TEAMWORK: INTERPROFESSIONAL DEVELOPMENT THAT CREATES IMPACT The National Perinatal Information Center is dedicated to the improvement of perinatal health through comparative data analysis, program evaluation, health services research and professional continuing education. EMPOWERED by Data. CONNECTED by Purpose.
NURSE PLANNER Carolyn L. Wood, PhD, RN, Clinical Nurse Consultant Purpose/Goal(s) of this Education Activity The purpose/goal(s) of this activity is to enable healthcare providers to have a better understanding of the approaches to interprofessional teamwork development. 1.0 Contact Hour(s) This continuing nursing education activity was approved by the Northeast Multistate Division (NEMSD), an accredited approver by the American Nurses Credentialing Center s Commission on Accreditation. Maine, New Hampshire, New York, Rhode Island, Vermont Nurses Associations are members of the Northeast Multistate Division of the American Nurses Association. 1.0 AMA PRA Category 1 Credit Accreditation: Women & Infants Hospital is accredited by the Rhode Island Medical Society to sponsor intrastate continuing education for physicians. Women & Infants Hospital designates this online educational activity for a maximum of 1.0 AMA PRA Category 1 Credit. Physicians should only claim credit commensurate with the extent of their participation in the activity.
DISCLOSURES AND SUCCESSFUL COMPLETION OF THIS ACTIVITY No commercial support has been provided for this activity. No persons involved in planning or presenting this program has a conflict of interest. There will be no discussion of off-label usage of any products. In order to successfully complete this activity and receive 1.0 Contact Hour/1.0 AMA PRA Category 1 Credit you must attend/watch the program and return the completed posttest/evaluation to NPIC.
Teamwork: Interprofessional Development that Creates Impact Thursday February 15, 2018 Kim Armour, PhD, NP-BC, APRN, RDMS, NEA-BC Director, Women s Obstetric and Neonatal Services Northwestern Medicine, Prentice Women s Hospital Chicago, IL 60611 Karmour@nm.org
Objectives Explain two generational differences that drive employees Describe current leadership models Describe elements of quality regarding leadership Discuss psychological safety
Concept Outline 1. Intergenerational differences in the workplace and how to lead and manage Managing the Intergenerational Nursing Team K. Lynn Wieck PhD RN FAAN and Kimberly D. Moss PhD RN 2. Identify effective communication techniques (texting, memos, newsletters, staff meetings, huddles) that are in practice and what may be most effective for your team. 3. Promoting team building and identifying characteristics of a healthy interprofessional team. Psychological Safety work Amy Edmondson
Intergenerational & Interdisciplinary Challenges in the Workplace Managing the Intergenerational Team 2015; Wieck & Moss
2015; Wieck & Moss
2015; Wieck & Moss
2015; Wieck & Moss
2015; Wieck & Moss
2015; Wieck & Moss
Leadership Models Transactional Adaptive Transformational Servant
Culture of Safety
Trust Respect Collegiality Innovation Adaptation Pliability Members Leader Pride Team Fun MUST HAVES
Background The emotions were overwhelming and chaotic. I now realize of course that the clinicians were also crushed and devastated. Nevertheless, in that moment, they were not able to help me through the experience October 2003 Over 300 NMH providers receive training on difficult conversations Spring 2014 September 2011 Proposal to implement provider communication training
Why it Matters Patient Experience Hidden Curriculum Malpractice Concerns Ethical Obligation
Patient and Provider Impact Patients Providers Patients want their doctors to be truthful, caring, and compassionate, to speak in simple terms [patients] want to be given the diagnosis and prognosis honestly and in simple language, but not too bluntly [clinicians] may lack confidence and describe themselves as ill prepared for difficult interpersonal interactions providers fear of being sued, with subsequent increases in malpractice premiums or termination of malpractice insurance coverage fear they will say too much, too little, or the wrong thing altogether Clinical adherence and understanding Provider trust Patient satisfaction Conversation delay / avoidance Patient-provider relationship Providers as 2 nd victims
The Intervention Lecture Case studies Discussion Simulation Feedback Workshop Method Measureabl e Impact Goals Objectives Disclosure Gap Knowledg e sharing System-wide spread Practical Guidance Resources
Preliminary Results Measurable Impact 100% 90% 80% 78% 82% 76% 88% 93% 89% Pre Workshop Post Workshop 90-Day Post 70% 60% 50% 64% 56% 62% 54% 50% 45% 40% 30% 33% 29% 36% 20% 10% 0% Preparedness* Communication skills* Develop & maintain relationships Confidence* Level of anxiety* The most satisfying and personally rewarding experience I ve ever had -Actor Nurses and doctors are always fighting for the same things, but aren t always on the same page this workshop helped -Nurse practitioner It s important to remember that what is normal to providers is completely unusual and unexpected for patients it s good to take a step back and remember this -Manager Chart highlights the top 2 positive survey responses for each question (level of anxiety is reverse coded) *Statistically significant
Psychological Safety
Psychological Safety Amy Edmondson
Hum Resour Health. 2013; 11: 19. Published online 2013 May 10. doi: 10.1186/1478-4491-11-19 PMCID: PMC3662612 Ten principles of good interdisciplinary team work Susan A Nancarrow, 1 Andrew Booth,2 Steven Ariss,2 Tony Smith,3 Pam Enderby,2 and Alison Roots4
Interprofessional & Intergenerational Team Development NICU Mom Baby Labor & Delivery
Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Percent of Cases Treated Within 60 Minutes ILPQC Obstetric Hypertension Time to Treatment Within 60 Minutes 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 66% 46% Time to Treatment Within 60 Minutes 57% 67% 67% 65% 59% 83% 79% 79% 80% 84% 88% 80% 83% 84% 87% 73% 74% NMH NMH Baseline (57%) All Hospitals Level III Hospitals Goal (80%) Northwestern Medicine Prentice Women s Hospital 2017-2018
Percent of Cases Follow-Up Appointment 7-10 Days Discharge Follow-Up 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Follow-Up Appointment Scheduled Within 3-10 Days 56% 60% 53% 58% 30% 64% 46% 62% 67% 56% 75% 64% 62% 60% 54% 58% 84% 83% 75% NMH NMH Baseline (45%) All Hospitals Level III Hospitals Goal (70%) Northwestern Medicine Prentice Women s Hospital 2017-2018
Unintended Extubations per 100 Ventilator Days Total Unintended Extubations FY17-18 Unintended Extubation Rate 7 7 6 5.75 6 5 5 4 3.73 4.11 4.00 4 3 2 2 1.09 2.40 1.94 1.33 1.79 1.98 1.43 1.95 1.43 3 2 1 1 0 0 1 0 2 3 2 6 1 1 2 3 2 4 3 2 5 0 0.00 0 Unintended Extubations Unintended Extubations per 100 Ventilator Days Target ( 2.18) FY18 YTD Rate (2.20) FY17 YTD Rate (2.09) Northwestern Medicine Prentice Women s Hospital 2017-2018
References & Resources Generational diversity: what nurse managers need to know. Henricks, Joyce M., Cope, Vicki C.. Journal of Advanced Nursing. Mar2013, Vol. 69 Issue 3, p717-725. 9p. Med Educ Online. 2011; 16: 10.3402/meo.v16i0.6035. Published online 2011 Apr 8. doi: 10.3402/meo.v16i0.6035. PMCID: PMC3081249. Interprofessional collaboration: three best practice models of interprofessional education. Diane R. Bridges, MSN, RN, CCM, 1,* Richard A. Davidson, MD, MPH, 2 Peggy Soule Odegard, PharmD, BCPS, CDE, FASCP, 3 Ian V. Maki, MPH, 3 and John Tomkowiak, MD, MOL 4 Ten Principles of Good Interdisciplinary Teamwork. Hum Resour Health. 2013; 11: 19. Published online 2013 May 10. doi: 10.1186/1478-4491-11-19 Registered Nurse Association of Ontario. http://rnao.ca/bpg/guidelines/interprofessional-team-work-healthcare http://rnao.ca/bpg/guidelines/interprofessional-team-work-healthcare
Thank you for your time and consideration! QUESTIONS??? Karmour@nm.org 312-472-3813 office
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