Running Head ACADEMIC SERVICE PARTNERSHIP Academic Service Partnership: Supporting Nurses Transitioning to a New Hospital Marisa Vaglica RN, BScN, MN Director of Professional Practice Excellence, Humber River Hospital, Toronto Canada Dr. Paula Mastrilli RN, MScN, PHD Chair, Nursing, George Brown College, Toronto Canada Ellen Bull RN, BScN, MA Professional Development Liaison, George Brown College, Toronto Canada March 2016 Common Curriculum Team Members: Wendy Clark, BScN, MHM, Orientation and Training Coordinator, Humber River Hospital Natalie Murray, BScN, MN, Clinical Practice Leader- Cardiology/General Medicine, Humber River Hospital Agnieszka Przywolska BScN, MScN, CNCC(C), Clinical Practice Leader- General Medicine, Humber River Hospital Nela Crisan BScN, MN, Clinical Practice Leader-PACU, SDC, Surgical Prescreening Suba Sivaramalingam BScN, MN, Nursing Faculty, George Brown College Judith Barnaby BScN, Med, MSN, ANP, Nursing Faculty, George Brown College/Ryerson University Khelesh Persaud RN, PHD, Nursing Faculty, George Brown College/Ryerson University Patricia Mazzotta, BScN, MScN, PHD Student (U-Vic), Nursing Faculty, Centennial College Marsh Astrop BScN, MScN, Nursing Faculty, Centennial College
ACADEMIC SERVICE PARTNERSHIP 2 Introduction On October 18, 2015, Humber River Hospital (HRH), Toronto Ontario, Canada combined three existing sites and moved patients, staff and services to North America s first fully digital hospital. Humber River Hospital (HRH) partnered with The Sally Horsfall Eaton School of Nursing at George Brown College (GBC) to create an innovative strategy to support the transition of clinical staff into the new facility. With the transition, the nursing leadership focused on establishing a climate of mutual support through mentorship and a renewed commitment to excellence in client care. HRH provides comprehensive health care services for residence in a large metropolitan centre. The hospital maintains 656 acute care beds in addition to emergency and a variety of outpatient services in a 1.8 million square foot footprint. The School of Nursing at GBC delivers a broad range of nursing programs ranging from a Collaborative BScN Degree (with Ryerson University and Centennial College as partners), Practical Nursing Diploma, Personal Support Workers Certificate and a bridging pathway for RPN to a BScN in partnership with Trent University. The faculty in the school possess both Master s and PhD degrees in Nursing and/or Education. Partnership Description HRH and GBC collaborated to develop an Academic Service Partnership which was defined by Degeest et. al. (2013) as a structural linkage between [an academic institution] and a practice setting based on a shared vision that builds on the strength of each partner, demonstrates collaboration and supports change such as quality patient care, staff retention and innovation. The project addressed the complex professional development needs of over 1,500 nursing staff and allied health professionals transitioning to a new fully digital facility. The timeline for this project was limited to a three month period between the completion of the new facility and the
ACADEMIC SERVICE PARTNERSHIP 3 transfer of all staff, hospital services and patients to the new site. During this time period, all nursing and allied health care providers were required to learn how to use the new technologies, automated equipment, patient care processes, and relevant hospital policies. To assist the employees, HRH Clinical Practice Leaders (CPLs) partnered with GBC curriculum design, mentorship and practice experts to develop an innovative professional development strategy. Bally (2007) identified mentorship as the fundamental strategy for developing clinical skills and supporting changes in workplace culture. Project Description The Academic Service Partnership s project goals aspired to build clinical knowledge, skills and confidence among the nursing and allied health care staff during the transition to a new environment. A Memorandum of Understanding (MOU) outlined the project goals, partner responsibilities, deliverables, timelines and a budget. GBC assigned both full-time and part-time faculty to work with the HRH clinical practice leaders to design online learning modules and onsite workshops containing Common Curriculum. The workshop content included the knowledge and skills required for all nurses and allied health care providers to function within the new facility. Examples of content included: an orientation to a new electronic documentation and ordering system; new automated equipment, revised/hospital policies and processes (e.g. creating positive working spaces). GBC faculty and HRH clinical practice leaders also created workshops to advance evidence-informed assessment and care of patients on specialty units (i.e., enhanced nursing assessment skills, complex care for respiratory, nephrology and phase 2 perianesthesia patients). An innovative implementation strategy was developed to deliver the Common Curriculum Workshops to all 1,500 plus staff just prior to the transition into the new facility.
ACADEMIC SERVICE PARTNERSHIP 4 Approximately 150 staff nurses were identified as informal leaders on each unit by their nursing managers. These nurses were given the title of Super Users. These nurses participated in a train-the-trainer program which was delivered by the GBC faculty and HRH clinical practice leaders. The Super Users were the first to receive the Common Curriculum content and workshops. Additionally, these nurses participated in a Teaching and Mentorships Skills Workshop- delivered by the GBC faculty. The Transformational Mentorship Model (Jacobson & Sherrod, 2012) was used to structure the workshop and define the mentor and mentee roles. Following their preparation, the Super Users, were mentored by the GBC faculty to deliver the Common Curriculum Workshops to other staff nurses and allied health care staff throughout the organization utilizing a Train the Trainer methodology. As the Super Users became more confident with facilitation and teaching, the GBC faculty decreased their role involvement leaving the Super Users to function independently in delivery of the workshops. After the transition into the new facility a Super Users took on the role of Unit Mentors. A Unit Mentor was assigned on every unit and every shift to reinforcing the content and skills that were taught within the workshops and to help establish sharing, supportive and caring environments at the unit level until the units within the new facility were fully functional. Project Evaluation and Findings GBC Faculty and HRH clinical practice leaders developed a program evaluation for the professional development strategy (Workshops) and the academic service partnership. The professional development strategy was evaluated using two sources of data collection. A knowledge and clinical skills self-assessment survey developed by the project team, was administered to the 150 Super-Users immediately before and after the Common Curriculum and Mentorship Workshops. Survey responses were based on a 5-point Likert Scale (1=no
ACADEMIC SERVICE PARTNERSHIP 5 knowledge, 3=some knowledge, 5=a lot of knowledge). A comparison of the pre- and postsurvey results were used to evaluate the learning acquired by the participants. A second survey was administered at the end of the workshops to collect data related to the participants perceptions of the content and quality of the learning experience. The responses to the second survey were also based on a 5-point Likert Scale (1=strongly disagree, 2=disagree, 3=cannot decide, 4-=agree, 5=strongly agree). In addition, the survey asked participants to identify the most useful and least useful aspect of the workshop. The academic service partnership was evaluated through interviews conducted with the project team. Questions were directed at exploring strengths, areas of improvement, lessons learned and recommendations. All data was anonymized in preparing the final project evaluation report. A total of 76 of the 150 participants responded to the surveys. The pre and post workshop self-evaluation responses indicated an increase in participants self-assessment scores in all areas of knowledge and skills addressed in the workshop. (pre workshop mean: 2.33; postworkshop score: 4.13). The mean score for overall satisfaction with the workshop was 4.16, indicating a high degree of satisfaction among participants. Participants identified the most useful aspects of the workshops to be the: hands on practice, the vendor fair and the mentorship content. The least useful aspects were identified as the didactic presentation related to customer communication (repetitious). Several participants identified a need for additional unit specific and equipment information and comments were made about some of the new technology glitches which occurred during the initial training. The effectiveness of the academic service partnership was evaluated through focus group feedback interviews with the project team members. The feedback responses and recommendations could be divided into in four themes; (1) project structure and organization; (2)
ACADEMIC SERVICE PARTNERSHIP 6 commitment to project success and quality; (3) communication; and (4) team work. See Table 1 for a summary of feedback included within each of the themes. Table 1 Qualitative Data: Academic-Service Partnership and Project Feedback Project Structure and Organization The MOU promoted clarity for the scope of the project and required deliverables within the concentrated project timelines. Dedicated, effective coordinators from each partner ensured tasks and processes are complete. Responsive and approachable administrators offered team support and facilitated decisions for institutional or departmental challenges in a timely manner. Commitment to Project Success and Quality Content review teams reviewed changing materials and information. Exemplary vendor and department representatives assisted with the teaching on equipment, policies and process. Starting from scratch, with little information takes patience, but when it all comes together, you appreciate the journey. Communication Consistent communication between GBC & HRH project coordinators and administrators ensured team support and facilitated the program development and implementation. Some managers and department heads were not clear that the program was common clinical, not unit specific which impacted negatively on participant expectations. Early and ongoing access to an electronic team communication system (the G-drive, ihumber) provided a common communication and curriculum development platform. Teamwork Working in pairs (GBC & HRH) was encouraging and productive and provided more flexibility to shifting challenges and demands. Meeting new people and working in an excellent team was a satisfying personal and positive professional experience. Academic partnership/collaboration builds sustainable programs and strong healthcare providers. Summary The academic service partnership and professional development strategy proved to be effective and successful in building strong teams, coordinating work and meeting critical
ACADEMIC SERVICE PARTNERSHIP 7 objectives for transitioning the nursing and allied health care staff into the new digital environment. Strong communication and dedication to quality with a focus on interprofessional collaboration were key attributes to the success of the project team. The senior leadership of the two partnering organizations maintained support and responsiveness to the project team requests and challenges that proved invaluable in moving forward. Based on the success of the partnership, GBC and HRH project team members have volunteered to participate in future scholarship activities and are currently preparing journal and conference submissions. Both organizations have expressed a commitment to expand the partnership with the development of additional projects and funding proposals to support clinical practice education, knowledge translation activities and initiatives which promote quality provider focused-patient centred care outcomes as future endeavors. References Bally, J. (2007). The role of nursing leadership in creating a mentoring culture in acute care environments. Nursing Economics, 25(3), 143-148. De Geest, S., Dobbels, F., Schonfeld, S., Duerinckx, N., Sveinbjarnardottir, E., & Denhaerynck, K. (2013). Academic service partnerships: what do we learn from around the globe? A systematic literature review. Nursing Outlook, 61, 447-457. Jacobson, S. L., & Sherrod, D. R. (2012). Transformational mentorship models for nurse educators. Nursing Science Quarterly, 25(3), 279-284. doi:10.1177/0894318412447565