Expert Caring. Innovation. Lifelong Learning. Quality Achievement. Empowered Leaders. Annual Report Exhibit OO3.b

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1 Annual Report 2013 Professional Nursing Staff Organization Expert Caring Empowered Leaders Innovation Lifelong Learning Quality Achievement

2 Reflections Exhibit OO3.b Dear Nurse Colleagues, One of our most important accomplishments this year was to create a strategic plan that will guide us through the end of A strategic plan can be vital in enabling an organization to focus its resources and meet its goals but only if it meets three criteria. The first is that it be inclusive. When we kicked off the planning process in November 2012, we were determined to involve nurses from every area of the Health System. During the course of 2013, our planners returned again and again to staff members to solicit their responses and input. The ideas nurses contributed shaped each of the plan s five strategic objectives. The second criterion is that it be meaningful. To this end, we framed the plan around the Health System organizational goals I Care. I Heal. I Build. and focused on five key objectives that you helped us identify. Our first objective is putting in place the conditions that will better enable nurses to build their careers here. This is the key to developing a caring, committed, highly engaged, and expert staff. We also recognized that whatever happens in healthcare reform, we must be more efficient at the bedside and more proactive in the community. This means that we must pursue thoughtful redesign initiatives that focus on the patient. This second objective dovetails nicely with another objective, which is to support a culture of superb quality and patient safety. As part of the plan, we identified strengthening our model of relationshipbased care as yet another objective. We want to provide nurses with opportunities for growth so that they can better fulfill their responsibilities to their patients and families and to the rest of the healthcare team. Finally, we are using the strategic plan to reaffirm our commitment as an academic health system to innovate and create new nursing knowledge that will improve patient experiences and outcomes. I believe the plan is a strong one but to be successful it must meet a third criterion. We must all take ownership of it. That s why I urge you to get involved. Pick a passion and find a way to offer your time, energy and experience. Working together to implement this plan will help us become a high-functioning nursing team that is well positioned for the future of healthcare. Dear Fellow PNSO Members, At UVA Health System, we are fortunate to have one of the most wellestablished shared governance structures in the United States. To ensure its relevance to all clinicians, it underwent a refresh. After two years of preparation, the PNSO acted in 2013 to unlock its potential by focusing on the local level. We tackled this issue from a number of perspectives. The PNSO organized an intensive program of education and training, both for managers and front-line clinicians. These initiatives were designed to encourage staff in each practice setting to develop a shared governance structure that reflected their individual needs and requirements. These initiatives were also intended to assist nurses in various roles learn to work together in a culture of shared decision making. For managers, this means becoming comfortable with relinquishing some of their decision-making responsibility. For clinicians, it means becoming accustomed to assuming it. At the same time, we devoted time and energy this year to instituting shared governance structures in ambulatory settings. The great diversity of ambulatory settings makes implementing outpatient shared governance difficult, but it is essential. The increasing focus on preventive care means that ambulatory nurses will play an ever larger role in the future of healthcare. It is very important that they are empowered in decision making that affects their patients. We have the opportunity to be a national leader in this area. Finally, we reached out to our night shift nurses. We launched a successful pilot program to schedule committee meetings and education sessions during their shift. The result: they feel more connected to the PNSO and can participate in the local rollout of our shared governance structure. This emphasis on local shared governance has already made a tremendous difference just in terms of communication. The minutes of local shared governance meetings are kept on the Health System s Z drive, so that all members of the PNSO can read them and share information across practice settings. We established check-ins that give local committee chairs the opportunity to share successes and exchange ideas with each other and invited them to present to the PNSO cabinet. This year we also changed our professional practice model to reflect our nursing vision statement. This will enable us to focus the energies and enthusiasm unleashed by our reinvigorated shared governance structure more efficiently to benefit our patients. Christina Knicely, BSN, RN, CAPA 2013 PNSO President Lorna Facteau, DNSc, RN Chief Nursing Officer Cover: Matt Henrich, Dawn Shaver, Eileen Watkins, Catherine Deane, Olaoti Opaleye

3 The UVA Nursing Professional Practice Model Serving as the anchor for the model is our quality star. Encircling the star are words that represent our care delivery system, Relationship-Based Care. This system identifies the three relationships at the core of the patient experience: the nurses relationship to self, to colleagues and to patients and families. Our model was developed by frontline nurses using concepts from the UVA Nursing Vision Statement: As Empowered Leaders, nurses participate in decision making. Every nurse is a leader. Delivery of Expert Caring is at the root of every nurse s passion for our craft. Innovation is demonstrated through research, problem solving and collaboration. Lifelong Learning means that UVA nurses value education, certification and learning. Quality Achievement is our commitment to excellence and continued growth. These elements partner perfectly with the organizational goals I Care, I Heal, I Build and the organizational values represented in R.I.S.E. Respect, Integrity, Stewardship, Excellence.

4 Expert Caring Our nurses demonstrate caring in ways too numerous to count. We embrace best practices to show our patients and families how committed we are to their care and safety: Bedside Report, Care Partners and Hourly Rounding. Our Magnet Champions led a service project to collect clothing for our patients in need, 1,180 pieces of clothing were collected and delivered to Social Work for distribution. Empowered Leaders Career Ladder in 2013 Number of RN portfolios reviewed by the peer review panel: 109 Number of successful advancements: 85 Nurse Development in clinical nurses completed one or more Informal Leader courses 49 nurse managers attended the Uteam Leadership Education Forum

5 Quality Achievement The ultimate demonstration of our commitment to our patients is through the achievement of quality care. In 2013, we achieved amazing outcomes for our patients. Compared to our academic medical center peers, we achieved outcomes considerably better in central line-associated blood stream infections, hospital acquired pressure ulcers and patient falls with injury. We are very close to achieving our goals, and expect to break the threshold in Clinical Outcomes % 4.7% 3.5% 2.6% Number of Central Line-Associated Blood Stream Infections % 4% 3% 2% 1% 0% Percentage of Patients in Limb/ Vest Restraints 10% 9% 8% 7% 6% 5% 4% 3% 2% 1% 0% 0.9% 3.3% 1.5% 2.0% Total Falls with Injury Number of Catheter-Associated Urinary Tract Infections Percentage of Patients with Hospital-Acquired Pressure Ulcers

6 Lifelong Learning $1,203,912 in educational assistance was provided to 384 nurses in % of all RNs at UVA are certified in their specialty. 370 RNs received support to attend conferences, with funds totaling $378,764 in fiscal year Innovation The Research Mentor Program obtained IRB approval to start 8 new studies, had 6 presentations at conferences and published 4 studies in people attended the 9th Annual Evidence- Based Practice Symposium featuring the research and improvement projects of UVA nurses. There were 15 podium presentations and 23 poster presentations.

7 Nursing Strategic Plan Exhibit OO3.b Nurse leaders in partnership with frontline nurses developed the objectives found in this strategic plan. The patients of UVA deserve the skilled, expert care that UVA nurses deliver. Goals Strategy Ensure the development of caring, committed, highly engaged, expert staff Formal Education Certification Recruitment Retention Shared Governance Reach the highest levels of efficiency and effectiveness through accountable care models and redesign initiatives that positively affect the health of our community Population Care Care Coordination Provide expert relationship-based care in partnership with the patient, family and healthcare team Healing Environment Hourly Rounds, Bedside Report, Quiet Time, Pain Control Family Participation Care Partners, Family Presence at Resuscitation RN Workforce Wellness/Safety Culture of Teamwork Advance a culture of superlative quality and patient safety Quality Improvement Effective Communication Preservation of Nursing Time Optimize Epic Innovate and create new nursing knowledge Pioneer Evidence-Based Practice Nursing Research Dissemination: Presentation, Publication Implement Evidence-Based Practice Advance Nursing Knowledge/Expertise Skill Building, Innovation Evaluate Care Delivery Models 2013 Nursing Excellence Award Winners Beginning Practitioner of the Year Mary Falk, 4 Central Exemplary Clinical Practice Barbara Gordon, TWP Excellence in Caring Aileen Feola, 5 Central Excellence in New Knowledge and Innovations Kim Garrison, Continuum Home Health Nurse of Distinction JoAnn Plencner, Continuum Home Health Nurse Manager of the Year Angel Cyphert, PACU Preceptor of the Year Marie Manz, PACU Transformational Leader Award Clara Winfield, SAS

8 Falls Champion CLABSI Champions This year revealed what dedication and focused attention can achieve. These unit-based nurse sensitive indicator champions are just a few of the many who devote time, energy and talent resulting in organizational improvement in every category. They engage frontline care delivery staff in quality assurance, quality improvement and peer review of practice, thus leading to better outcomes. Magnet Champions served as a conduit of practice information to and from larger PNSO practice and quality groups. Congratulations to these important leaders! Pain Champion CAUTI Champion Pain Champion Professional Nursing Staff Organization PO Box , Charlottesville, VA by the Rector and Visitors of the University of Virginia Produced by UVA Health System Marketing Communications 5/14