The Amazing Race to Unit Excellence: Developing Professional Practice Behaviors to Impact Quality of Patient Care

Purpose:
Shared governance is an organizational model that allows nurses to have control over their practice. The overall goal of this project was to lay a foundation for professional practice behaviors by developing a culture of shared governance to improve patient care.

Significance:
Research has demonstrated that nurses who consider themselves to be valued, supported, and empowered can have a positive impact on overall patient care. We will highlight the innovative model used to enhance staff empowerment and shared governance, resulting in a culture of unit excellence

Strategy and Implementation:
With the support of a grant, partially funded by 2 local foundations as well as the REACH Healthcare and Robert Wood Johnson Foundations, we were able to implement a project that encourages staff nurses to take control over their professional practice. Using the concept of gaming, we were able to elicit staff enthusiasm, participation, and friendly competition throughout the process. The Amazing Race to Unit Excellence is loosely based on a popular television reality game show in which team's race around the world receiving clues that provide directions for performing a task or directing them to their next destination. The staff on a medical-surgical unit was divided into teams and weekly “clues” were posted directing them to complete a group task or attend a meeting. Overall objectives of the project included development of a unit-based practice council, increasing attendance at monthly staff meetings, and engaging frontline staff to improve the quality and safety of patient care.

Evaluation:
The achievement of “unit excellence” was measured by participation in a variety of unit-based activities, staff retention rates, and staff satisfaction scores. Improvement in patient care was measured through a variety of nursing sensitive quality indicators including patient falls.

Implications for Practice:
The concept of The Amazing Race to Unit Excellence is a fun, non-threatening, and team-building model that can easily be applied to a variety of healthcare projects. It served as a vehicle for driving the development of unit-based shared governance and resulted in a variety of positive outcomes.