 Adirondack Health ~ A legacy of healing The only full service health system in the 6 million acre Adirondack Park A family of facilities and individuals who have provided care to the region for over 100 years The largest private employer with over 800 employees and a $145 million annual impact on the local economy

4 CNO #1 Retention-Recruitment-Engagement Without Sustainable Change = Increased Costs Automatic salary increases

5 Nurse Engagement - What Do they Want? Five Generations of Nurses Working Together Geographic location is key to many Onboarding process-orientation: is it hardwired? Preceptor Mentor: are programs in place? Flexible Scheduling & Adequate Staffing Communication & Transparency Culture & Empowerment Equipment & Technology Salary and Benefits Tuition reimbursement Training and Education Life Long Learning Shared Decision Making - Governance

6 Environment at the Bedside Open Communication & Transparency Appreciation & Gratitude Supportive of Professional Advancement Work-Life Balance Humor at Work Its ok to laugh Its ok to have fun A Culture They Desire

7 Engagement Things you shouldn t do in your daily interactions with staff: Micro-mange them Appear disorganized Hold back information from them Not be present in the moment Letting people get away with things Be disengaged Not personally greeting others or smiling Not listening to them Not demonstrating caring or compassion Remember. What you permit you promote!

8 Key Attributes of the Engaged Nurse Inspired to do their best work Personally motivated to help the organization be successful Work ethic goes above and beyond to exceed the expected level of effort Demonstrates energy and innovation A supportive work environment is as important as your staffing levels if you can achieve this: Satisfied - Energized - Productive Nurses

9 How Did We Promote Engagement? Through the Development of Shared Governance

10 What do you need to be successful? Committed Nurse Executive C-Suite Support Staff Education and Involvement Strong and Committed Leadership Team Change Hardiness Modeling Research & time for Council Development- Bylaws, Charters, Philosophy, Logo.

11 Committed Nurse Executive

12 C-Suite Support Do they understand what nurse engagement means to the organization? Do they recognize the value or costs to the organization if they don t?

13 Educate, Educate, Educate You can NEVER provide too much Education to: The Board The C-Suite The Leadership Team The Staff

14 What Does Your Current Environment Look Like? Nursing Leadership Structure When was the last time you really looked at it? Competent & Engaged Advanced Education or Specialty Certification Trusted & Respected Change Hardy The best prediction of the organization s performance: Quality & Safety & Overall Patient Care Experience Operational Performance Financial Metrics

15 High Functioning Nursing Leadership Team Positive & Proactive Supportive Team Climate Daily Huddles GLAD Technique Clarity of Vision & Future Appropriate Skill Mix Mutual Respect Visible via Rounding

16 Shared Decision Making; What Does That Mean? What it is: Partnership Interdependence Autonomy Empowerment Engagement Equity-Accountability-Ownership-Negotiation What it is NOT: Self-Governance-Hierarchical-Anarchy-One Person Rule Blaming or Independence

17 Shared Governance is Raising the Bar When implemented and utilized effectively Nurses using their voice means: Accountability Responsibility Involvement to drive change Expectations Culture Change Improvement Ready EBP Having Pride in accomplishments Personal & Professional Satisfaction Building a foundation of CHANGE

18 Foundation & Structure You must research, build & implement: Organizational Structure & Foundation Professional Practice Model Evidence Based Best Practices Scope of Services Defined Shared Governance Structure, model, bylaws, etc. Growth & Development Advancement Structures ANCC Pathway to Excellence Evaluation & Assessment

19 Developing Council Bylaws Charters, etc. The development of bylaws, charters & standardized tools are key to your success

20 Organizational Chart Shared Governance Patient Care Services Executive Council Main Governing Council Nurse Practice Council Education & Professional Development Council Technology & Information Council Recruitment & Retention Council Quality Assurance and Performance Improvement Council Developed Fall 2014 Revised 1/17

21 Our Shared Governance Structure

22 Shared Governance Success Stories QLIQ Secure Texting Nursing Grand Rounds Grow as a Professional Day Preceptor & Mentor Programs Nightingale Nurse Recognition Program Rapid Response Revision and Debriefment Tool Nursing 5K-fighting Childhood Obesity Unit-Based Competencies Streamlined Nursing Documentation

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24 Organizational Successes & Outcomes Demonstrated Improvements Include: Increased Patient & Nursing Satisfaction Decreased Nurse Turnover Increased New Grad Retention Do No Harm - NDNQI Results - VBP Increased Cost savings due to all of the above Laid Groundwork for ANCC Pathway To Excellence Journey

25 ZERO HARM IS OUR GOAL DO NO HARM IMPROVMENTS

26 Adirondack Medical Center 2017 HCAHPS Summary Report 90% 80% % Top Box 70% 60% 50% Rate hospital Recommend the Comm w/ Nurses hospital Response of Hosp Staff Comm w/ Doctors Hospital Environment Pain Management Comm About Medicines Discharge Information Care Transitions Global Comparison Domain Comparison You All DB Small PG DB All PG DB Inp. NY Listing

27 Beyond the Bedside

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31 Encourage & Embrace Life Long Learning New York State BSN in Ten Through Tuition Assistance, Grant Funding, Scholarships & Commitment.. Our Nursing Staff has embraced: Advanced Degrees Clinical Ladders Specialty Certifications Professional Organizations

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33 If You Remember Nothing Else.. Be patient, especially the first year when building the foundation and structure There will be setbacks, don t get discouraged Know that consensus may be painful Celebrate the successes, even the small ones Think Like A Futurist Harness the spirit of discovery, the power of imagination, innovation and the collective energy of those around you.

34 CELEBRATE

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36 Questions? Linda McClarigan MSHA, BSN, RN, BC-NE CNO & VP Patient Care Services Adirondack Health Saranac Lake, New York Office:

37 References Grant, Rebecca (2016, February 3). The U.S. is Running Out of Nurses. The Atlantic Kerfoot, K. (2015). Four Measures That Are Key to Retaining Nurses. Hospitals and Health Networks Kutney, et.al (2016). Nurse engagement in shared governance and patient and nurse outcomes. JONA: The Journal of Nursing Administration, 46(11), doi: /nna Press Ganey. (2015). Nursing Special Report: The Influence of Nurse Work Environment on Patient, Payment, and Nurse Outcomes in Acute Care Settings Sawatzky, J. A., & Enns, C. L. (2012). Exploring the key predictors of retention in emergency nurses. Journal of Nursing Management, 20(5), Swihart, D., & Hess, R. (2014). Shared Governance: A Practical Approach to Transforming Interprofessional Healthcare (Third Ed.). Danvers, MA: HCPro. Schaufenbuel, K. (2013). Powering your bottom line through employee engagement. UNC Kenan-Flagler Business School. Retrieved from: the2015 National Healthcare Retention & RN Staffing Report (NSI Nursing Solutions, 2015).