The relationship and collaboration between the nurse, patients, families and other providers, enhances problem-solving and promotes dialogue and

Transcription

1 OOD 14 Theoretical/practice framework(s) stylized within the nursing services that structures various aspects of professional practice (e.g., patient care, nursing research, staff development, and performance evaluation and improvement) and performance. The Massachusetts General Hospital Patient Care Services Professional Practice Model (PPM) is the guiding framework for Nursing practice and the practices of other health care disciplines. Crafted and launched in 1996 and revised in 2007, the PPM is comprised of nine inter-locking components which guide the care provided to MGH patients and families. These components include: Patient Centeredness Vision and Values Standards of Practice Narrative Culture Professional Development Clinical Recognition and Advancement Collaborative Decision-Making Research, and Innovation and Entrepreneurial Teamwork. The PPM is grounded in values and beliefs that embrace patient-centered care in partnership with the nurse and other providers of care within the patient care environment. The nurse seeks to promote health of the person, recognizing their uniqueness as a person (e.g. age, culture, ethnicity, gender, health status) and the complexity of the patient situation. The goal is to provide care to the individual, families, and groups that is holistic and responsive to patient s situation. The model is predicated on the availability of resources, qualified professionals and an institutional commitment to safe, timely, efficient, costeffective, quality patient care. The PPM promotes the use of discipline-specific knowledge and theoretical positions to guide patient care, extend existing knowledge and transform practice. Research is seen as a vehicle for generating, testing and evaluating knowledge. Information obtained from research as well as information yielded from clinical investigations is translated into practice to improve care. Evidence gained from clinical evaluation of current practice serves to inform care and link nursing contributions to patient outcomes. 1

2 The relationship and collaboration between the nurse, patients, families and other providers, enhances problem-solving and promotes dialogue and reflection. Each individual plan of care is continuously revised to respond to the changing needs of the patient and families. Desired outcomes for patients are achieved in mutual partnership, with the nurse and patient leading to the implementation of a plan that best responds to each individual situation. The internal health care environment fosters the autonomy of the clinician through multiple initiatives designed to enhance quality care and provider performance. The Patient Care Delivery Model embraces provider attributes (doing for and being with the patient) and seeks to teach, evaluate and transfer new competencies that enhance professional practice and foster growth. Continued support for professional development within and external to the MGH is encouraged and resourced, when appropriate, to enhance the professional practice environment (e.g. The Norman Knight Center for Clinical & Professional Development and The Yvonne L. Munn Center for Nursing Research). Changes in professional responsibility and practice roles are responsive to educational advancement, scholarship and experience. Within the Patient Care Delivery Model, (Force 5.5) the nurse is depicted as assuming a variety of roles in the delivery of patient care. Multiple elements contained within a nursing role (e.g. coordination, accountability, autonomy, cultural competency and authority) are implemented in ways unique to the practice setting, promoting the optimization of professional practice across settings. The nurse s preactice is guided by professional standards of practice and adherence to appropriate preparation, credentialing regulations and academic qualifications. This certifies to the consumer quality and competent performance. Formal evaluation of staff performance within the patient care setting occurs on an annual basis. In concert with leadership, areas for improvement and further development are identified and support strategies identified to enhance provider performance. Through continued mentoring and guidance, the professional s competence and overall performance is monitored and promoted. Multiple initiatives within the internal health care environment are designed to promote quality care and strengthen professional practice. Evaluation of the Professional Practice Environment through the administration of the Staff Perceptions of the 2

3 Professional Practice Environment Survey (OOD 16, Force 1.8 and RD 6) occurs on a regular basis. All professional providers are invited, to participate with nurses comprising the largest group of respondents (61% on the returns in 2006). The data provides the leadership with a report on the clinician s perception of the professional practice environment around eight organizational characteristics (e.g. autonomy, control over practice, conflict resolution and teamwork). Changes in the practice environment are made within the institution overall as well as at the unit level based upon significant survey results. Data from subsequent survey s provide continuous evaluation of the professional practice environment of care. Evidence documenting changes are used as measures of effectiveness reported to support the quality of patient care outcomes. The PPM is also evaluated on a regular basis and revised to reflect changes in health care nationally. A detailed explanation of the PPM and each of the nine components follows in the April 5, 2007 special issue of Caring Headlines featuring the revised PPM. 3

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