Texas Health WINTER 2011-2012
NURSE
Texas Health nurses put
innovation in action
Texas Health Nurse is a publication for all Texas Health Resources’ nurses. Texas Health Resources is one of the largest faith-based nonprofit health care delivery systems in the United States and the largest in North Texas in terms of patients served. Executive Editor Joan Clark Managing Editor Brandi McManaman Texas Health Nurse Editorial Board Members Martha Bolt Texas Health Kaufman Pam Green Texas Health Plano Juanita Hernandez Texas Health Fort Worth Gretchen Hunt Texas Health Southwest Ilda Martinez Texas Health Stephenville Phyllis McCorstin Texas Health Dallas LaDonna McKee Texas Health Cleburne Denise Pisoni Texas Health Allen Rose Reese Texas Health Specialty Hospital Marcia Shumate Texas Health Azle Mary Teague Texas Health Arlington Memorial Karen Wright Texas Health HEB
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Letter from the Editor Way to Go Having a Bedside Chat Let’s Meet… Some of Our Newest CNOs High Impact: Harnessing Innovation of Frontline Staff Transforming Care One Practical Project at a Time Earn Extra Income Through Centralized Staffing Office
ON THE COVER Georgia Zachariades, R.N., and Marsha Weissenborn, R.N., lead Texas Health Presbyterian Hospital Plano’s participation in the Center for Care Innovation and Transformation (CCIT). They created a brainstorming board for nurses on 7C at the hospital to share their improvement ideas.
Letter from the Released by the Institute of Medicine in the fall of 2010, The Future of Nursing: Leading Change, Advancing Health is a groundbreaking report that calls for the transformation of the American health system by strengthening nursing care and better preparing nurses to help lead reform. Through educational scholarships from the Texas Health Resources Nursing Excellence Fund, tuition reimbursement, the Nursing Career Advancement Program, and a number of other programs, Texas Health Resources is providing the education and leadership training that will be keys to achieving the goals of the report. In this issue of Texas Health Nurse, we’ll take a look at some of the programs and opportunities available for frontline nurses to become involved in leading change.
editor
Joan Clark
D.N.P., R.N., N.E.A.-B.C., C.E.N.P., F.A.C.H.E., F.A.A.N.
As the nursing Texas Health profession works to Resources senior lead change and advance vice president and chief nurse health, I hope you personally executive will consider taking advantage of the opportunities available at Texas Health to help you gain the skills and confidence needed to make change happen. The impact that nursing will have on the future of health Leading change at Texas Health HEB care relies on are members of the hospital’s Care our education, Innovation and Transformation team, including (left to right) Bernette Dong, professionalism B.S.N., R.N., M.A.; Ester Bowman, B.S.N., and leadership. R.N.; Lori Krogman, B.S.N., R.N., unit manager; Holly Haddad, B.S.N., R.N., patient care facilitator; Jessica Rusinko, R.N.; Marah Murphy, unit secretary.
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Texas Health nurses named Texas Christian University Evidenced-Based Practice Fellows Eight Texas Health Resources nurses are learning new techniques for integrating evidenced-based practice into their work as Texas Christian University (TCU) Evidenced Based Practice Fellows. Texas Health’s 20112012 fellows are: • Texas Health Southwest – Rebekah Brooks • Texas Health Azle – Rosemary Cruickshank • Texas Health Dallas – Boyce Davis • Texas Health Dallas – Marina V. Reeves • Texas Health Plano – Angie Marshall • Texas Health HEB – Kerry Miller • Texas Health Physicians Group – Sarika Pich • Texas Health Fort Worth – Jessica Maack-Rangel
Industry Spotlight Barbara Baggett, Texas Health Dallas, has been elected president-elect for Dallas Orthopaedic Nurses, Inc. Patti Bentley and Julie Holland, Texas Health Arlington Memorial, presented on “Role Commitment� at the Versant Conference. Linda Cole, Texas Health Dallas, has been elected president of the local chapter of the Oncology Nursing Society for 2012. Susan Cooper, Texas Health Dallas, made a poster presentation at the American Society for PeriAnesthesia Nurses National Conference in April. The poster abstract was published in the Journal of PeriAnesthesia Nursing in July. Kirsten Drake, Texas Health Fort Worth, was published in Nursing Management Congress in May.
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Sharon Markham, Texas Health Arlington Memorial, presented on the “Use of the Admission/Discharge Team” at the Med/ Surg Conference. Barbara McGarrah and Beth Stenson, both of Texas Health Fort Worth, made a poster presentation at the National WOCN Conference in June. Jane McNelis, Texas Health Arlington Memorial, presented on the “Effects of Black Pepper and GI Motility” at the Alliance of International Aromatherapists. Kindra McWilliam-Ross, Texas Health Fort Worth, made a poster presentation at the National Association of Orthopaedic Nurses conference. She was also published in the Journal of Orthopaedic Nursing.
Susan Smith, Texas Health Plano, made a podium presentation at the American Association of Critical-Care Nurses National Teaching Institute this past summer.
Sandy Minchew, Texas Health Dallas, is presidentelect for the Dallas chapter of AORN for 2012. Libby Morse and Julie Balluck, both of Texas Health Dallas, made a poster presentation at the 1st Annual International PeriAnesthesia Conference in October.
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Katherine Rhodes and Cathy Johnson, both of Texas Health Southwest, received the AEIX Risk Management Award from Premier in June. Lisa Roberts, Texas Health Dallas, was selected for the AONE Nurse Manager Fellow Program for 2011. Christine Russe, Texas Health Plano, received the 2011 Emergency Nurses Association Nursing Education Award, as well as the 2010 Texas Emergency Nurses Association Nursing Professionalism Award. Susan Smith, Texas Health Plano, presented a poster along with Nicole Hodges, Texas Health Plano, at the ACESTAR seminar in July.
The American Association of Critical-Care Nurses presented the bronze level Beacon Award for Excellence to the Trauma ICU at Texas Health Fort Worth. In addition, Charlsea Prichard, Texas Health Fort Worth, has been selected to be a reviewer as part of the Beacon Award process. Barbara True, Texas Health Arlington Memorial, was selected to serve on the American Academy of Family Physicians’ CareTeam OB Patient Safety Training Program Advisory Board. Della Wrightson, Texas Health Dallas, made a poster presentation at the Academy of Neonatal Nurses’ 11th National Neonatal Nurses Conference.
a g n i v a Hedside Chat B The Surgical Unit at Texas Health Harris Methodist Hospital Cleburne has experienced a significant and steady boost in patient satisfaction scores specifically related to communication with nurses in the last half of the year. While scores concerning communication with nurses were regularly in the 60th to 70th percentile in the spring, the scores have been between the 84th and 94th percentile since July. So what's the secret? continued
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Texas Health Cleburne implemented bedside reporting on the surgical unit in April and scores have been going up ever since. Hospitals throughout Texas Health Resources are experiencing similar positive results. As opposed to gathering at the nursing station or in the hallway for patient handoff, nurses on the unit now meet at the patient’s bedside to talk with each other and the patient. The off-going nurse introduces the patient’s new nurse, and they discuss the patient’s plan of care, medications, goals for the day, concerns and other critical information. “Involving the patient in the reporting allows them to get involved in their own
care, ask questions, provide feedback and agree to what is expected for that day,” said Martha Petty, R.N., M.S.N., C.M.S.R.N., Texas Health Cleburne. Bedside reporting can increase patient safety, improve quality of care, increase accountability and strengthen teamwork.
“Involving the patient in the reporting allows them to get involved in their own care, ask questions, provide feedback and agree to what is expected for that day.”
— Martha Petty, R.N., M.S.N., C.M.S.R.N., Texas Health Cleburne
“We’ve found that bedside reporting provides continuity of care and accountability,” said Joy Spears, R.N., B.S.N., C.M.S.R.N., patient care facilitator, Texas Health Cleburne. “Being in the room allows us to actually see the patient’s condition and any discuss concerns.”
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Let’s meet… Denise S. Claussen R.N., B.S.N., M.S.N. Chief Nursing Officer Texas Health Presbyterian Hospital Kaufman Years in nursing: 30+ My favorite hobbies are: Horseback riding, playing the saxophone My favorite sports team is: LSU Tigers My worst habit is: Eating out of the ice cream box from the freezer
The two people I’d most like to meet are: Jesus, Mother Mary If I had a different job, I’d be: Rich I am happiest when: My desk is clean
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Let’s meet… Lori Donovan R.N., B.S.N., M.S.N., C.N.O.R. Chief Nursing Officer Texas Health Arlington Memorial Hospital Years in nursing: 25 years
My worst habit is: Constantly planning
My favorite hobbies are: Working out – swimming, biking and running
If I had a different job, I’d be: Bicycle tour guide
Books on my nightstand include: Murder mysteries and inspirational sayings
I’m most proud of: Being a nurse and completing the Hawaiian Ironman
My favorite sports team is: Green Bay Packers
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Let’s meet… Cynthia McCarthy R.N., M.B.A., M.H.A., B.S.N., C.E.N. Chief Nursing Officer Texas Health Harris Methodist Hospital Stephenville Years in nursing: 32 My favorite movies are: Dirty Dancing, Top Gun My favorite hobbies are: Boating My favorite sports team is: Pittsburgh Steelers
The two people I’d most like to meet are: George W. and Laura Bush If I had a different job, I’d be: FBI agent I am happiest when: I’m relaxing with my family
High Impact
Have you ever had a performance improvement idea for your unit or department, but you couldn’t get beyond simply having the idea? Thirty frontline Texas Health Resources nurses are currently learning how to move beyond an idea to making change happen through the Frontline Impact Program. continued
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Sponsored by Texas Health Resources and offered in conjunction with The Advisory Board Company, the 12-month Frontline Impact Program is designed to harness the innovation and leadership potential of frontline staff by providing them with the skills, opportunity and confidence to successfully implement their own improvement ideas. The program includes four learning sessions and several projects, and each participant has a coach for more focused learning and support. The Center for Learning and Career Development coordinates the program. Jeannine Tate, R.N.C., Texas Health Presbyterian Hospital Dallas, joined the Frontline Impact Program to improve her
leadership skills after she became president of her Unit Based Council. “The program has taught me how to take an idea, get everyone on board with it and then implement it so that we’re making a real difference,” said Tate. All nurses are eligible for participation in the Frontline Impact Program. If you would like more information about the program, send an email to THRUniversity@texashealth.org and include “Frontline Impact” in the subject line.
Transforming Care One Practical Project at a Time
Texas Health Resources nurses are putting brainstorming into action one project at a time at five of the system’s hospitals. Through participation in the American Organization of Nurse Executives’ (AONE) Center for Care Innovation and Transformation (CCIT), nurses are implementing practical projects that are having a big impact at the bedside and in their working environment. Red dots next to a name on the board let Texas Health HEB nurses know that one of their co-workers needs help.
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The goal of the CCIT is to engage frontline nurses in pushing change forward.
PRACTICAL CHANGES AT TEXAS HEALTH HEB At Texas Health Harris Methodist Hospital Hurst-Euless-Bedford on the Tower 4 Medical/ Surgical Unit, a 16-member team meets for two hours every week to implement projects that were suggested at an in-depth brainstorming session last summer. “It’s a big commitment, but we need the time to focus on truly making innovative operational changes,” said team lead Lori Krogman, B.S.N., R.N., Texas Health HEB. Some of the projects being implemented on the unit include: • Ready, Set, Go – Each shift prepares medications for the next shift.
• I’m Drowning – Team members can place a red magnetic dot by their name on the unit’s communication board to indicate that they are feeling overwhelmed and need some help • Good Morning Patient-Centered Care – The time for morning lab draws has been moved to between 6:30 and 7:30 a.m.
STAFF-LED INNOVATION AT TEXAS HEALTH SPECIALTY HOSPITAL Texas Health Specialty Hospital is just getting started on their CCIT projects which include: • Large, customized communication white boards in patient rooms • Project Red – Providing patients with red binders for holding all education materials, as well as discharge instructions
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• Cup holders for urinals “The ideas are coming from staff who are in the patient rooms, and we have management support to make changes,” said Mavis Jones, R.N., Texas Health Specialty Hospital. IMPROVING COMMUNICATION AT TEXAS HEALTH SOUTHWEST On the Med/Surg 5th Floor Telemetry Unit at Texas Health Harris Methodist Hospital Southwest Fort Worth, nurses have begun several CCIT projects: • Redesign of the employee break room, creating a quieter, more peaceful environment • Communication improvements, including bedside reporting and the creation of a Team Assist DL on Vocera to be used when assistance is needed
Pa’Shauna Evans and Zandra Mendoza, both of Texas Health Southwest, share their work for improving communication at the CCIT Conference in San Antonio in September.
“Bedside reporting has made an impact on our quality of care as it has helped patients see their nurse earlier in their stay and has helped us decrease the number of falls on the unit,” said Gretchen Hunt, M.S.N., R.N., A.C.N.S.-B.C., director of Critical Care, Progressive Care and Med/Surg at Texas Health Southwest. continued
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CHANGING VITAL SIGN FREQUENCY AT TEXAS HEALTH PLANO The most significant CCIT project at Texas Health Presbyterian Hospital Plano has been changing vital sign frequency from every four hours to every six hours on stable patients to improve efficiency on 7C. The innovation will soon become a hospitalwide protocol for Acute Care Services.
A brainstorm board is used at Texas Health Plano to capture the staff’s ideas for the CCIT team.
“CCIT is different than other process improvement initiatives for the simple fact that changes are being initiated by unit staff instead of by administration,� said Georgia Zachariades, R.N., Texas Health Plano. BACK TO THE BEDSIDE AT TEXAS HEALTH DENTON Bedside reporting is one of the first CCIT projects for Texas Health Presbyterian Hospital Denton. "We had our brainstorming session, and we soon realized that bedside reporting could help us tackle a lot of our issues," said Nicole Forryan, R.N., B.S.N., Texas Health Denton. The fourth floor at Texas Health Denton implemented bedside reporting in June and has seen overall improvements in their patient satisfaction scores.
Earn Extra Income Through Centralized Staffing Office
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icking a facility, picking a shift and picking up some extra income sounded like a good idea to Larry Wong, C.C.R.N., C.N.R.N., nurse in the ICU at Texas Health Harris Methodist Hospital Hurst-EulessBedford, when he began participating in the Centralized Staffing Office (CSO) nine months ago. Since then, Wong has become a regular filling in at the Emergency Department at Texas Health Harris Methodist Hospital Southwest Fort Worth. “The hourly rate matched my current hourly rate, it hasn’t been hard to adapt, and I’m grateful for the extra work,” said Wong. Patients, employees and managers all benefit from the CSO: • The CSO helps ensure that patients are
cared for by Texas Health nurses who are committed to the organization’s mission and Promise. • Employees can increase their income by picking up extra shifts or supplementing for missed shifts at other Texas Health facilities through the CSO. • The CSO provides managers a resource for filling their staffing needs. “The CSO allows us to provide the appropriate resources for staffing, both planned and dynamically,” said Kathy Srokosz, associate chief nursing officer, Texas Health Presbyterian Hospital Denton. “Plus, it gives our staff greater flexibility for working throughout the system.” To take advantage of the flexibility and other benefits offered by the CSO, call 817-274-9767.
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Susan Henchal, R.N., B.S.N Texas Health Presbyterian Hospital Dallas From gardening and beekeeping to housing purple martins and playing the accordion, Susan Henchal, R.N., B.S.N., Texas Health Presbyterian Hospital Dallas Operating Room, believes it’s important to have good hobbies. “Because I have so many interests I enjoy outside of my job, I can come to work satisfied and ready to give and serve,” she said. Henchal loves flowers, and she and her husband recently started beekeeping. They also have been housing purple martin birds for more than a decade, with 28 to 30 nests each year producing 100 to 130 baby birds who leave the nests. In addition to her outdoor interests, Henchal also plays the accordion.