Emerson Hospital strategic plan update
Linda Wells, vice president for nursing and patient care services, spoke to attendees about the updated nursing mission, vision, values and philosophy statements. She distributed copies of the nursing newsletter, which was re-launched. She spoke about the recent change in titles from nurse managers to nursing directors, which more clearly reflects roles and responsibilities.

She noted that recent Press Ganey patient satisfaction results demonstrated the highest scores for nursing services and pain management in recent history. Finally, Linda shared the plans for Project SCORE (Surgical Center, Obstetrics and Radiology Expansion) and its positive effect on the work flow for nursing care.

Update on quality initiatives
Regina Burzynski, director of patient care assessment, provided an update to the council on the quality initiatives occurring at Emerson, including hospital-wide projects in fall prevention, reconciling medications, infection prevention, medication error reporting, pain management, restraint reduction and safety walk rounds. She emphasized that these initiatives are part of a state-wide and national quality process that compares Emerson to similar hospitals.

Patients First
Kevin Whitney, director of nursing services, updated participants on the Massachusetts Patients First initiative, which is a state-wide effort to inform patients and families about staffing plans and patient outcomes for all hospitals in the Commonwealth. This effort has gained national attention as a model that keeps the public informed of the potential effect of staffing on patient care. Staffing plans are available to the public on www.patientsfirstma.org. The outcome measures are in a pilot project and should be available by the winter of 2007.

Nursing council reports

Professional practice council
Evidence-based practice (EBP) has been adopted as the model for all nursing policy and procedure review. EBP involves the review of current research, literature and professional practice standards to inform nursing care. Maureen Canava relayed that a Healthstream module is being developed to assist nursing staff in EBP. She also said that some of the current work of the
council involves:

• updating  the nursing IV Push reference guide
• collaborating with the laboratory to create a blood tube chart
• approving applications for complementary therapy staff
• working with IS to develop Intranet access for the nursing Q drive
• ongoing policy review

Nursing quality council
Judy LeSage reported on the work of the council, including the development of a report card to show Emerson nurses what patient outcome data are available to the public on the Web. The goal will be to create a user-friendly format that busy nurses can review to understand how nursing care affects outcomes.

Professional development council
Sue Holman informed council members of the following efforts: ensuring uniformity of orientation and role responsibility at the unit level, establishing a relationship with human resources to explore recruitment and retention strategies and supporting clinical development of staff nurses (e.g. certification, care of the geriatric patient).

OB unit council
Claire McNamara spoke to the group about specific measures taken by OB nurses. Efforts include: a new OB patient satisfaction survey given to patients the night before discharge, noise reduction efforts based on the results of a noise meter, enhancing the discharge process through the use of a class and video and research on footprints as patient identifiers.

CCU practice council
Mary Beth McKinney reported on several nursing practice initiatives in the CCU including:

• A-Line policy changes based on best practice
• critical care order sheets
• poster presentation to the National Teaching Institute
• a staff morale initiative called Fast Hug
• new educational opportunities for staff funded by proceeds from a new snack cart on the unit
• a picture board with photos of all CCU staff and physicians available for patients to view

Interventional radiology council
Vicki Mihalek told members that interventional radiology is working on a project to identify opportunities to input patient care information into the computer that would be accessible to the units. A positive work environment now allows nurses enough space to sit.

Vicki will present information on vascular screening at an upcoming nursing grand rounds. She was also happy to report that three nurses have taken the radiology certification exam.

OR unit councils
Ginny Caples shared the following information on the OR councils and teams:

• Communication and events: Staff meeting minutes are now distributed via e-mail and hard copy, and celebrations are planned for OR Nurses Week
• Safety and patient care: Working on hand-off language and “No Sticks In ‘06” campaign
• OR systems: Major initiative of “turbo turnover” to increase efficiency; also working on patient flow issues and staff scheduling
• OR, SDC, PST and PACU are working on strategies to bridge relationships between these areas (e.g. morning report)

Wheeler 4 unit council
Leslie Strong talked about the initiatives being addressed by the Wheeler 4 unit council, including: seamless change of shift process, improved communication between RNs and PCTs, smoother process for daily lab draws and preparing patients for procedures off the unit, developing playroom rules, pediatric welcome packets/coping kits, review of LPN role and safety of pediatric patients.

Home care unit council
Eileen Asoian described a quality of work life project that was initiated in home care. The project involves exploring new options for cell phone reimbursement given the expense of using phones in the community. Cell phones are the primary method for home care staff to communicate with patients, physicians, colleagues and the office.

TCU unit council
Janice Clement said that TCU is participating in:

• a trial of new CPM machines
• development of a form to capture PCT hours of patient care to accurately reflect their role for the mandated assessment form tied to reimbursement for the TCU unit for care rendered
• a project to monitor pain
• revisions to the intake and output sheets
• development of a vision statement for the unit

Wheeler 5 unit council
Jane Quinn focused on the following efforts on Wheeler 5:

• looking at the role of the LPN in IV push medications
• shift report process
• evaluating noise levels
• developing an orthopedic nursing education plan and care protocol
• review of response to call lights
• safety of computer docking stations
• communication between RNs and PCTs
• taped report

North 5 unit council
Tom Feight reported on the following activities for North 5: implementation of a self-scheduling model, development of supervisor groups, inservices for ethics and boundaries issues, development of a patient satisfaction tool for Milieu and Partial programs, unit-specific policies/procedures and a restraint review process.

North 6 unit council
Kelly Handy highlighted the following work of the North 6 council:

• RN/PCT communication processes
• call light response
• self-scheduling
• staff morale initiatives
• North 6 patient brochure
• RN/PCT walking rounds at change of shift

ED unit council
Donna Zimmerman reported on the following ED work:

• holding unit council meetings prior to staff meetings to increase participation
• EDIT communication board
• staff recognition program called Emerson Emmy awards
• Welcome to the ED brochure
• scripting process for staff when bringing patients to rooms

Nursing research committee
Peg Bitter reported on the work of the research council, including our relationship with Simmons College nurse researchers, development of needs assessment and program strategies, plans to develop a nursing research sub-committee to work with Emerson Hospital IRB for future research projects, the collaborative relationship with Nancy Serotkin (manager of library services), inservices for committee members and unit-based research journal clubs.

Clinical Advancement Program (CAP) committee
Fran Kline updated members on the efforts of CAP, including the implementation of CAP Level IV, revisions to portfolio format, development of an interview process for Level IV and preparations for the CAP Recognition Tea in April.

PRN nurses
Peggy Flood described the work of the PRN nurses. They

• contributed to Emerson’s ranking in the top one to two percentile for patient satisfaction with management of pain
• meet every month for educational sessions and collaboration with the interdisciplinary pain team to discuss case studies
• have decreased referrals directly to Peggy as the PRN nurses have increased knowledge and comfort level
• developed a poster presentation “road show” for units
• listed PRN nurse on the hospital Intranet

ET resource nurses
Peg Corr reviewed the work of the ET resource team, who helped her prepare information for a poster board delineating the pressure ulcer prevalence study process, skin care algorithm and bed guide. This group also participates in the quarterly NDNQI Pressure Ulcer Prevalence Study and reviews unit-based results to find opportunities for improvement.

Nurse/physician collaboration
Donna Kilcoyne reported on the goals of this group, which are to increase empowerment of nursing in managing patient care, develop a standardized communication tool with physician input and coordinate with Hand-off Task Force efforts. The group has conducted an initial MD satisfaction survey and will speak with a group of physicians to develop an action plan.

Magnet update
Patti Shanteler presented an update of the Magnet project and timeline. She shared several examples of “Magnet Moments,” using examples of Emerson nursing at its best. The application was filed at the end of March 2006, and the tentative date for documentation submission is March 2008. In the next few months, Patti and the Magnet Core Team will develop Magnet Force Teams and identify Magnet Champions.

Special Presentation - Magnet experience
Katherine McDonough, RN, of the McDonough Group, spoke of her personal experience as the Magnet coordinator for Dana-Farber, which received Magnet  in 2005. She explained that "this is a difficult and time-consuming project, but it is also incredibly rewarding."

Questions? Story ideas? Contact Patti Shanteler, director of nursing quality, ext. 3365 or Mary Seymour, director of education, ext. 3051.