Using Appreciative Inquiry to SOAR through Strategic Planning 21 st Annual NICU Leadership Forum April 25 29, 2017 Barbara Wadsworth, DNP, RN, FACHE, FAAN Main Line Health Bryn Mawr, PA Synova Associates: Innovative Solutions for Nurse Leaders
2 Disclosure I have no conflicts to disclose.
3 PRESENTATION OBJECTIVES Discuss the Appreciative Inquiry process utilizing strengths, opportunities, aspirations and results (SOAR planning model) Describe how bedside staff can be involved in nursing strategic planning linking organizational goals to nurses daily work
BACKGROUND A STRONG SYSTEM Paoli Hospital (PH) 4 10,559 Employees 2,052 Medical Staff* Members 2,500 Volunteers 95 Researchers 158 Residents and Fellows in Training 1,340 Licensed Beds 166,259 ER Visits 60,370 Total Discharges (including NICU) 8,032 Births 1,145,328 Outpatient Visits $10,452,226 Operating Revenue *includes Dentists and Podiatrists Bryn Mawr Rehab Hospital (BMRH) Riddle Hospital (RH) Source: FY2014 Data Lankenau Medical Center (LMC) Bryn Mawr Hospital (BMH) Mirmont Treatment Center (MTC)
Main Line Health, System Magnet Designation March 2015 5 THIRD Designation Lankenau Medical Center Bryn Mawr Hospital Paoli Hospital INITIAL Designation Riddle Hospital Bryn Mawr Rehabilitation Hospital ML HomeCare & Hospice Follow us on
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BACKGROUND 7 Synergy Systemness Decreasing Variance Increasing Efficiency STEEP Principles
BACKGROUND 8 USING THE MLH STRATEGIC PLAN TO CREATE & SUSTAIN A CULTURE OF EXCELLENCE Highly Engaged People Superior Patient Experience Goal #1: Nurse and physician partnerships Professional Practice Model Goal #2: Achieve desired clinical outcomes: Exemplary Practice Market Growth Goal #3: Partner for a healthy community
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BACKGROUND 10 NURSING PROFESSIONAL PRACTICE MODEL
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BACKGROUND 12 Foundation of practice ANA SCOPE & STANDARDS OF PRACTICE: NURSING ADMINISTRATION Orchestrates, influences work in a defined environment Catalyst for change creating a shared vision Advocates voice of nursing Creates Culture of Safety Safe, Timely, Effective, Efficient, Equitable and Patient Centered Appreciative Inquiry Mentoring Emotional Intelligence Transformational & Servant Leadership
BACKGROUND 13 LEADERSHIP COMPETENCIES
DRIVING CHANGE AT MLH 14 KOTTER S STAGES OF CHANGE MODEL Maintain the momentum Institutionalize the Change Introduce new practices Consolidating and Build on Gains Generating Short Term Wins Empowering Broad-Based Action Create conditions for change Communication the Change Vision Developing a Vision and Strategy Creating a Guiding Coalition Establish a Sense of Urgency Kotter, J. P. (1998) Leading Change. Harvard Business School Press, Boston, Mass.
DRIVING CHANGE AT MLH MANAGING COMPLEX CHANGE 15
DRIVING CHANGE AT MLH 16 APPRECIATIVE INQUIRY MODEL A perspective that assumes change is inevitable and that dialogue can promote organizational growth Helps staff link the nursing vision and goals to their daily work in a meaningful way and promotes an engaged workforce Builds engagement, empowerment and transforms the way in which nursing approaches their work Strengths Opportunities SOAR Aspirations Results
DRIVING CHANGE AT MLH 17 APPRECIATIVE INQUIRY: THE 4 D CYCLE Discovery Destiny Affirmative Topic Choice Dream Design
DRIVING CHANGE AT MLH 18 ORGANIZATIONAL ALIGNMENT CONNECTING THE DOTS. Key Strategy Nursing goals aligned with organizational strategic initiatives: Superior Patient Experience Highly Engaged People Market Growth Research Clinical Education Financial Performance
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DRIVING CHANGE AT MLH 22 PARTICIPATIVE PROCESS Invite participation from nurses at all levels in the SOAR process Use Appreciative Inquiry to understand the positive and build from there Meet them where they meet Magnet Ambassadors Quality Champs and Council Nursing Councils and Individual Campus SOARs Strategic Planning Retreat (133 participants) Total years in nursing = 3373 Total years as a MLH nurse = 2100
DRIVING CHANGE AT MLH 23 MLH SYSTEM SOAR
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DRIVING CHANGE AT MLH 27 QUALITY YEAR 2015 (APRIL 2014-MARCH 2015) PERFORMANCE METRICS Creating a Safe Environment Decreased Pressure Ulcers - Unit Acquired Stage II or worse - Rehab by 100% Decreased Cath. Assoc. Symptomatic UTI per 1,000 cath. days - Decreased Hospital Acquired Potentially-Preventable VTE (VTE-6) Decreased Inpatient Falls Harm Score PSN E or Worse/ 1,000 Pt. Days - Decreased Pressure Ulcers - Unit Acquired Stage II or worse - Decreased Central Line Assoc. BSI per 1,000 line days - Decreased Cath. Assoc. Symptomatic UTI/1,000 Cath. days - Decreased Central Line Assoc. BSI Standardized Infection Ratio - Rehab by 100% by 55% Acute by 32% Acute Critical Care by 24% Acute Critical Care by 20% Med/Surg/Tele by 10% Acute All Units by 13%
DRIVING CHANGE AT MLH 28 QUALITY YEAR 2015 (APRIL 2014-MARCH 2015) PERFORMANCE METRICS Creating a Patient-Centered Environment Increased HCAHPS GLOBAL RATING Increased HCAHPS Pain Management Increased HCAHPS Nurses Communication - Domain by 3% by 2% by 1%
DRIVING CHANGE AT MLH 29 MLH EDUCATION: BSN OR HIGHER DEGREE
DRIVING CHANGE AT MLH 30 MLH NURSE CERTIFICATION RATES 70% 60% 54% 55% 55% 58% 56% 50% 42% 43% 40% 37% 38% 32% 33% 30% 20% 21% 16% 22% 10% 0% 2009 2010 2011 2012 2013 2014 2015 Rate Annual Goal 2020 Goal Trend
DRIVING CHANGE AT MLH 31 Identified in 2013 SOAR Exercise SAFE PATIENT HANDLING Healthy Work Environment Council works on system wide initiative and policy Connect with CNO Create a system wide workgroup Create policy for MLH Create Education & skills lab Identify needs seek >500K in unbudgeted capital for bedside equipment Advocate with pilot data information and employee injury data System wide approach, embedded in orientation with reduction in staff injury across the system
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DRIVING CHANGE AT MLH 34 ACHIEVEMENTS 2015-2016
DRIVING CHANGE AT MLH 35 MLH The BEST Place to GIVE & RECEIVE CARE Nursing Strategic Plan Outcomes with Impact A Culture of Excellence Culture of Safety Journey of Excellence Nursing SOAR Cascading Organizational Goals MLH Strategic Plan Nursing Vision Appreciative Inquiry How We Do Our Work
DRIVING CHANGE AT MLH 36 SPECIAL THANKS to.. Synova Associates: Innovative Solutions for Nurse Leaders Barbara Wadsworth, DNP, RN, FACHE, FAAN, NEA-BC wadsworthb@mlhs.org 484-337-4324