UPMC St. Margaret Nursing Division Strategic Planning Retreat September 20, 2013

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1 UPMC St. Margaret Nursing Division Strategic Planning Retreat September 20, 2013 Mary C. Barkhymer, MSN, MHA, RN, CNOR Vice President, Patient Care Services & Chief Nursing Officer UPMC St. Margaret

2 Rules of Engagement 1. TITLES/POSITIONS are left at the door. 2. No side discussions. If you need to get information to another person, write it down for later. 3. Everyone s opinion counts. Respect the views of others. 4. Keep your comments BRIEF. No sermons, no grand-standing, no beating the dead horse! 5. We will SEND IT TO THE PARKING LOT if the topic is worthy of revisiting/capturing, but is off topic or off track. 6. Some items will be discussed through Round Robin so everyone participates. 2

3 Goals for Today 1. Review/SMH Nursing Mission, Vision, Values 2. Review Professional Practice Model (RBC) 3. Review of Accomplishments 4. Engaging Nurse Leadership in Accountable Care 4. Cultural Transformation 5. Identify key methods for Nursing Council work redesign to position us for the future. 6. Magnet Site Visit Preparation, Sustainment, 2014 Moving Forward Plan 3

4 Nursing Division Mission, Vision, Values

5 Nursing Mission and Vision NURSING MISSION The Nursing Division supports the mission of UPMC in the delivery of safe, effective quality nursing care in every patient interaction. VISION Nurses transform the patient experience through interprofessional partnerships reflecting excellence in quality and service to our patients, their families and the communities we serve. 5

6 Nursing Values We believe: VALUES Nursing is the art and science of caring established through our professional practice model of relationship based patient centered care. Utilizing transformational leadership to achieve dynamic change and patient satisfaction. Recognizing ethical principles and respecting cultural diversity. Synergistic practice and relationships to deliver state of the art care to our patients. Integrating innovation, new knowledge and technology to support the strategic plan. Nurturing the art of healing, caring and desire to work with the underserved and disadvantaged. Generating empowerment of nurses through shared governance, autonomy, accountability and evidence based research. 6

7 Nursing Strategic Plan

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10 System Priorities Dashboard - July, 2013

11 FY 2013 Major Accomplishments

12 Transformational Leadership A vital presence in clinical areas, Transformational Leadership qualities promote a healthy environment for employees and staff. Promoting teamwork. Encouraging self-esteem. Motivating high levels of performance. Empowering involvement in the development and implementation of policies and procedures. Trustworthiness. Inspiration. Optimistic, positive, encouraging. (Excerpted from Are you a transformational leader? Mary Atkinson Smith, FNP-BC. Published in Nursing Management, September 2011, Volume 42, Issue 9, p 44-50). 12

13 TRANSFORMATIONAL LEADERSHIP FY 2013 Major Accomplishments COMPLETED APPLICATION FOR MAGNET RE-DESIGNATION. Completed construction and successfully opened the Neil Y. Van Horn Pavilion. Completed construction and opened the Geriatric Outpatient Center at Presbyterian Senior Care in Oakmont. Recruited and transitioned two Allegheny Valley practices to UPMC St Margaret (Darrell Petz and Hanzlik, DeFrances and Wang). Market share increased for UPMC St. Margaret by.4% from prior year, while AKMC market share decreased by (.8%). Total market admissions declined by 1,386 or 5.5% during that time period. 13

14 TRANSFORMATIONAL LEADERSHIP FY 2013 Major Accomplishments Successfully managed LOS reduction over the course of the year. LOS under budget for second six months while CMI stayed constant. MedSurg LOS 0.5 days under budget since April 1, Opened dedicated Observation unit April 1. Reduced ALOS on unit from 1.6 to 1.2. Reopened unit August 1 on 6B. Family Medicine Program successfully achieved full five-year accreditation and retained 8 of 12 graduating residents within UPMC St. Margaret. Granted three-year Cancer Program Accreditation with Commendation from the Commission on Cancer (CoC) of the American College of Surgeons. Sponsored Care Transitions Seminar with participation of over 20 Long Term Care Facilities. 14

15 TRANSFORMATIONAL LEADERSHIP FY 2013 Major Accomplishments Achieved Highmark Blue Distinction Center+ for Hips/Knees and Spine Surgery. Sustained surgical robotics program. Achieved Leapfrog recognition with score of A. Implemented No One Dies Alone program. Whiteboard communication. Reprocessing savings of 31K. Consolidated positions/right sizing/mrs. 15

16 Structural Empowerment Structural Empowerment promotes the highest levels of clinical excellence and professional practice. Greater autonomy. A voice in decision making. Fully empowered practice as a professional nurse. Involvement in organizational structure. (Excerpted from Structural Empowerment: Boosting Professional Practice, Sandra Swearingen, RN, PhD, Nurse.com. Accessed April 2013.) 16

17 STRUCTURAL EMPOWERMENT FY 2013 Major Accomplishments COMPLETED APPLICATION FOR MAGNET RE-DESIGNATION. Completed Community Health Needs Assessment process and plan. Implemented expanded focus on Nursing Professional Practice Council participation in community initiatives; increase community benefit by $300K from prior year. To date, Professional Practice Council members have volunteered hours exceeding our target goal of 250 hours for the 2013 calendar year. Shared governance council empowerment. 17

18 STRUCTURAL EMPOWERMENT FY 2013 Major Accomplishments Expanded executive rounding, in-house administrator (IHA) and unit director on call programs. DCOI role. School of Nursing standardized curriculum. Nursing Assistant job description. Implemented updated UPMC Dress Code policy. 18

19 EDUCATION JULY 1, Nurses 176 BSN 28% 35 MSN - 6% 0 DNP/PhD 19

20 Exemplary Professional Practice Magnet organizations actively promote collegial relationships and believe that all members of the healthcare team make essential and meaningful contributions to achieve positive patient outcomes. Professional Practice Model RBC assessment for sustainment. Autonomous nursing practice. Clinical and organizational decision making. Evidence-based care decisions according to unique patient needs using RBC approach. Competency assessment. Peer evaluation. Interprofessional collaboration through relationship building. Comprehensive, coordinated and effective care. (Excerpted from Exemplary Professional Practice: The Core of a Magnet Organization, Craig Luzinski, MSN, RN, NEA-BC, FACHE, Journal of Nursing Administration, February 2012, Volume 42, Issue 2, p ) 20

21 EXEMPLARY PROFESSIONAL PRACTICE FY 2013 Major Accomplishments COMPLETED APPLICATION FOR MAGNET RE-DESIGNATION HAP Achievement Award winner for reducing falls with injury. Worked with UPMC East to ensure support and coverage of administrative (IT, regulatory) and clinical (thoracic surgery, orthopedics, nursing) support during East s first year of operations. The Emergency Department and Ambulatory Surgery exceeded the 50 th percentile target for patient satisfaction scores. Overall patient satisfaction is above the Rehab Network mean for the first six months of Ranging from the 99 th percentile to the 35 th percentile. 21

22 EXEMPLARY PROFESSIONAL PRACTICE FY 2013 Major Accomplishments Achieved maximum points for Highmark Quality Blue P4P initiatives (106 points). Recognized by the Hospital Engagement Network for successful quality outcomes in reduction of falls with injury, pressure ulcers, and readmission of patients with COPD and heart failure. Achieved Joint Commission Primary Stroke Center Recertification and Stroke Gold Plus Quality Achievement Award. Participated in the 2013 National Database of Nursing Quality Indicators (NDNQI ) RN Survey in which we outperformed all benchmarks on all subscales of the Nurse s Practice environment scale. 22

23 EXEMPLARY PROFESSIONAL PRACTICE FY 2013 Major Accomplishments Fine Award finalist. Enhanced and refocused Just Culture program. Recognized in UPMC Spotlight on Safety. Achieved completion and analysis of results for Culture of Safety Survey to help build a stronger culture of safety. Implemented Reliable/Variable Rounder program. Implemented Bedside Shift Report. Reinforced Medication Scanning. 23

24 PRESS GANEY SUCCESSES The Emergency Department and Ambulatory Surgery exceeded the 50 th percentile target for patient satisfaction scores. EMERGENCY DEPARTMENT AMBULATORY SURGERY 24

25 PRESS GANEY SUCCESSES The Emergency Department and Ambulatory Surgery exceeded the mean for patient satisfaction scores consistently over the past six quarters. EMERGENCY DEPARTMENT AMBULATORY SURGERY 25

26 Mean Trends Inpatient UPMC St. Margaret Overall UPMC St. Margaret Displayed by Discharged Date

27 New Knowledge, Innovations and Improvements An ANCC Magnet Recognition Program organization sees itself as a partner in the larger healthcare delivery system. Quest for continuous quality improvement. Improvement in patient care through use of literature, empirical studies, participation with other professionals. Contribution to nursing science and health care science. Journal publication. Professional presentations. Local meeting contributions, unit-to-unit discussions. (Excerpted from White Paper: Component IV: New knowledge, innovations, and improvements. HCPro s Advisor to the ANCC Magnet Recognition Program, August 1, 2009.) 27

28 NEW KNOWLEDGE, INNOVATIONS AND IMPROVEMENTS FY 2013 Major Accomplishments COMPLETED APPLICATION FOR MAGNET RE-DESIGNATION. Enhanced Ethics Program through collaboration with the University of Pittsburgh Consortium. Developed and successfully implemented Project RED pilot, PARTNERS program pilot and Safe Patient Handling program. Developed Nursing Assistant Course and graduated first class of 13 to facilitate skill mix goals for FY14. Accepted for a poster presentation on the COPD Readmission Reduction initiative at the 2013 National Magnet Conference in Orlando, Florida in October. 28

29 NEW KNOWLEDGE NURSING EDUCATION OFFERED 454 HOURS OF CONTINUING EDUCATION PROGRAMS OCTOBER 1, 2012 THRU SEPTEMBER 30,

30 NEW KNOWLEDGE HOT TOPICS Nursing Innovation Summit 2012: Hot Topics in Nursing - March 5, 2012 Attendees: 27 Presenters: 12 Nursing Innovation Summit Fall 2012: Hot Topics in Nursing - October 15, 2012 Attendees: 53 Presenters: 16 Nursing Innovation Summit 2013: Hot Topics in Nursing - August 27, 2013 Attendees: 61 Presenters: 15 RESEARCH Meeting the Challenge of Change: Empowering Nurses through Clinical Research May 24, 2013 Attendees: 92 # IRB Projects: 7 complete; 6 in-progress # Research Fellows: 8 for

31 POSTER/PODIUM PRESENTATIONS POSTER PRESENTATIONS 30 poster submissions - local & national 24 poster submissions accepted PODIUM PRESENTATIONS 8 podium submissions - local & national 3 podium submissions accepted 31