BPSO : Are You Ready for the SPOTLIGHT? Dr. Irmajean Bajnok, RN, MScN, PhD Heather McConnell, RN, BScN, MA(Ed) International Affairs and Best Practice Guidelines Centre Registered Nurses Association of Ontario
Welcome & Introductions Irmajean Bajnok, RN, MScN, PhD Director, International Affairs and Best Practice Guidelines Centre Heather McConnell, RN, BScN, MA(Ed) Associate Director, International Affairs and Best Practice Guidelines Centre 2
Presentation Outline Describe the Best Practice Spotlight Organization (BPSO ) designation program and the process for becoming a BPSO Discuss eligibility requirements for organizations interested in applying for the BPSO designation Review the pre-designation BPSO deliverables Describe supports provided by RNAO Opportunity for questions and discussion
Guideline Development OUTCOMES Nurse Patient Organization Societal Deployment & Implementation Evaluation & Monitoring RNAO Best Practice Guideline Program 4
RNAO Best Practice Guideline Program 5
RNAO's BPG Implementation Methodology Individual Level Champion Network Learning Institutes elearning programs Nursing Order Sets Organizational Level Best Practice Spotlight Organization Designation System Level Implementation Projects
Organizational Implementation Key Strategy Best Practice Spotlight Organizations (BPSO) Goal To influence the uptake of best practice guidelines across all health care organizations, to enable practice excellence and positive client outcomes
Best Practice Spotlight Organization Organizations partner with RNAO to implement multiple clinical best practice guidelines over a 3-year period and attain the BPSO Designation Application process and formal partnership with RNAO Specific requirements re: Systematic guideline implementation Infrastructure supports Reporting and monitoring Knowledge exchange Sustainability planning Measuring outcomes through use of standard indicators Designated BPSO after the 3 years and beyond: sustained use, expansion, spread, and mentoring opportunities
73 BPSOs: over 330 healthcare and academic sites!
BPSO Organizations: Eligibility Criteria 2015-2018
BPSO Eligibility Criteria (2015-2018) Organizations are considered eligible to apply for BPSO designation if they meet the following criteria:. Strong, explicit support from the Board, senior management, senior nurse leader, clinical nursing staff, union and other key stakeholders. Vision and mission that provides an opportunity for leveraging other initiatives related to evidence-based practice, quality care and client safety.
BPSO Eligibility Criteria (2015-2018) Organizations are considered eligible to apply for BPSO designation if they meet the following criteria:. Demonstrated a commitment to evidence-based practice by previous implementation of one or more RNAO clinical best practice guidelines. Supported staff to participate in opportunities to develop capacity in evidence-based practice (e.g., Best Practice Champion Network, ACPF, RNAO Learning Institutes and other quality improvement capacity building initiatives, etc.)
BPSO Eligibility Criteria (2015-2018) Organizations are considered eligible to apply for BPSO designation if they meet the following criteria:. Has the capacity to implement, monitor and evaluate nursing best practice guidelines including the collection and submission of data on nursing practice, client outcomes and organizational structure indicators baseline, and at regular post-implementation intervals (participation in NQuIRE). Has capacity to commit a BPSO lead (RN, preferably Master s prepared) to support implementation, evaluation and sustainability activities.
BPSO Eligibility Criteria (2015-2018) Organizations are considered eligible to apply for BPSO designation if they meet the following criteria:. Has demonstrated ability to engage in successful partnerships with the healthcare community, across a range of sectors. Has established relationships with nursing academic entities. Has the capacity to meet the requirements of the terms and conditions of the BPSO designation in order to maintain BPSO status.
BPSO Deliverables 2015-2018
BPSO Deliverables 2015-2018 At minimum, the BPSO will commit to: Engage in a three-year partnership with RNAO, to be reviewed and renewed annually, provided criteria are met. Contribute financial resources to support this initiative. BPSO organizations, during the three year period, are required to, at minimum, match the budget requested in their proposal. 17
BPSO Deliverables 2015-2018 Implementation: Implement a minimum of five RNAO clinical best practice guidelines, 2 of which must be implemented across the entire organization. Engage a critical mass of at least 15% of nursing staff as RNAO Best Practice Champions over the span of the 3 years of the pre-designation period. Send nursing staff annually to the RNAO Clinical Summer Institute number dependent on size of organization. 18
BPSO Deliverables 2015-2018 Implementation: Submit proposals, by RNs, to participate in the RNAO Advanced Clinical Practice Fellowship (ACPF) Program over the span of the 3 year partnership Maintain a database of staff who are engaged in BPSO activities through the Best Practice Champions Network, Clinical BPG Institute attendees, ACPF fellows etc and establish a program for knowledge exchange Send two staff to the BPSO Orientation Session, and the Annual BPSO Knowledge Exchange Symposium. 19
BPSO Deliverables 2015-2018 Implementation: Establish a BPSO infrastructure including a steering committee responsible for the BPSO designation within their organization and include a reporting and accountability structure to guide the work of the team. Commit to working with an assigned RNAO BPSO Coach (RNAO Nurse Manager/Nursing Research Associate) throughout the 3-year period Provide 0.5-1.0 FTE RN to the position of BPSO Lead to coordinate the implementation, evaluation and sustainability activities. Commit to working with a BPSO designate mentor organization. 20
BPSO Deliverables 2015-2018 Evaluation and Research: Mandatory participation in the RNAO international indicator data system Nursing Quality Indicators for Reporting and Evaluation (NQuIRE ). Collection of NQuIRE indicators for a minimum of 3 BPGs is required It is required that a NQuIRE Data Usage Agreement be signed by the BPSO prior to participation in NQuIRE 21
BPSO Deliverables 2015-2018 Evaluation and Research: Select quality indicators related to organizational structure, nursing practice, and client clinical outcomes relevant to the guideline identified for implementation and appropriate to the practice setting. Indicator selection will be in collaboration with RNAO, considering alignment with the practice recommendations being implemented, and feasible and of priority for the BPSO 22
Nursing Quality Indicators for Reporting & Evaluation 23
VISION Improved quality health care through the use of nurse-sensitive indicators based on implementation of RNAO Best Practice Guidelines, to impact practice, management and policy decisions, education and health system research 24
Key Features of NQuIRE A database of quality indicators from practice recommendations within RNAO s clinical BPGs (guidelines) reflecting structure, process and outcomes of care arising from BPG implementation collected in Best Practice Spotlight Organizations Collection, analysis and reporting of comparative indicator data To evaluate outcomes of BPG implementation in Best Practice Spotlight Organizations 25
NQuIRE: Evaluating Guideline Impact through Measurement of Indicators Structure Indicators CLINICAL BPG Process Indicators Outcome Indicators Nursing care & Client outcomes specific to BPG Practice Recommendations 26
BPSO Deliverables 2015-2018 Evaluation and Research: Collect and submit indicator data: The RNAO will provide the BPSO with the data collection requirements and data collection tools (via NQuIRE ) for the quality indicators chosen for monitoring and evaluating guideline implementation Data collected will not include individual client identifiers, and will be aggregated to determine the impact of clinical guidelines on client outcomes and nursing practice. 27
BPSO Deliverables 2015-2018 Evaluation and Research: Conduct regular quality improvement monitoring activities related to implementation of each best practice guideline and submit results in bi-annual reports to RNAO. 28
BPSO Deliverables 2015-2018 Evaluation and Research: Take advantage of opportunities to participate in research projects, as requested by RNAO and appropriate. Apply for organizational membership in the Nursing Best Practice Research Centre (NBPRC) within the first year, and support at least one staff member to become an individual member of the NBPRC. Nursing Best Practice Research Centre Advancing care through knowledge 29
BPSO Deliverables 2015-2018 Dissemination: Submit a minimum of one (1) manuscript for publication (preferably peer reviewed) during the 3-year predesignation period related to client outcomes that result from best practice guideline implementation. Share learnings, materials developed and achievements with the wider health care community. This dissemination may be facilitated through posting of implementation resources on the RNAO website, BPSO Communities or through participating in events, such as at the RNAO Institutes and conferences. 30
BPSO Deliverables 2015-2018 Dissemination: Develop a BPSO webpage on the host organization website by the end of the first year to disseminate information about the BPSO designation. Links to the RNAO website will be facilitated. Display the BPSO logo, provided by RNAO, on any professional practice, nursing and BPSO related work, and acknowledge BPSO status in relevant organizational communications and dissemination activities. 31
BPSO Deliverables 2015-2018 Dissemination: Present a minimum of one paper/poster in each of the three years at local, provincial, national or international conference(s), highlighting the outcomes of BPSO related activities. Include a statement of acknowledgement on all presentations, publications and other BPSO related dissemination activities BPSO, RNAO and Ontario Ministry of Health and Long-Term Care. 32
BPSO Deliverables 2015-2018 Sustainability: At the end of the three year pre-designation period, and assuming all deliverables are met, the organization will achieve BPSO Designate status. As a designated BPSO, and in order to maintain the BPSO designation (renewable every two years), organizations are expected to focus on sustaining and spreading current guideline activities, expanding guideline implementation internally and externally, and supporting others in the development of evidencebased practice cultures. 33
BPSO Designate Deliverables Sustainability: Continue to support staff participation in capacity building opportunities (e.g., Champions Network, RNAO Learning Institutes, ACPF, Knowledge Exchange Symposium) and maintain 15% of nursing staff as champions. Sustain guideline implementation and evaluation activities, including NQuIRE participation, initiated during the BPSO pre-designation period, and spread this work to other practice areas within and/or beyond the organization. 34
BPSO Designate Deliverables Sustainability: Initiate the implementation and evaluation of two additional guidelines within the two-year designation period. Support the global health community by serving as a mentor to new BPSO organizations at the local, national or international level. Continue to disseminate the outcomes of the BPSO designation, as noted previously. 35
RNAO Commits to. Provide the BPSO with an orientation to the IABPG Centre, the BPSO designation, and to specific guidelines and implementation resources, as appropriate. Support Champion development and BPG capacity building through provision of Best Practice Champion s workshops, access to the Best Practice Champions Network and RNAO Best Practice Clinical Institute Provide expert consultation on guideline implementation and uptake and evaluation 36
RNAO Commits to. Provide free access to RNAO Nursing Order Sets to facilitate technology-enabled BPG implementation Nursing Order Sets are a group of evidence-based interventions that are specific to the domain of nursing. Intended to standardize the care provided for a specific clinical condition (e.g. pressure ulcers). Ordered independently by nurses (i.e. without MD signature). 37
RNAO Commits to. Facilitate participation in the network of BPSO Leads for the purposes of knowledge transfer and exchange, through regular teleconferences, or other meetings/events. Provide opportunities to BPSO organizations to participate in various aspects of guideline development, implementation projects, and dissemination activities. Host an annual BPSO Symposium and Final Summit to support continued capacity development, knowledge dissemination and networking with BPSO organizations. 38
RNAO Commits to. Meet on bi-annual basis (via teleconference) with each BPSO to review reports, monitor progress and provide recommendations. Conduct a minimum of one site visit over the three year period, at a mutually agreed upon time, to review on the ground implementation, monitoring and evaluation activities (NQuIRE ) Provide a BPSO Coach for each BPSO for the duration of the pre-designation period role will include consultation, coaching, linking with resources, referrals and site visits. 39
RNAO Commits to. Support a consistent approach to data collection, through NQuIRE, of nursing practice, organizational structure, and client outcome indicators, and by providing relevant instruments along with instruction and guidance for collecting these data. Provide BPSO organizations with regular quality improvement updates by creating NQuIRE reports of aggregate quality indicator data from BPSO 40
RNAO Commits to. Provide up to $105,000 per Ontario-based healthcare organization for the duration of the 3 year BPSO predesignation period. Organizations are required to submit, with their proposal, annual budget requests to RNAO of up to $35,000 per year, for a maximum of $105,000 over the 3-year agreement. Organizations must commit to match or exceed the amount requested in each budget. 41
RPF Release September 19, 2014 Letter of Intent October 30, 2014 Proposal Submission Deadline December 17, 2014 Release of Results January /February 2015 BPSO Launch April, 2015 IMPORTANT DATES BPSO Pre-Designation Period: April 1, 2015 March 30, 2018
Are You Ready for the SPOTLIGHT? www.rnao.ca