Cincinnati Children's 2016 Patient Services Annual Report

Clinical Innovations Advancing Patient Care

2016 PATIENT SERVICES ANNUAL REPORT

Focused on Excellence 2016 PATIENT SERVICES ANNUAL REPORT Welcome

Colleagues and Friends, With our ultimate vision in mind—to become the leader in improving child health—the Department of Patient Services continues to move forward, changing the outcome together for our patients and families.

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Telling the Patient’s Story: Longitudinal Plan of Care

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Got Milk?

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Protecting At-Risk Infants with Mother’s Milk

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No More Snoring

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Expanding the Reach of Perinatal Hospice

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Newest Team Members: Canine 13 Assistants Leica, Drummer and Chevy We Never Rest on our Laurels

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Patient Services Awards

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2016 in Review—Optimal Outcomes 19 2016 in Review—Nursing Continuing Education

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Research in Patient Services

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2016 Nationally Recognized Nursing Certifications

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This annual report highlights some of the ways in which Cincinnati Children’s staff are thinking differently about our delivery of care. From our outstanding nurses to our incredible dieticians, perinatal hospice workers, Shared Governance councils, pharmacists and other allied health professionals— even our new canine colleagues—this publication captures the dedication and enthusiasm of our Patient Services team. It also showcases some of the novel approaches we have adopted to improve our patient and family experiences.

As you will see in each one of these stories, striving for exceptional care is ingrained in our culture. It is about innovation. It is about fostering teamwork.

Cincinnati Children’s was one of the first institutions across the country to establish an interprofessional practice model. Because of the positive patient outcomes of this coordinated care approach, other hospitals have since adopted a similar framework.

Our forward-thinking mindset ensures that we still have much to contribute to the health of tomorrow’s kids.

Indeed, we have many successes to celebrate here at Cincinnati Children’s.

Our forward-thinking mindset ensures that we still have much to contribute to the health of tomorrow’s kids. I hope these stories enlighten you on how inspirational our staff is.

Sincerely,

Cheryl Hoying PhD, RN, NEA-BC, FACHE, FAAN Senior Vice President of Patient Services

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WELCOME

WELCOME

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Supporting patient/family engagement and coordination of care makes a difference in patient’s lives.

Telling the Patient’s Story: Longitudinal Plan of Care Improving the management of complex patient care Children with complex medical conditions see multiple specialty providers throughout Cincinnati Children’s. Some patients and families are able to independently coordinate their child’s appointments. Other patients and families find the services offered in care coordination beneficial in navigating a multi-faceted healthcare system. The Longitudinal Plan of Care (LPOC) is a tool used by nurses and other healthcare professionals to document a patient’s goals and interventions. Working collaboratively with the patient and

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LONGITUDINAL PLAN OF CARE (LPOC)

family, a Care Manager establishes specific goals that are realistic, achievable, timely and measurable.

Stated in the patient or family’s own words, these goals often address barriers to care, health and wellness outcomes, safety issues, patient and family skill building and confidence in independent care. Embedded within a patient’s electronic health record, the LPOC provides the opportunity for multiple specialty care providers to collaborate with the patient and family to achieve optimal outcomes and goals.

Historically, patient care plans and care goals exist within specific episodes of hospitalizations, yet there is not a coordinated plan of care to communicate patient care goals between and across the care continuum.

Cincinnati Children’s has received national recognition from the National Committee for Quality Assurance as a patient-centered medical home.

The LPOC was launched within the electronic medical record for medically complex patients in primary care. It displays an electronic report of the primary care provider, the patient’s

Unique Patient and Family Needs Care Management with the Longitudinal Plan of Care has proven successful for one young boy and his family.

Our patient lives with his maternal grandmother as his guardian, and with his disabled parents. He has velo-cardio-facial syndrome also known as 22q11.2 deletion syndrome resulting in complex medical needs. This syndrome can affect any body system and often includes heart abnormalities, cleft palate, autoimmune disorders, kidney abnormalities, thrombocytopenia, gastrointestinal disorders, skeletal abnormalities and hearing loss.

Individuals with 22q11.2 often experience difficulties in breathing, feeding and many children are developmentally delayed in growth, learning and speech. Adults with this syndrome are at increased risk for mental illnesses including schizophrenia, depression, anxiety and bipolar disorder. This young boy is tracheostomy dependent, ventilator dependent during sleep and gastrostomy-tube dependent for his nutritional needs. He wears diapers, has very limited speech, yet he walks independently.

medical home site, three patientspecific care goals, a care coordination note, functional plan, and safety plan.

The young boy’s father also has the same 22q11.2 deletion syndrome. There are approximately 16 pediatric specialty departments who provide care for this boy and he often attends weekly appointments throughout the Cincinnati Children’s health system. He has some in-home nursing care provided by independent nurses and is otherwise cared for by his grandmother who is a strong advocate for him. He has been delayed entering the public school system due to his grandmother’s concerns regarding the need for nursing care during school hours. This young boy is enrolled in Care Management with Sharon Cook, MSN, RN, CPN, CCM, as his Care Manager, of whom his grandmother has said she couldn’t do without.

Longitudinal Plan of Care • The LPOC is used by care managers in Primary Care as a ‘primary work space,’ as many elements of practice are reflected here. Practice Guidelines note the specifics on how Primary Care care managers utilize the LPOC elements such as Care Team, Care Coordination Note, Goals, and Problem List.

• Other health care team members have knowledge of the LPOC and are able to use it to support their work with patients/families.

• Teams will use the LPOC as a standard tool for Pre-Visit Planning which will be supplemented by condition specific information related to their outcomes.

LONGITUDINAL PLAN OF CARE (LPOC)

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Got Milk?

Giving every infant the best opportunity to thrive What started as a group of Cincinnati Children’s care providers passionate about human milk, has led to a successful Rapid Cycle Improvement Collaborative (RCIC) project and continued interventions to increase the percentage of infants discharged on maternal breastmilk. Made up of an interdisciplinary team including nutrition therapy, registered and advanced practice nursing, lactation consultants, physicians, nursing management, and education; the initiative made strides with a 2014 RCIC project titled “Optimizing Human Milk Use in the Newborn Intensive Care Unit.”

Fueled by their own passion and the recommendation that children receive exclusive breastmilk feeding for the first six months of life by the World Health Organization, Department

of Health and Human Services, American Academy of Pediatrics, and American College of Obstetricians and Gynecologists, the project identified current processes, failure modes, and appropriate interventions for increasing breastfeeding rates.

Starting with a baseline of 63% in January 2014, the project aimed to increase the percentage of infants discharged on any maternal breastmilk in their diet to 70% by June 2014.

They successfully reached 75% at the end of their study and have continued to maintain similar rates in the following years.

Since the success of their 2014 RCIC project, the team has continued their Got Milk project through implementing interventions and maintaining the higher rates of breastfeeding. Though challenges including space issues and

bed relocating caused the rates to fall briefly below the 75% mark in 2016, the team shows no signs of slowing down their work.

Since they started, they have improved knowledge and communication by hosting hospital discussions and presentations, developing posters and signage for staff and families, collecting surveys from staff and mothers, and optimizing Epic documentation.

The team also encourages collaboration both between disciplines and area hospitals by identifying breastfeeding champions, working together with physicians and delivery hospitals, and promoting their Breastfeeding Pathway.

The Breastfeeding Pathway The Breastfeeding Pathway, which describes the three phases parents go through to transition into breastfeeding, has been a helpful tool for new mothers since the beginning of the project, and it continues to gain traction. In January the pathway was placed at the bedside using crib cards and in March large copies were placed on pumping room doors. The team applied collaborative thinking to their Breastfeeding Pathway and are now working with other level-three

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GOT MILK?

hospitals in the area to share the pathway and provide a consistent message that new mothers can trust and connect with.

Their most recent effort brought Diane Spatz, internationally-recognized expert, to speak to Cincinnati Children’s about her work. The team plans to use the experience to gain insight into other programs and initiatives that will continue to shape their work.

Our lactation consultants offer expert help throughout the breastfeeding experience.

The Breastfeeding Pathway— Introduction to Breastfeeding in the NICU

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Preparing milk and bottles for breastfeeding

• Pump for 15 minutes every 3 hours to make milk for your baby. Use hospital-grade pump at hospital and at home.

• Label bottles as instructed, and give to nurse.

• Use your milk for mouth care (if baby is not intubated) until your baby is able to begin feeding.

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Providing skin-to-skin contact

• Kangaroo Care (holding a baby skin-to-skin on chest): Moms and Dads do this to bond and provide warmth for their baby.

• Kangaroo Care begins the introduction to breastfeeding by helping parent-infant bonding and increasing the mother’s milk supply.

• Provide kangaroo care during your baby’s tube feedings.

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Transitioning from non-nutritive to nutritive breastfeeding

• Non-nutritive breastfeeding (placing infant on your breast during and/or after tube feeding or pumping): This allows your baby to practice breastfeeding without actually drinking your milk.

• Start giving your baby tastes at your breast followed by tube feeding.

• Begin nutritive feedings at your breast and supplement with a bottle or tube feeding afterward.

• Continue breastfeeding your baby as directed by the medical team.

GOT MILK

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Infants can benefit from breastmilk as oral care.

Protecting At-Risk Infants with Mother’s Milk Optimizing the oral care of newborns with breastmilk In September of 2014 Keri Robison, BSN, RN, IBCLC, a Nutrition Therapy lactation consultant working in the Neonatal Intensive Care Unit (NICU) and a team participant on the Got Milk study, learned of a novel nursing practice while attending a neonatal conference. Robison consulted with the NICU Quality Outcomes Manager Tammy Casper, DNP, RN, who had also learned of this same practice at another conference. Inspired by the potential for improved newborn care, a clinical question was formed to search the literature: Is the use of

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mothers’ colostrum for oral care safe and beneficial for infants receiving intensive nursing care?

The search for evidence yielded a systematic review of the use of oral lactoferrin (a protein found in human milk which has antimicrobial and mucosal protective properties) as potentially preventing sepsis in preterm infants. Synthesizing the available evidence, Robison and Casper concluded that although there is scant research evidence on the effectiveness to prevent infections,

PROTECTING AT RISK INFANTS WITH MOTHER’S MILK

the use of an infant’s mother’s breastmilk for oral care is feasible, safe and inexpensive for intubated infants. The evidence-based recommendation for care is to use the mother’s breastmilk for oral care among intubated infants.

The NICU oral care team comprised of Keri Robison BSN, IBCLC; Tammy Casper DNP, MEd, RN; Pamela Pockras MSN, APRN, IBCLC; Lindsay Rack BSN, RN, RNC-NIC; Kristin Westerfield BSN, RN, RNC-NIC; Brandy Segar MSc, RRT-NPS and Whittney Brady DNP, RN, NE-BC began to trial the practice change of using the mother’s breastmilk for oral care in non-intubated infants in 2014. The trial period determined the best processes for implementation as nurses cleaned the infant’s mouth with sterile water and then applied 0.2 ml of the mother’s fresh breastmilk to the infant’s oral

Percentage of Intubated Infants who Received Mother’s Milk as Oral Care

100% 90% 80% 70% 60% 50% 40% 30% 20% 10%

mucosa. Once a successful process had been determined Robison presented the evidence and the care recommendation to multiple committees seeking adoption of the practice change.

Following approval from the Nursing Profession Practice Council to spread the intervention to all care areas, Robison enlisted the assistance of a team to develop and implement the following activities: • October 2015: Mouth care kit created • July 2016: Knowing Note created for patient/family education • Job aid created for online learning module and documentation in electronic health record • August–November 2016: Online education for clinical nurses and respiratory therapists as part of 2017 Prevention Standards

• August 2016: Procedure for Mouth Care revised Prior to full implementation, nurses in the NICU were surveyed daily for seven days regarding the practice change. Bedside nurses reported that the job aid tool, amount of milk, quality of the swabs and process for obtaining breastmilk for mouth care was a doable and positive change.

The ease of incorporation into the daily workflow showed improvement over time.

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08/01/16

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0% 07/01/16

% of Patients Who Met the Process Outcome

>Days of life; intubated for at lest 24 hours

The practice change was fully implemented in September 2016.

At that time it was estimated that 40% of intubated infants received their mother’s breastmilk for oral care.

Since implementation of this new practice in the NICU, the percentage of intubated infants who have received their mother’s breastmilk for oral care has increased to 80% with a high of 100% in November of 2016.

Caring for your baby’s mouth • Express your breastmilk, following your usual routine.

• Place 5–10 ml of breastmilk in a small bottle.

• Place a label on the bottle with your baby’s name and write “mouth care” on it.

• Give the bottle to the nurse who will place the breastmilk in the refrigerator.

PROTECTING AT RISK INFANTS WITH MOTHER’S MILK

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No Snoring in this Clinic Making informed decisions for Obstructive Sleep Apnea kids The Upper Airway Center (UAC) was established in 2013 to provide a comprehensive, interprofessional approach to caring for patients with complex Obstructive Sleep Apnea (OSA). The UAC has specific expertise in treating OSA in infants, children and young adults with craniofacial abnormalities and Down Syndrome.

OSA is a common, treatable condition that causes breathing difficulties while sleeping. While it is not uncommon for some children to snore, only around 2% of children have OSA, which most often causes snorting or gasping while sleeping. Children with OSA have trouble sleeping at night and as a result of their extreme sleepiness, often exhibit behavioral problems during the day. If left undiagnosed, OSA can lead to problems at school, and delayed growth. In extreme cases,

OSA can cause heart failure due to decreased blood oxygen levels.

Treatment for this population is varied and often complex, and many parents have difficulty making an informed decision concerning the best treatment for their child. When the UAC was initially established, the team of physicians and nurses, including Angela Duggins, RN, BSN, MCCTR, CCRC, and Karin Tiemeyer, MSN, RN-BC, created prototypes of available treatment options for parents to make an informed decision. Despite the use of those prototypes, however, families continued to experience challenges making decisions regarding treatment options after meeting with the clinic team. The interdisciplinary team needed a way to educate families on treatment options in a way they could understand.

In the fall of 2015, members of the UAC healthcare team participated in a shared decision-making collaborative to create a shared decision-making (decision aid) tool for obstructive sleep apnea families.

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NO SNORING IN THIS CLINIC

The use of decision aid tools has been shown to consistently improve patient/parent knowledge, increase involvement in decisions, decrease uncertainty about choice, and improve compliance.

The goal of the UAC interprofessional team was to reduce the degree of decisional conflict experienced by caregivers of children with OSA to a score of less than 25 (considered low decisional conflict). Improvement of decision-making among families was measured pre and post-clinic visit using a decisional conflict validated tool.

Duggins, who coordinates and manages the clinical research for the UAC worked with Tiemeyer, the nurse coordinator for the project, to interact with patients and families while trialing various prototypes. They collected and maintained data for analysis, and in April of 2016, several iterations of the decision aid were tested with families until the team approved the final version.

By September 2016 the interprofessional team had conducted a single-blind randomized controlled trial for children with OSA. The study group used the shared decision-making tool while the control group did not. Measures of decisional conflict, based on the validated tool, were taken before and after the clinical visit.

Parents better understand the options for their child’s best outcome.

The uncertainty, the informed, and the effective decision subscales showed statistically significant improvement in patients using the decision aid tool.

• The uncertainty subscale relates to how clear and easy the treatment choice was and how sure the parent feels about their choice.

• The informed subscale identifies the parent’s feelings around knowledge regarding the options, benefits and risks associated with each treatment for OSA. • The effective decision subscale indicates family satisfaction, their motivation to stick with their treatment decision and their feeling of making an informed choice that supports what is important to them.

In December 2016 the data analysis and final revisions to the OSA decision aid tool were complete.

The new process for practice flow was developed and staff were trained. Surveys were loaded onto

each computer in clinical areas for families to complete at the end of their visit and by January 2017 the OSA shared decision-making tool became part of each clinic visit.

Decision Aid Tool Study During the study, the baseline group of 26 patients who did not receive the new decision aid tool scored an average of 13.31 on the decisional

conflict scale versus 6.08 for those who used the new tool.

• Improved patient/family education • Increased understanding of options • Decreased decisional conflict

Improved outcomes and patient/family satisfaction!!

NO SNORING IN THIS CLINIC

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When a family gets a terminal diagnosis related to a pregnancy, where do they turn? Since the year 2000, families in the Tristate region who are served

by Cincinnati Children’s and StarShine Hospice have relied on our perinatal hospice program.

Expanding the Reach of Perinatal Hospice Extending a helping hand to parents in need The perinatal hospice program was designed by the Department of Genetics and StarShine Hospice to support families dealing with an “uncertain or unexpected” birth diagnosis. These diagnoses can leave families, who are now preparing for next steps in the pregnancy of a child with a terminal condition, feeling overwhelmed. This program fills the gap in services providing support and

assistance with decisions of how to proceed with care for these special families.

In order to alleviate some of the stress, families enrolled in this unique program receive an initial home visit from a hospice nurse, a social worker and a chaplain. Within a week following the initial visit, and in collaboration with the expectant mother’s physician,

Bereavement coordinators at Cincinnati Children’s create bereavement books for parents 11

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PERINATAL HOSPICE

the development of a birthing plan begins. During the next visits with the family, a nurse and a bereavement counselor identify services across the interdisciplinary team such as holistic health, child life and/or music therapy to ease the family through the process.

A member of the perinatal hospice program team is always available to attend the birth of the infant at the request of the family. A member of the team may also attend the infant’s funeral and coordinate special memorymaking activities with the parents and siblings to provide emotional support.

Bereavement care is provided by a nurse, social worker, chaplain and physician, and begins at the time of the infant’s death. During bereavement, members of the Bereavement team visit the family between two and eight times over the course of two years.

Families are also invited to attend the

annual bereavement family camp and memorial service, for which there is no charge.

Faced with the difficulty of telling families they don’t qualify because they live beyond the service region, Susanne Evans, BSN, MS, RN, clinical director for Cincinnati Children’s Private Duty Nursing, worked together with StarShine Hospice and the StarShine Coordinator. They developed an alternate plan to include these to meet with the families at the community OB/Gyn practice locations or at the Family Resource Center located within the Medical Center.

With a plan in place to reach more families, Evans presented a proposal for additional funding to the Wyler Family Foundation on December 14, 2015. In early 2016, the perinatal hospice program was awarded $150,000 over three years to expand

its reach and services, a significant increase in funds compared to FY2015’s self-funded cost of $27,860.

Due to the generosity of the Wyler Family Foundation, the perinatal hospice program has been able to increase services to include families outside of the local service area.

Additionally, $250 per family is now available for funeral expenses including a keepsake bassinet and special gifts for siblings. Bereavement counselor of 15 years, Marcella Cameron Meier, PhD, LISW, refers to this work as “unique and beautiful” as she assists in some of the most difficult moments in a family’s life.

Throughout the last 15 years, the perinatal hospice program has continued to grow. Community OB/ GYN physicians have become more familiar with the services and have dramatically increased referrals. In FY2016, 16 families received services through the perinatal hospice program.

In the same year, our hospice nurses, community OB/GYN providers and Cincinnati Children’s Fetal Care Center were also aware of more than 200 families in need of services, but lived outside of the service area for StarShine Hospice.

In early 2016, the perinatal hospice program was awarded $150,000 over three years to expand its reach and services.

PERINATAL HOSPICE

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Research shows that dog-assisted therapy can lower stress and anxiety levels, impact blood pressure, increase patient mobility and provide an alternative focus from pain.

Newest Child Life Team Members: Leica, Drummer and Chevy Canine assistants bring patients a unique, unspoken compassion Drummer, Leica and now Chevy are specially bred and trained to work as therapy dogs in a hospital setting; their training and selection had been in the works for almost two years.

Cincinnati Children’s received the dogs from Canine Assistants, a nonprofit in Milton, Georgia, that breeds and trains service dogs and 13

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NEWEST TEAM MEMBERS

has worked with five other pediatric hospitals across the country.

Unlike volunteer dogs that visit the medical center, the Child Life dogs are considered staff and are at Cincinnati Children’s every day with their handlers accessing both clinics and inpatient units. They cannot

access intensive care units, sterile environments or see patients in isolation, but facility dogs still manage to work a 40 hour week, with naps and meals included.

In the first year of the facility dog program at Cincinnati Children’s, the dogs have already made significant

In February of 2016, Cincinnati Children’s welcomed two dogs to the Division of Child Life and Integrative Care.

The golden retrievers, Drummer and Leica, provide physical and emotional support to patients, like Gia Biondo, as part of the Facility Dog Program.

9-year-old Gia didn’t smile for months while she was an inpatient being treated for chronic pancreatitis. Nothing her family did helped her feel well enough to be the spunky girl she was outside of the hospital. But all of that changed when she met Drummer.

“She was out of it, not happy, and in a lot of pain,” said Leanne Biondo, Gia’s mom. “A few minutes later, Drummer came in and her eyes lit up when he jumped on the bed. Suddenly, that pain was forgotten. Gia is like a whole new person when Drummer walks in.”

impact on patients. The dogs can physically interact with patients to provide comfort and love in ways that medical caregivers and therapists cannot. Research shows that dogassisted therapy can lower stress and anxiety levels, impact blood pressure, increase patient mobility, and provide an alternative focus from pain.

When the dogs first came to Cincinnati Children’s, then senior clinical director Sharon McLeod said, “My vision is that this is only the beginning. Our dream is that the program will grow, and we will have more members of our hospital staff with beautiful, wagging tails.” Since that time the program has added a new member

to the canine staff, Chevy, a spunky Golden Retriever/ Black Labrador mix.

Chevy came in and picked right up in the paw prints left by Drummer when he and his handler transferred out of the area.

NEWEST TEAM MEMBERS

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The steering committee for the redesign had intra-disciplinary leadership ranging from nursing to medicine to allied health.

We Never Rest on our Laurels Assessment of the Interprofessional Practice Model and the Redesign of Shared Governance Cincinnati Children’s Interprofessional Practice Model (IPM) represents clinical application of the standards in Cincinnati Children’s mission, vision and values to team-based care.

The care delivery system is deeply rooted in the interprofessional practice of providers to meet patient needs. Encouraged by Sr. Vice President Cheryl Hoying, the IPM was developed in 2012 by the Patient

Care Governance Council (an interdisciplinary group of direct care providers representing their professions). The IPM describes the principles of interprofessional practice and the expectations for team-based care. Commonly held standards for professionals are the foundation of each tenet of this model, including Innovation and Research.

When explaining unit-based decision-making at Cincinnati Children’s, the discussion must include the point-of-care. Shared decision-making is quite historical at Cincinnati Children’s. Developed and implemented in 1989, nursing shared governance was immediately embraced and became the gold standard as it evolved.

Over the years, our robust Shared Governance structure has served us well, gaining national attention and recognition. As with all systems, inherent challenges and opportunities for improvement exist. Our structure had grown to more than 100 operating councils, reducing our ability to be responsive, communicate effectively, and sustain us in our constantly changing environment. As a result, in April of 2016 we began the journey to evaluate the IPM and redesign our Shared Governance framework to

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WE NEVER REST ON OUR LAURELS

better actualize our shared leadership model. A day-long retreat was held to revisit the tenets and realign their implications in practice.

The steering committee for the redesign had intra-disciplinary leadership ranging from nursing to medicine to allied health. The new model effectively reduces the number of councils and streamlines the process, allowing for swift, efficient movement of items through the council structure, enabling us to avoid duplication and increase our ability to have 80% of decisions made closest to the point-of-care delivery.

The new structure ensures alignment of our IPM, Magnet sources of evidence and the organization’s strategic goals.

Within the new structure, every council meets during one eight hour day, once per month. The councils collaborate on shared goals, each focusing on

their tenet of expertise, yet supporting identified organizational priorities.

While working on council issues, all members of the council receive leadership development, coaching and mentoring. The structure is tightly aligned with the tenets of the IPM. The chairs of each tenet council, in collaboration with our patients and families, Dr. Derek Wheeler, Chief of Staff; Cheryl Hoying, PhD, RN, NEA-BC, FACHE, FAAN, Sr. Vice President Patient Services, and Mary Sitterding, PhD, RN, CNS, Vice President—Center for Professional Excellence Patient Services, provide oversight of function of the model and continued success of the structure.

Over the years, our robust Shared Governance structure has served us well, gaining national attention and recognition.

WE NEVER REST ON OUR LAURELS

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Patient Services Awards Ruth Lyons Award of Child Life and Integrative Care Distinction

Melanie Hunt Registered Dietitian of the Year Award

Award for Service Excellence in Division of OT, PT, TR

Rebecca Wilhelm, MS, RD, LD

Alicia Brummet, BS

David Gerard Huschart, RPh Pharmacist Excellence Award

Managing Success Award

Amy McGrory, MA, CCLS

Zenith Award, Respiratory Therapy

Denise LaGory, RPh

2016 Carolyn Stoll Award

Robert E. Davis Award of Excellence—Patient Escorts

Ann Brandner Award— Social Work

Sarah Herrle, MSN, RN, CPN

Mary Bodle

Stacey Litman-Padnos, MSW, LISW-S

Barbara Jean Black Technical Excellence-Pharmacy

Director’s Award for Excellence—Speech-Language Pathology

Jessica Watkins, CPT

Mary Baskin, RTIII, MBA-NPS

Rob Antony, MBA

Award for Clinical Excellence in Occupational Therapy/ Therapeutic Recreation

Nursing Awards

Katherine Gibson, OTII, OTR/L

• B. Robison-Sporck Award Melissa Bubash-Williams, RN, CPN • Excellence in Nursing Leadership Award Nicole Kneflin, BSN, RNII, CPN 17

Tonya Honeycutt, BSN, RN

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PATIENT SERVICES AWARDS

Award for Clinical Excellence in Physical Therapy Christin (Christy) Zwolski, DPT, OCS

Zenith Award, Respiratory Therapy award winner—Mary Baskin, RTIII, MBA-NPS

Join us in celebrating the achievements of our interprofessional team members.

Maggie P. Montgomery Award-HUC Aimee Weeks, HUCII

Carol McKenzie Award for Excellence in Advanced Practice Nursing-Winner Lisa Reebals, APRN, CPNP

Excellence in Nursing Leadership Award winner—Nicole Kneflin, BSN, RNII, CPN, and B. Robison-Sporck Award winner— Melissa Bubash-Williams, RN, CPN

2016 Daisy Award Ashley Kramer, BSN, RN Nicole Slomiany, MSN, RN Michelle York, RNII Brianne Reedy, BSN, RN, CCRN Kristin Westerfield, BSN, RNII, RNC Lauren Schoenfeld, MSN, RNII Noel Alford, RNII, CPN

Robert E. Davis Award of Excellence— Patient Escorts award winner—Mary Bodle

Carla Beaty, BSN, RNII, CPN Linda Godsey, RNII, CPN Tony Maccani, RN Tiffany Proto, BSN, RNIII, CPN, CPON Kara Neel, BSN, RN

Carol McKenzie Award for Excellence in Advanced Practice Nursing award winner—Lisa Reebals, APRN, CPNP

PATIENT SERVICES AWARDS

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Cincinnati Children’s strives to provide the best possible outcomes for our patients and families by growing our professionals and advancing clinical practice.

2016 in Review—Optimal Outcomes Hospital Facts and Figures — 2016 Number of beds licensed

673

Number of beds staffed

635

Number of ambulatory clinic visits Number of admissions

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OPTIMAL OUTCOMES

534,360 19,698

Number of RN FTEs

2,991

RN skill mix

90.7%

RN turnover rate

9.9%

RN vacancy rate

2.5%

RN Professional Development

41.4% Percentage of certified direct care RNs

50 401 1,851

92.4% Percentage of certified RNs serving in leadership positions

Allied Health Publications Allied Health Presentations Total number of RNs who have nationally recognized certification

RN Continuing Education

12

129 Other online clinicians across 11 US states and 2 countries

Number of Nursing Grand Rounds live presentation

614

Number of nurses who attended Nursing Grand Rounds

1,732

Number of nurses who attended Nursing Grand Rounds online

Student Information

228 1,249

Undergrad cohort groups Undergrad students completing clinicals

154

Graduate students completing clinicals

453

Allied Health students completing clinicals

1,990

Total students in patient services OPTIMAL OUTCOMES

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Staying current to maintain, develop, and increase the knowledge, skills, and professional performance of our nurses and allied health clinicians.

2016 in Review—Nursing Continuing Education Highest nursing degrees overall for RNs ADN/Diploma BSN

2,208

MSN

841

Doctorate

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NURSING CONTINUING EDUCATION

612

47

Highest nursing degree for RNs who provide direct care

20.4%

70.7%

382

1,923

ADN/Diploma

8.8%

.1%

238

4

88.6%

6.0%

412

28

MSN

BSN

Doctorate

Total 2,721

Highest nursing degree for RNs in leadership positions

0% 0

ADN/Diploma

5.4% 25 BSN

MSN

Doctorate

Total 465

Number of employees who received nursing degress in 2016

34 209

BSN

81

MSN

9 Total 333

ADN/Diploma

333

Doctorate Total

NURSING CONTINUING EDUCATION

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Research in Patient Services Research translates into improved patient outcomes As scientists with backgrounds in nursing, communication sciences and other allied health specialties, it is critical that we stay closely connected with our clinical colleagues in Patient Services. Through these connections we can most effectively translate discovery into clinical practice at the point of care.

Two of our renowned Patient Services researchers: Heather Tubbs-Cooley, PhD, RN and David R. Moore, PhD together secured over $1 million in research funding in 2016.

62 Total # of Publications $4,106,257

Research grant dollars (funding secured in FY16)

Cincinnati Children’s is an ANCC Magnet designated hospital since 2009.

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RESEARCH IN PATIENT SERVICES

2016 Nationally Recognized Nursing Certifications Certification demonstrates to patients and families that we are the most skilled and experienced nursing professionals.

Stephanie Ackley Amy Adam Emily Addison Emily A Addison Ashley Adkins Libby Ann Ahrens Julie Alexander Shannon Allen Stephanie Allen Diane Allgeyer Bruna Andrade Katherine Arata Shannon Asbach Lisa Ashdown Samrawit Asrat Mark Atkinson Stephanie Audette Keyna Austin Holly Bachus Melanie Baker Kathleen Ball Janelle Ballinger Katherine Bandoroff Lisa Battista Holly Baugh Sandra Bechtol Erica Beck Heather Bedacht Cindi Bedinghaus Kathryn Bedinghaus Deah Behler Emily Bell Kara Bendle Stacy Benton Molly Berger Kayla Berry Kristina Beson Elizabeth Bessler Deanna Best Joan Biggs Kathleen Bischoff

Mary Bishara Jennifer Bisig Amie Blankenship Honey Blankenship Jennifer Blessing Marguerite Blignaut Samantha Blum Jennifer Marie Boberschmidt Antoinette Boehm Kelly Boehringer Anne Bosche Coty Bovard Susan Bow Kimberly Bowling Melissa Brackett Whittney Brady Jaymee Brandenburgh Amy Brandt Evelyn Brignole Julia Brinker Shannon Brogan Alexa Brown Jamie Brown Rachel Brown Sabrina Brown Katherine Brunck Lori Brunner Sara Brunner Allen Buck Julie Burke Ashley Burwinkel Anna Butts Mary Cabrera-Thurman Anne Campbell Katie Campbell Raquel Campbell Angela Campos Kristina Carlisle Tara Carmody Christa Carson

Julie Casebolt Kathryn Catalanotto Taylor Cawein Christina Chambers Karrie Cheeseman Niehaus Kelly Christian Carol Chute Julie Clark Courtney Clement Kathleen Clifton Charles Coe II Kristen Coleman Kelly Collins Sandra Conn Julieanne Connell Heather Connelly Brittany Cooper Megan Copas Judy Correll Teresa Couch Lauren Cowell Ashley Creelman Stephanie Cronin Rebecca Crozier Paula Cuthrell Emily Dastillung Lori Davis Anmarie Dean Beth Decker Kristen Dekok Brenda Kay Demeritt Mariah deWeaver Michelle Dickey Laura Elizabeth Dickman Kimberly DiSalvio Cindy Donelan Kelly Downey Elizabeth Dreier Monica Dugan Jessica Duke

Kelly Dunn Adrienne Durham Carla Elaine Earlywine Amanda Eberhart Stephanie Edwards Bessie Egelston Andrea Shaffer Ellis Anna Ellis Kelly Ely William Enderle Angela Ervin Julie Estenfelder Dorothy Everts Jennifer Faircloth Kelly Falcone Elizabeth Farmer Stephanie Feist Gwen Feldhaus Deborah Fieglein Victoria Figg Susan Finan Tricia Fischer Mary Fisher Courtney Flick Teresa Flower Sharon Foreman Lisa Forsthoefel Melissa Forton Brittany Frakes Jessica Frank Jill Freudenberg Eric Fries Megan Frischmuth Patricia Froese Heidi Frondorf Allison Fry Katie Fullenkamp Melissa Gallo Amy Garcia Muriel Garcia Cassie Gardner Barbara Gary Susan Geiss James Gelement NURSING CERTIFICATIONS

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2016 Nationally Recognized Nursing Certifications

Cori Gelvin Kari George Abigail Gillman Sandra Girten Jennifer Green Gail Greene Jennifer Gripshover Lilly Grote Tamara Gullett Rebecca Gunn Emily Gural Katherine Gutierrez Lisa Hallum Barbara Hanlon Christopher Hannah Timothy Hardesty Victoria Hardy-Murrell Katherine Harms Carrie Hartman Laura Hatcher Chelsea Hawkins Lauren Heeney Chantel Heidebrink Macy Heitmeyer Andrea Hempel Amy Hendrix Jacquelyn Hensel 25

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NURSING CERTIFICATIONS

Diane Herzog Shawna Hess Angela Hibberd Molly Hicks Misti Hill Patricia Hirsch Kelley Hoban Rhonda Hocker Shelly Hoehn Molly Hollmann Tina Hood Joan Hornsby Debbie House Delilah Hucik Margie Hueneman Susan Hull Pamela Hunter Margery Huron Nicole Inman Megan Isley Keith Israel Jennifer Jacob Joanne Jacob Lindsey Jett Katelyn Johnson Brent Johnstone Abby Jones

Jonathan Jones Mary Ann Jones Rhonda Jones Hannah Karg Kristen Kellogg Laura Kelly Stefani Kelly Kimberly Kennedy Natalie Kerby Melissa Kerlin Theresa Kerth Kelsey King Mary Klekamp Cron Kimberly Klumb Jordan Knost Julie Koch Dana Koehler Lisa Kollstedt Michelle Kroeger Kimberly Kruspe Jill Kummer Nancy Kurnick Sharon Kwiecinski Nancy Lacey Tara Lachenman Ashley LaFollette Amanda Lang Shawna Langworthy Kyra Laupp Bethany Lavoy Jennifer Lecompte-Phelps Kelsey Leifheit Diane Lemen Stacy Marie Levi Cris Lewin Emily Licata Kelli Lichner Melissa Lipps Rebecca Little Staci Loer-Fisher Ashlee Lonnemann Jennifer Losee Lisa Louder Sara Loveless

Colleen Lowe Jennifer Lutz Molly-Melissa Lutz Timothy Lynch Debbie Sue Maas Karen Macke Eric Mailloux Arielle Marasligiller Michelle Marcum Adrienne Martin Amy Martini Alexandra Mathes Melissa May LaShonda McAdams Katherine McAfee Audrey McCabe Edward McClure Sarah McCune Cheri McCurley Kate McFarland Colleen McGuine Eboni McGuire Miranda McLinden Jennifer McNeely Melissa Mehlon Lisa Meiners Patti Mercurio Bonnie Merrill Diana Meyer Kathy Meyer Mary Ann Michael Crystal Miller Christa Mills Donna Minor Natalie Mitchell Sherene Mitchell Alyssa Mohr Erin Monroe Ashley Moran Jennifer Moretz Shelly Morning Leann Mount Leah Mousa Pamela Mulhall-Smith

Julie Mullalley Joanne Munoz Nataline Myers Angela Neidich Elizabeth Neiheisel Lori Neises Lisa Nelsen Lynn Nguyen Debra Nickell Kelli Niehaus Jessa Niemeyer Robin Noel Patricia Nordbloom Andrea Norman Patricia Norton Susan Oaks Maureen Anne Ohman Elizabeth Overman Kaitlin Owen Lauren Pack Theresa Padilla Erin Paff-Rich Pamela Palazzolo Suzanne Palmisano-Austin William Parker Heather Pascoal Gail Patten Cathy Patterson Shannon Patton-Baker Anne Pearson Randy Peck Sheila Pelle Angela Pelzel Ashley Pennington Emily Perazzo Kathryn Perkins Catherine Perry Sommer Peveler Serena Phillips Katie Phirman Jennifer Pierson Julie Pinson Sarah Pluckebaum Kathleen Pompa

Kristin Portaleos Katherine Potts Tammy Potts Shelby Prenger Lori Prine Tiffany Proto Anita Pryor Dolores Puthoff Angela Quatman Kate Queen Dana Raab Charlene Rakes Bailey Ramsay Amber Rea Kimberly Reed Maureen Reese Deborah Reeves Matthew Reeves Katherine Reynolds Emily Rheaume Laurie Rheaume Deborah Richardson J Erin Riehle Elizabeth Riffle Elizabeth Riley Amy Ritter Sherry Ritzenthaler Jordan Roberts Michelle Rodgers Patti Roese Jennifer Rollins Elizabeth Rompies Samuel Rose Richard Rowland II Michelle Rudisell Kimberly Rumpke Christina Russell Tiffanie Russell Katherine Russo Mary Russo Shannon Sarver Meg Satterlee Katrina Sauerwein Sandra Sawyers

Sara Scaggs Rebecca Scalf Abby Schaefer Margery Schaffer Heather Schappacher Amberly Schmaltz Susan Schneider Theodore Schneider Tracy Schoenhoft Emily Schuetz Jennifer Schwab Allison Schwandner Jerome Schwartz Katelyn Scott Anna Shelton Kimberly Shepard Mary Angela Shinkle Leanne Bainer Siberski Michelle Siekerman Sherri Sievers Benjamin Sillies Maria Skiles Erin Slater Andrew T Smith Kristina Smith Shannon Smith Susan Lee Spear Carrie Spencer Maggie Spindler Amy Sprong Julie Stalf Taylor Stammer Ashley Stanton Emma Starnes Natalie Starr Jill Stein Stephanie Steiner Jennifer Steinmetz Ellen Swain Jessica Thielen Anita Thoerner Ann Thulin Jenifer Tierney Brian Tietz

Kristina Tingle Jean Tomasic Megan Travis Ellen Tucker Cynthia Tudor Mary Ann Twilling Leah Ullery Rachel Vakerics Micole Vaughn Emily Vincent Brooke Vogelsang Susan Wade-Murphy Kelly Wagner Marjorie Walker Rebekah Wang Jennifer Weaver Suzanne Weghorn Maria Weickert Tammy Weis Heather Wetterich Amanda Wheatley Kimberly Ann Wheeler Donna White Kathy Whitfield Christine Wilkins Heather Williams Michaela Williams Sarah Wilson Susan Wirtz Lisa Witte Melissa Wolf Kelsey Wolfangel Tara Wolfe William Wright IV Elizabeth Wright Tiona Wright Sandra Wuertz Jordan Wyrick Melissa Yockey Sarah Yost Diana Young Mary Youtsey William Zurkuhlen

NURSING CERTIFICATIONS

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