The DAILY MORNING REPORT: A NEW BENCHMARK FOR LEADERSHIP EXCELLENCE

Purpose:
We are challenged to synthesize best practice recommendations in a coherent way into our operations to improve the quality and safety of our patients. The Daily Morning Report was implemented as a best practice TRANSPARENCY strategy where all nursing units collectively focus on patient safety.

Significance:
With the trend that “all will demand results”, visibility of the nursing leaders to lead and manage change speak volumes. Presence of the Chief Nurse Executive and nurse leaders with charge nurses create a culture of authenticity, creativity, and value that positively impact the care environment.

Strategy and Implementation:
To raise the bar higher, nursing leadership implemented a structured Daily Morning Report. Led by our Chief Nurse Executive, nursing leadership and their charge nurses convene daily to discuss census, staffing and patient care issues and highlights are shared with senior management. Transparency of the patient issues heightened staff awareness to collectively focus on the veteran's safety. Commitment to provide best practice evidence-care and continually set new benchmark for excellence permeate down to all levels of the nursing staff: “Excellence as a habit, Outcome as an end point”. In Daily Morning Report, new employees are formally presented with a magnet pin, staff accomplishments and patient compliments are announced, top-down communication are shared and new programs are introduced. Patient Safety becomes our operational standard and our nurses viewed it as a moral imperative. And for that reason, we measure it daily in spheres of clinical quality and patient satisfactation.

Evaluation:
First and Second quarter comparison of NDNQI indicators: Pressure Ulcer Prevalence 17% to 9%. Facility-acquired pressure ulcer 8% to 5%.Total restraints usage 63 to zero. Total VAP 4 to 1. VAP infection rate 5 to 3.Total CRBSI cases 1 compared to zero. Fall rate was 67 compared to 62.

Implications for Practice:
Daily Morning Report reinforces behavior accountability in all levels of nursing. Mentoring from our Chief Nurse signaled leadership authenticity. Post-fall huddles were re-examined and hourly comfort rounds emphasized. Established collaboration in inter-agency patient fall prevention initiative.