Massachusetts General Hospital Nursing & Patient Care Services Strategic Plan

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Massachusetts General Hospital Nursing & Patient Care Services 2017 Strategic Plan January 2017

Mission Guided by the needs of our patients and their families, we aim to deliver the very best health care in a safe, compassionate environment; to advance care through innovative research and education; and, to improve the health and well-being of the diverse communities we serve.

Vision & Values Vision As nurses, health professionals, and Patient Care Services support staff, our every action is guided by knowledge, enabled by skill, and motivated by compassion. Patients are our primary focus, and the way we deliver care reflects that focus every day. We believe in creating a practice environment that has no barriers, that is built on a spirit of inquiry, and reflects a culturally-competent workforce supportive of the patient-focused values of this institution. It is through our professional practice model that we make our vision a demonstrable truth everyday by letting our thoughts, decisions, and actions be guided by our values. Values As clinicians, we ensure that our practice is caring, innovative, scientific, and empowering, and is based on a foundation of leadership and entrepreneurial teamwork.

Guiding Principles We are ever-alert for opportunities to improve patient care; we provide care based on the latest research findings. We recognize the importance of encouraging patients and families to participate in the decisions affecting their care. We are most effective as a team; we continually strengthen our relationships with each other and actively promote diversity within our staff. We enhance patient care and the systems supporting that care as we work with others; we eagerly enter new partnerships with people inside and outside of the Massachusetts General Hospital. We never lose sight of the needs and expectations of our patients and their families as we make clinical decisions based on the most effective use of internal and external resources. We view learning as a lifelong process essential to the growth and development of clinicians striving to deliver quality patient care. We acknowledge that maintaining the highest standards of patient care delivery is a neverending process that involves the patient, family, nurse, all healthcare providers, and the community-at-large.

Relationship-based Patient and Family Centered Care We believe that care delivery is driven by compassion As clinicians and support staff we demonstrate empathy for the patient s well-being, we utilize our expertise to alleviate suffering and to address patient and family needs. Patient and Family Centered Care High Quality Care Designed with patient at the center Provided through seamless healthcare Comprehensive Clinical and non clinical care Designed through the eyes, ears, thoughts and emotions of a patient Provided consistently and without redundancy Accessible Physically convenient Responsive Flexible to patients needs Supportive Reduces anxiety for patients and their families Includes all appropriate staff Personalized Responsive to individual concerns Private Patient friendly Relationship Based Care: Dimensions Leadership: vital to creating and sustaining a culture that supports relationship-based care; Leaders create caring and healing cultures. Teamwork: requires a group of diverse members from all disciplines to define and embrace a shared purpose and to work together to fulfill that purpose. Professional practice: exists to provide compassionate care to individuals and their loved ones, helping them heal, maintain health, cope during times of stress and suffering and experience a dignified and peaceful death. Care delivery: structure to support the professional role of the clinicians, to promote collegial relationships among members of the team, to organize work, and to effectively utilize resource. Resource-driven care: practice which maximizes all available resources staff, time, equipment, systems, budget in the interest of achieving desired outcomes and safeguarding patient care. Outcome measures: capturing, processing, analyzing and reporting relevant data that provide a meaningful representation of the impact of patient care. Koloroutis, 2004

Strategic Goals Goals we will pursue to advance/support the organizational mission and our vision 2017 Strategic Goals Goal #1: Workforce: Maintain MGH s Position as Employer of Choice Goal #2: Goal #3: Goal #4: Goal #5: Lead and Participate in Partners 2.0 Initiatives to Realize Targeted Cost-Savings Implement and Support MGH Diversity Goals and Strategies Maximize Capacity through Emergency Department targeted initiatives Sustain and/or Improve Select Quality, Safety and Patient Experience Indicator Performance

2017 Strategic Goals Goal #1: Workforce: Maintain MGH s Position as Employer of Choice Tactics: Continue to provide and expand opportunities for developing resiliency through Conflict resolution training Stress reduction strategies training Management of aggressive behavior training (MOAB Training) Unit-based support groups facilitated by MGH Chaplaincy. Participate in Partners 2.0 Injury Reduction Program to enhance workforce safety. Provide support and study / review opportunities for support staff to become certified in field of expertise.

2017 Strategic Goals Goal #2: Lead and Participate in Partners 2.0 Initiatives to Realize Targeted Cost-Savings Tactics: Partners Tiger Teams: The Partners Chief Nurse Council (PCNC) launched the following cross-institutional tiger teams: PHS Agency Tiger Team: Create a business plan to launch a Partners agency through Bulfinch temps. Look at current utilization of agency staff and determine waves of specialties to be rolled out. PHS AvaSys Patient Observer Tiger Team: Create a proposal to leverage observer technology and to establish standard criteria for when to utilize an observer. Mandatory/Required Training Tiger Team: Determine opportunities to standardize across PHS entities. PHS Workforce Injury Reduction Tiger Team: Identify opportunities to reduce workforce injuries and compare variations in how nurses come back to work post injury. PHS Quadramed Team: Improve consistency and reliability of productivity tracking across the system. Implement or revise agreed upon standards previously articulated. PHS Clinical Advisory Council: Utilize a comprehensive, standardized, system-wide approach in acquiring, coordinating and standardizing clinical supplies and patient safety technologies within Patient Care Services. PHS Procedural Areas Productivity Model Development Tiger Team: To develop and implement productivity models in procedure areas (perioperative service, endoscopy, cardiology, and radiology) across the Partners entities to maximize benchmarking and opportunities to standardize optimal productivity targets.

2017 Strategic Goals Goal #3: Implement and Support MGH Diversity Goals and Strategies Objectives: People Build, sustain and educate a diverse workforce at all levels of the institution Grow and support diverse patient populations in care settings and communities Cultivate a diverse research participant population Environment Recognize the value of a diverse and inclusive environment at MGH and ensure our: Workforce is engaged and feels their individual backgrounds, traits, and skills are valued and respected. Patients, families, caregivers and visitors are engaged and feel their individual backgrounds, traits and skills are valued and respected. Ensure the workforce has the knowledge and skills to leverage diversity and inclusion to enhance effectiveness and performance on individuals and teams. Operations Incorporate diversity, inclusion, and equity into day-to-day operations and decision-making for improved performance and outcomes across all areas of the mission -- community health, clinical care, teaching, and research.

2017 Strategic Goals Goal #3: Implement and Support MGH Diversity Goals and Strategies (Continued) Tactics: Develop and promote programs and competencies that demonstrate our ability to provide high quality, equitable care to diverse populations. Create a comprehensive talent management model focused across the continuum of pipeline development, recruitment, retention, growth and advancement with specific focus on increasing workforce diversity where underrepresentation exists. Partner with central and department-based research study recruitment teams to increase the number of study participants from groups currently underrepresented in research studies. Increase the percentage of the MGH research portfolio that is focused on diverse groups and topics of diversity, inclusion, and disparities. Acknowledge, reflect and celebrate the diversity of our patients and workforce in the MGH physical and virtual environment. Proactively seek out input from employees, patients and families on issues of diversity, inclusion and equity and respond to issues and concerns brought forward in these areas in a routine and ongoing manner. Collaborate with department chiefs, senior vice presidents and members of their management teams to develop plans for systematically embedding topics of diversity, inclusion, and equity into their department infrastructure and routine operations. Develop a centralized infrastructure, including the creation of a chief Diversity officer position, that will guide and manage the implementation of the diversity and inclusion strategy and provide coordination amongst the numerous diversity and inclusion programs, department-based initiatives and other related functions.

2017 Strategic Goals Goal #4: Maximize Capacity through Emergency Department targeted initiatives. Tactics: Emergency Department Overcrowding: Mitigate ED safety risks in the setting of capacity constraints Pilot 13-bed auxiliary unit Develop system for RN to RN handoff Develop ED discharge (ecare) and transfer workflows Enable staff to assess readiness for discharge Plan for Cardiac RPPR Leverage population health programs Implement operational tactics to address safety Reduce ED patient hours by ten percent (hospital-wide metric). Clinical services reduce Average Length of Stay for admitted patients by 8%.

2017 Strategic Goals Goal #5: Sustain and/or Improve Select Quality, Safety and Patient Experience Indicator Performance Tactics: Quality and safety Falls: Host on site review with National Expert Pressure Ulcers: Implement recommendations from Tod Brindle s site visits Patient Experience (in Development) Improve performance on HCAHPS Measures and Targets: Quiet at Night (CY17 Target as of 1/18/17: 50.9%) Staff Responsiveness Composite (CY17 Target as of 1/18/17: 66.0%) Communication about Meds Composite (Process measure)