The key to achieving a highly engaged workforce is supporting professional development of the individual RD/RDN/DTR.

Transcription

1 Susan Konek, MA, RD, CSP, LDN, CNSC, FAND The Children s Hospital of Philadelphia The key to achieving a highly engaged workforce is supporting professional development of the individual RD/RDN/DTR. Opportunities for individual growth can support employee motivation and satisfaction. Job Descriptions based on the Academy s SOP/SOPPs provide clear criteria for advancement empowering individual and team Integrate Standards of Professional Performance into job descriptions that support the individual s growth. Utilize job descriptions that provide a path to increased staff engagement and team achievement. Consider a Clinical Ladder to support professional development. Discover opportunities that support team development in any economic setting. 1

2 Professional Development is driven by the individual! Support from your organization will enhance or limit what can be achieved. Enriching experiences in the work we do can be included in all settings. Base your department mission on the hospital mission. Vision and goals provide a line of sight to the work of the department. Department Mission and Goals support achievement of hospital goals Strategic plan and hospital Operating Plan - guide development of short-term goals 535 bed Pediatric Teaching Hospital Main Campus Inpatient and Ambulatory Center 31 Primary Care practices 13 Specialty Care and Ambulatory/Surgery Centers in PA and NJ - RDs active in 7 centers 60 RDs (53 clinical FTEs) support inpatient and outpatient clinical services The Children's Hospital of Philadelphia, the oldest hospital in the United States dedicated exclusively to pediatrics, strives to be the world leader in the advancement of healthcare for children by integrating excellent patient care, innovative research and quality professional education into all of its programs. 2

3 Supports the hospital Mission Integrating excellent patient nutrition care, participation in innovative research and quality professional education into all of our programs An interdisciplinary team approach Individualized patient care that reflects current nutrition knowledge and research; Effective education of patients, families, healthcare professionals, students and the community Leadership in pediatric nutrition through diverse and multifaceted roles as clinicians, researchers and educators; promotion of the role of nutrition and the profession of dietetics in the hospital and community, as well as nationally and internationally; achievement of personal and professional growth through networking, continuing education and research. set the path for the achievement of organizational goals provide a step wise increase in responsibility with increasing expertise provide opportunities for an enriched work experience provide the foundation of employee engagement All lead to an empowered Clinical Nutrition team Key Resource: Academy of Nutrition and Dietetics- Standards of Practice/Standards of Professional Performance from Novice through Advanced levels in Pediatrics SOP in Nutrition Care SOPP for RDs Ensure competency of food and nutrition professionals (Academy 2013, Peds 2009) 3

4 Provide standards for the responsibilities outlined in job descriptions - What is expected at each level State expectations for expertise for advancement Provide a framework for individual development - Identify the skills to be developed. - Provide information to structure the Academy s Professional Development Portfolio. Definition of levels for Pediatric Dietitian Generalist: 1) Novice within 3 years of credentialing & practice experience in pediatric nutrition or 2) Generalist experience in several areas of practice no pediatric experience Specialty: has acquired practice experience in pediatric nutrition Advanced Practice: extensive knowledge and skill in pediatric nutrition care and is considered an expert within work setting and community (local and national) (ADA 2009) Assesses dietary intake for factors that affect health and conditions including nutrition risk - 1.1A Assesses adequacy, appropriateness, and modality of usual dietary pattern or nutrient intake (ie, usual dietary pattern includes adequate amounts of foods and nutrients) All levels Close agreement would be expected to specify the job requirements 1.1A1 Compares to established guidelines, given developmental stage, physical activity level, consults with health professionals, if needed (eg, out of the scope of practice) All Levels 1.1A2 Incorporates effects of health condition(s) and outside influences on dietary intake and estimated needs; identifies a need to transition from one modality to another; seeks additional information (eg, types and amounts of foods offered,, timing of meals/snacks/feedings, feeding-related behaviors) Specialty and Advanced Level 1.1A3 Identifies the need to tailor data collection based on health condition history and present state; identifies a need for transition and identifies factors that might influence the plan (eg, feeding skill level, economic factors, and expected outcomes to encourage the development of feeding/eating skills, as appropriate Advanced Level 2012 Revision of SOP/SOPP Standards and indicators reflect minimum competent level of nutrition and dietetics practice and professional performance for RDs Four Standards related to four steps in Nutrition Care Process (2013 JAND) 4

5 Be in alignment from Novice through Advanced levels Be specific to your organization Fuel the desire to advance! Patient Care Nutrition Education Business Functions Professional Development Progressive advancement in expertise and development as well as expectations in each advancing levels. Requirements for relevant certifications, graduate work with higher levels Completes initial and follow up nutrition assessments, determine nutrition diagnosis, plans interventions, monitoring and evaluation Attends and participate in appropriate service rounds, unit rounds and patient care conferences Performs daily operational tasks, including review of diet, PN and NPO lists and calorie counts Works cooperatively with foodservice staff to assure diet prescription is met Participates in departmental projects or research Same criteria with these additions: Actively participates in appropriate service rounds Takes a leadership role in multidisciplinary services and functions as the nutrition expert in a specialty area of pediatric nutrition Maintains pediatric and specialty expertise through critical interpretation and evaluation of current research Develops and leads department or specialty service nutrition projects or research Attends appropriate continuing education to maintain professional credentials and expand knowledge and skill. Develops and implements an individualized plan for professional growth and development - participate in professional organizations and activities, workshops, seminars and staff development programs. Maintains CDR Professional Portfolio by completing 75 CEU s per 5 year period - meets requirements for Pennsylvania L.D.N. 5

6 Same as level I plusi plusparticipates or leads institutional or professional organization committees related to pediatric nutrition or subspecialty area. Authors/publishes abstracts, book chapters, newsletters or journal articles that are peer reviewed. Presents in a variety of venues. Assume leadership role in areas of professional development within Clinical Nutrition. Share expertise with others Why should you write? Great way to increase your own expertise! Serve in leadership roles in areas of specialty Academy EAL, DPGs, Affiliates - also ASPEN and its local chapters Lead institutional committees Such as NICU Nutrition CQI Serve patient care team as the nutrition expert All support our Mission and that of the Individual! Staffing structure with multiple job levels Greatly desired as an means of recognition and reward for achievement Can be a high level motivator A statement of administration s recognition and value for the work group and job satisfaction of the individual Is a structured plan for Professional Development 6

7 Clinical Ladder explored in the 1990 s Staff wanted the ladder for: - Recognition and reward A path to advancement - Support for job satisfaction Retain experienced staff members decrease turnover Support job satisfaction, enrich our work place and increase engagement a happy work force! Support staff as they develop their strengths Provide manpower to accomplish much needed work at a level not possible by management alone 2006 Management Change Clinical Nutrition became a hospital department Three Level Clinical Ladder was in place at time of transition to the hospital 2007 Level IV Clinical Nutrition Specialist - Opportunity to bring diversity and leadership into Clinical Nutrition Literature review Survey of clinical ladders through network of pediatric hospitals Review of Clinical ladders at CHOP- Nursing, Occupational Therapy and Speech Therapy Ad hoc staff group studied and made recommendations (In 2009 Konek) 7

8 Financial Support additional staff approved Define the positions that were most needed Define the number of positions - Six Develop a formal application process Recruit candidates from Level III RD pool Nutrition Support Service Coordinator Education and Training Specialists Performance Improvement Specialist Technology Specialist Internet/Intranet Publication Specialist Internship/Student Coordinator EMR Specialist Community Nutrition Liaison Many benefits for individual and department Opportunity to have variety in the job Opportunity to develop leadership skills Work that is thoroughly enjoyed! Donna.megan.beth Support succession planning! Manpower for all this work! 8

9 2003 Joined CHOP as Level II RD, promoted to Level III in Internship/Student Coordinator Level IV position developed. Donna selected. Strong development of this new program - Development of preceptor education including Academy Preceptor training for all staff - Engaged all staff members in active support of interns and students Member of PNPG DPG and Nutrition and Dietetic Educators and Preceptors DPG Functions as nutrition expert to Neuromuscular Team Presentations on Neuromuscular Disease nutrition Peer-reviewed publications in Topics in Clinical Nutrition, ICAN, ASPEN, PNPG Building Blocks and Behavioral Health PG Newsletter Academy Leadership Modules - completed Now enrolled in graduate program in Organizational Leadership 2011 Joined CHOP as Clinical Dietitian II Skilled RD in Specialty Level as a relief dietitian. Trained in many specialty areas, NSS, Lipid Heart Team CHOP Leadership -Career Resource Group & Shared Governance Active in intern education presented at Class Day Professional (2011 present) Active in Philadelphia Chapter of ASPEN President PNPG Building Block For Life article Pediatric Inflammatory Bowel Disease (2013) co-author Enrolled in MS Nutrition Education program 2005 Joined CHOP as Level II Renal RD 2009 Promoted to Level III Interest in Communication and Media 2009 Present Leads Clinical Nutrition Media Team Academy Social Media Boot Camp 2012 Academy Representative Pediatric Malnutrition Workgroup 2012 Pediatric Nutrition Expert Philly.com 9

10 Numerous Publications : Topics in Clinical Nutrition, Pediatric Gastroenterology and Liver Disease, ASPEN Peds Core Curriculum. Nutrition in Clinical Practice Clinical use of probiotics in the pediatric population 2009 Presentations: ASPEN Clinical Nutrition Week (2009, 2013) PNPG Symposium 2013 Social Media 2013 Enrolled in MA in Communications program Recognition of high level expertise in specific area of pediatric nutrition Parallel position to Level IV Specialist RDs Position based on Academy s Definition and Criteria for Advanced Practice 2011 Approval for six RDs at this level Hire well. Hire people with excellent potential for development as well as strong experience! Discuss Job Descriptions in detail when interviewing candidates Clearly define expectations all must be known when you have a clinical ladder. All advancement is based on Achievement! Support the process Requires thoughtful coaching that builds on individual talents and interests Coaching for opportunities to support growing expertise Coaching on opportunities to become involved in and then to lead professional organizations Coaching on ways to share expertise at CHOP and in the profession 10

11 Employee Satisfaction Surveys Excellent staff retention Engagement Survey high score for Clinical Nutrition 87% Engaged or Content! Stay Interviews Why do you stay? results include: - like the opportunity to grow and develop - Love the variety in our work The Stay Interview is a tool to increase levels of employee engagement and motivation. Stay interview questions focus on how the employee feels about his/her job, level of job satisfaction, and career aspirations. Stay interviews are used to engage employees in a robust dialogue, build one-to-one relationships, and promote a genuine sense of appreciation. When conducting a Stay Interview, ask the employee to meet you in a neutral setting like a comfortable conference room or cafeteria. Create a safe and trusting climate. (Finnegan 2010) What are the things you like about your work? What is it that keeps you here? What makes for a great day at work? What is something new you would like to learn this year? Is there anything you d like to change about your job? Are there things you would like to change about your team or department? Are we using your talents? Fully? What is one thing that would make your job more satisfying and rewarding? Do you feel supported in your career goals? Do you feel we recognize you? What kind of recognition would be meaningful for you? Individual development allows enhanced enjoyment and engagement in our work Individual professional development allows greater contribution to teams and patient care Building on personal strengths supports happiness in the workplace Encouragement of individuals to serve the profession being involved in professional organizations supports our profession 11

12 A structured Professional Development Program and Clinical Ladder support the organization/departmental missions and the individual The result is an empowered Team! and additional resources on Professional Development! CHOP presentations - CME granting organization Focused use of travel/conference funds Financial support for presenting at conferences major motivator Nutrition texts study programs favorite of those who do not travel Leadership in Affiliates involvement in conferences Clinical Nutrition education Teaching sessions on ASPEN Core Curriculum, presentations from conferences Professional Organization CPEUs Academy, ASPEN and others Involvement/ leadership in Dietetic Practice groups opportunity to attend conferences Department Conferences and Practicums involvement in planning and presetting Leadership Development courses hospital based Sherry Archuleta, MS RD CNSC : Denver Children s Annual Updates in Clinical Nutrition one-day conference 6-7 CPE Approved CPE Provider with monthly CPE event teleconference Solicit staff input in terms of topics based on PDF needs Provide 9 10 CPE credits annually Linda Heller, MS, RD, CSP, CLE LA Children s Journal Club In-services with competencies - Webinars Community conferences External conferences Ginger Carney, MPH RD LDN IBCLC RLC FILCA FAND, St. Jude s City-wide pediatric nutrition group quarterly meetings with guest speaker (CEUs offered) Journal Club (staff presentations) In-house lectures, seminars, conferences Online webinars (AND or practice group sponsored) Sponsor Conferences for city-wide Academy group Sponsor travel to regional/national/international conferences 12

13 Deb Hutsler MS, RD/LD: Akron Children s Nutrition Study Club Monthly-staff presents Topics for 2014 include: Subject Global Nutrition Assessment Nutrition Focused Physical Assessment, indirect calorimetry, update on refeeding syndrome, vitamin D in CF and many more. Susan Teske MS, RD, LD, CNSC Children s Hospital of Birmingham, AL We provide monthly CPE programs for RDs in addition to any nutrition-related grand rounds (for CPE credit). Needs assessment of our RDs, developed an education plan for the year based on that. Monthly presentations plus skills labs on anthropometrics, feeding pumps, a simulation which targets infant feeding practices and clinical manifestations of nutrient deficiencies. - for a wide variety of online professional development programs - for the major categories of professional develop options including: Distance Learning Face to Face Learning FNCE CPE Toolkit learn how to plan conferences Selected CPE Activity Types for Free or Low-Cost Learning Charney, P, et al. American Dietetic Association: Standards of practice and Standards of Professional Performance (Generalist, Specialty, and Advanced) for Registered Dietitians in Pediatric Nutrition. J Am Diet Assoc 2009; 109, 8: , 1478.e e28. The Academy Quality Management Committee and Scope of Practice Subcommittee of the Quality Management Committee. Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians. JAND June 2013; Suppl 2, 113:S29 S45. Roberts S, Grim J. A Clinical Ladder Program: Enhancing Professional Growth and Staff Retention. J Am Diet Assoc 2008;108 Sept suppl: A16 abstract. Post S, Koch C, Roberts C. Raising the Bar: Addressing Job Satisfaction through the Development of an Achievement-Based Career Advancement Program. J AM Diet Assoc 2007; 107 Aug suppl: A88 abstract. Young H, O Connor A, Rogalski M. Development and Implementation of a Professional Recognition Program for Clinical Dietitians. Future Dimensions in Clinical Nutrition Management 2007;2:1-4. O Leary E. The Clinical Nutrition Career Ladder: A Ten Year Experience. Future Dimensions in Clinical Nutrition Management 2004;4:1-6. O Leary E. A Clinical Career Ladder can Improve Registered Dietitian Recruitment and Retention in a Pediatric Hospital. J Am Diet Assoc 1999; Sept suppl: A127 abstract. Buchan J. Evaluating the Benefits of a Clinical Ladder for Nursing Staff: an International Review. International Journal of Nursing Studies 1999;36: Pettno P. A Four-Level Clinical Ladder. Nursing Management 1998; Schmidt L, Nelson D, Godfrey L. A Clinical Ladder Program Based on Carper s Fundamental Patterns of Knowing Nursing. JONA 2003; 33: Drenkard K, Swartwout E. Effectiveness of a Clinical Ladder Program. JONA 2005;35: Konek S and Tracey C. Advanced Practice Clinical Ladder in Pediatrics: Supporting Individual and Program Development. Future Dimension in Clinical Nutrition Management 2009:1: Definition and Criteria for Advanced Practice, Final Approved by Council on Future Practice, 11/4/10 Academy of Nutrition and Dietetics. Accessed February 22, Finnegan, D. Before it s too late: The Stay Interview. For the Retention Institute, (copyrighted) Selected CPE Activity Types for Free or Low-Cost Learning. CDR