Creating A Shared Accountability Model of ership: Nurse Manager Medical Director Dyad Marguerite Fritsch, MSN, RNC-NIC Nurse Manager, NICU Nemours Alfred I. dupont Hospital for Children 1 I have no actual or potential conflict of interest in relation to this program/presentation. 2 Creating A Shared Accountability Model of ership: Nurse Manager Medical Director Dyad Objective: To describe at least two concepts of shared accountability and leadership Review: Historic Nurse-Physician relationship Nurse Manager-Medical Director Dyad Shared ership and Accountability Organization structures to support model 3 1
Alfred I. dupont Institute Nurse-Physician Relationship Historically physicians held the dominant power position 4 Nemours Alfred I. dupont Hospital for Children Nurse Manager-Medical Director Dyad 5 NICU Operation Committee Strategic Planning Medical Director Nurse Manager Incident Review NICU Operations Committee Mark Ogino, Marguerite Fritsch, Jane Mericle, Janice Boc, All NNP s, Scott Takata, Cortney Jones, Sam Mumford, Jennifer Toth, Lydia Edwards, Lori Fox, Joey Muller, Maggie Lynch, Arlene Zamora Nutrition Quality/Safety Respiratory Process Developmental Care Family Centered Care Outreach team Jane Ierardi Kevin Sullivan Deepthi Alapati Jane Ierardi Scott Takata Janice Boc Lynn Fuchs Katie Preedy Sam Mumford Mona Hamlin Emily Green Stephanie Zephren Jan Jezyk Marie Bryson Judy Guidash Sam Mumford Lauren Miller Pat Gilroy Lisa Collinson Joey Muller Maggie Lynch Arlene Zamora Marguerite Fritsch Beth Moore Lynn Bayne Elaine Guilday Neo Fellow PM RT Tina Keane Luana Liberatore Elaine Guilday Lynne Bayne BJ Rowland Heather Keskeny Tracy Harach Cortney Jones Ali Novitski Maggie Lynch Marie Bryson Marguerite Fritsch Sarah Dumais Scott Takata 6 2
2014 Dr. Daniel Dirnberger, MD Marguerite Fritsch, MSN, RNC-NIC Medical Director Nurse Manager 7 Creating A Shared Accountability Model of ership: Nurse Manager Medical Director Dyad Alfred I. dupont Hospital for Children (AIDHC) Model Structure: Paired ership Process: Continuous Improvement Outcome: True North 8 Leveraging our Organizing Structures Nursing Shared Governance Interprofessional Collaboration Magnet Continuous Improvement 9 3
Operational Implementation: Close Working Space 10 Operational Implementation Strategic Planning Safety Kevin Sullivan Katie Reiff Medical Director Nurse Manager NICU Operations Committee Dan Dirnberger, Marguerite Fritsch,, Janice Boc, Medical Safety Officer Kevin Sullivan Medical Quality Officer Patoula Panagos Quality Patoula Panagos Lauren Zawada Kelly Lindeblad Nutrition Respiratory Process Developmental Care Family Centered Care Lynn Fuchs Deepthi Alapati Lynn Fuchs Shannon Davis Jennifer Lester Katie Preedy Sam Mumford Mona Hamlin Emily Green Stephanie Zephren Kelly Lindeblad Arlene Zamora Beth Moore Elaine Guilday Kristen Vavala Katie Reiff Brigitte Curry Joey Muller Marguerite Fritsch Lynn Bayne Neo Fellow BJ Rowland Tina Keane Luana Liberatore Elaine Guilday Lynne Bayne BJ Rowland Michelle Morrow Scott Takata Marie Bryson Marguerite Fritsch Scott Takata Elizabeth Waczynski 11 Shift Huddle Principles Daily attention to problems Surfacing problems is celebrated Problems are escalated, as needed The intent of daily management is simple: Discover problems and implement countermeasures 12 4
Shift Huddle 13 14 Quality and Safety Error Free: Zero Defects: Perfect Care NICU Goal Reduce Unplanned Extubations: 30% in 2014 [rate/100 Ventilator Days] 2015 Goal: 2.31/100 Ventilator Days 15 5
Delivery No Delays NICU Goal Zero Delay in Immunization Administration (within a week timeframe of due date) 16 People 100% Engagement NICU Goal Enhance the Developmental Care Skill of the NICU 17 Shared ership & Accountability Key Elements Nurse Manager and Medical Director dyad Shared accountability Engagement Standardization work Shared workspace Shared goals 18 6
Questions 19 7