Text-based Document. Preparing Baccalaureate Nursing Students to be Microsystem Leaders. Belchez, Chito Arcos; Martin, David

Transcription

1 The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, researchrelated, and evidence-based nursing materials. Take credit for all your work, not just books and journal articles. To learn more, visit Item type Format Title Authors Presentation Text-based Document Preparing Baccalaureate Nursing Students to be Microsystem Leaders Belchez, Chito Arcos; Martin, David Downloaded 4-Jul :08:53 Link to item

2 Preparing Baccalaureate Nursing Students to be Microsystem Leaders Chito A. Belchez, MSN, RN-BC David Martin, MN, RN University of Kansas School of Nursing

3 Objectives Discuss integration of the CCNE Essentials into the system leadership course. Describe the principles and concepts of system leadership. State how the Donabedian framework was central to design the microsystem leadership curriculum.

4 Faculty Disclosure Faculty Name Conflict of Interest Employer Sponsorship/Commercial Support Chito A. Belchez, MSN, RN-BC None University of Kansas School of Nursing None Faculty Name Conflict of Interest Employer Sponsorship/Commercial Support David Martin, MN, RN None University of Kansas School of Nursing None

5 Background NLN Center of Excellence Designation since 2013 Traditional RN pre-licensure and RN-BSN Program New Shared Curriculum Program Total enrollment in 2016 NCLEX Pass rate Magnet Prepared Generalist Nurse Baccalaureate Big 5 Concept Based Curriculum

6 Kumm, S. & Fletcher, K.A. (2012). From Daunting Task to New Beginnings: Bachelor of Science in Nursing Curriculum Revision using the New Essentials. Journal of Professional Nursing, 28 (2):

7 Big 5

8 Assumptions System Leadership is an integral component of the Baccalaureate Big 5 Curriculum. Integration of the AACN Essentials into the course. Recognition of concepts involved in teaching a microsystem course to undergraduate nursing students. Understanding of how content can enrich an undergraduate nursing leadership curriculum.

9 Nursing Leadership Traditional leadership courses focused on personal skills, communication and delegation. Enhances individuals provider of care ability. Lacking the component of system thinking and system leadership competencies. Incorporate collaborative and team building skills.

10 The Essentials Basic Organization and Systems Leadership for Quality Care and Patient Safety (AACN, 2008) Outcome: 2.1: Apply leadership concepts, skills, and decision making in the provision of high quality nursing care, healthcare team coordination, and the oversight and accountability for care delivery. Outcome 2.3: Demonstrate an awareness of complex organizational systems Outcome 2.6: Apply concepts of quality and safety using structure, process, and outcome measures to identify clinical questions and describe the process of changing current practice

11 The Essentials Basic Organization and Systems Leadership for Quality Care and Patient Safety (AACN, 2008) Outcome 2.9: Apply quality improvement processes to effectively implement patient safety initiatives and monitor performance measures, including nurse-sensitive indicators in the microsystem of care Outcome 2.11: Employ principles of quality improvement, healthcare policy, and cost effectiveness to assist in the development and initiation of effective plans for the microsystem and/or system wide practice improvements that will improve the quality of health care delivery Outcome 2.12: Participate in the development and implementation of imaginative and creative strategies to enable systems to change

12 Conceptual Theme Selection System Thinking Clinical Microsystem Healthy Work Environment

13 Conceptual Theory Senge, Deming & Wheatley: System Thinking Quinn: Small replicable unit (SRU) or microsystem Mohr & Donaldson, 1990: High performing microsystem in health care Batalden & Nelson: Studied patient outcomes and researched ways to improve the design of healthcare systems; translated SRU concepts to healthcare Clinical Microsystem (Nelson et al. 2007)

14 What is a Clinical Microsystem The combination of a small group of people who work together on a regular basis to provide care and the subpopulation of patients who receive that care (Nelson et al, 2007).

15 Clinical Microsystem Self-care system Individual caregiver and patient system Microsystem: Patient, Family, HCP, OHCP

16 Course Development Avedis Donabedian (1982) Framework: 1. Structure 2. Process 3. Outcome

17 Course Development Course Framework: Structure: Structure denotes the attributes of the settings in which care occurs. This includes the attributes of material resources, of human resources and of organizational structure. Process: Process denotes what is actually done in giving and receiving care. Outcome: Outcome denotes the effects of care on the health status of patients and populations.

18 Concepts & Content Structural Elements of Healthy Work Environment Concept: Healthy work environment (HWE) Content includes Conditions of Work Effectiveness (CWEQ) Practice Environment Scale Nursing Work Index (PES-NWI) Essential of Magnetism Nine Essential Organizational Structures Patient s Room: Creating a Structure of Healing and Empowerment Concept: Leadership and Change agent Personal Leadership Style (Blake- Mouton) Becoming an Agent of Change (Rogers Diffusion of Innovation)

19 Concepts & Content Process Elements of Healthy Work Environment Concepts: Leadership, Motivation, Meaningful Recognition, Appropriate Staffing, Healthcare Economics, Standards of Practice Authentic and Transformational Leader Creating a Motivating Climate Meaningful Recognition Principles of Nurse Staffing Nursing Microsystem Financing Practice and Performance in a microsystem

20 Concepts & Content Outcomes Elements of Healthy Work Environment Concepts: Health Policies, Quality Outcomes, Data Management, Microsystem Analysis Employment Issues and Collective Bargaining Nursing Sensitive Quality Indicators (NDNQI) Hospital Quality Core Measures Healthcare Consumers Satisfaction and Experience (HCAHPS) Microsystem Analysis: Putting it All Together Project

21 Learning Environment Framework Structure: refers to the setting in which the collaborative and active learning is provided Process: the actions in interacting, giving, sharing and receiving knowledge Outcome: the impacts of learning on the formation of knowledge, skills and attitude of a professional generalist nurse. Healthy Learning Environment: the condition that sustains a learning and growing high performing team.

22 Learning Environment Simulate Healthy Work Environment Active Learning Team Based Learning Principles (Michaelsen et al, 2007) Class of 104, 14 Teams, 6-7 members Hybrid Classroom Data Analysis and Quality Improvement Scholarly Literature Review Publication through PubMed Commons Nursing Microsystem Analysis Application of Community of Inquiry Model (Swan, 2004) Cognitive Presence Social Presence Teaching Presence

23 Implications Raised awareness of what it takes to create and maintain a healthy work environment. Exposed students to practiced based initiatives that improve patient outcomes. Appreciate the complexity of the relationship between clinical microsystem and the larger systems in which they are embedded. Understanding how the elements of healthy work environment impact quality outcomes in a microsystem.

24 Questions

25 References American Association of Critical-Care Nurses (2005). AACN Standards for Establishing and Sustaining Healthy Work Environment: A Journey to Excellence. American Journal of Critical Care, 14, American Association of Colleges of Nursing. (2008). The Essentials of Baccalaureate Education for Professional Nursing Practice. Washington, DC. Donabedian, A. (1982). Quality, cost, and health: An integrative model. Medical Care 20(10), Kumm, S. & Fletcher, K.A. (2012). From Daunting Task to New Beginnings: Bachelor of Science in Nursing Curriculum Revision using the New Essentials. Journal of Professional Nursing, 28 (2): Michaelsen, L., Parmelee, D., McMahon, K., & Levine, R. (2008). Team-based learning for health professions education: A guide to using small groups for improving learning. Stylus Publishing. Sterling, VA. Nelson, E.C., Batalden, P.B. & Godfrey, M.M. (2007). Quality by Design: A Clinical Microsystems Approach. Josey-Bass, San Francisco, California. Pg. 233 Swan, K. (2004). Relationship between interactions and learning in an online environment. The Sloan Consortium. Retrieved from