Igniting the Fire: Empowering Nurses to Lead Change at the Bedside

Purpose:
The Institute of Medicine and others have called us to action to reduce and ultimately eliminate health care errors. Nurses are well positioned to impact patient care and safety processes. Our goal is to develop the capacity of the professional nurse to impact excellence in quality improvement

Significance:
Frontline nurses are the ideal leaders for quality initiatives. Their clinical expertise is invaluable and directly contributes to patient safety. We will highlight the inventive methods used to empower bedside staff to become a catalyst for changes resulting in improved patient outcomes.

Strategy and Implementation:
The mission of the Quality and Safety Investigator (QSI) program is to empower bedside nursing staff to improve patient outcomes and to ensure that every nurse understands that quality improvement is not separate; it is integrated into daily clinical practice. Each unit (in-patient and procedural) has a dedicated QSI who partners with their manager, educator, practice council, and a Performance Improvement expert (QSI Mentor) to drive changes at the bedside. QSI's receive monthly didactic education focused on communication skills, data interpretation, and problem solving processes including Plan-Do-Study-Act (PDSA). Each QSI is charged with utilizing the PDSA format to target a population-specific quality improvement project, disseminating their unit specific quality data, and implementing successful projects throughout the organization.

Evaluation:
The QSI's have been instrumental in driving change and advancing a culture of safety throughout the organization. QSI's have demonstrated a sense of empowerment through improved leadership, collaboration, and communication skills and express a new confidence in quality improvement

Implications for Practice:
Over 30 patient care projects have been implemented focusing on issues including patient handoff's, hand hygiene, documentation, patient satisfaction, and distraction management. The QSI program has demonstrated that frontline nurses can contribute positively to patient care quality and safety