Sucess vs Failure- Creating a Shared Vision of Acceptance, Accountability, & Alignment to achieve Effective Results

Purpose:
This presentation will provide care providers and nurse leaders with an understanding of the application of metrics to nursing practice, the process of creating a culture where metrics are meaningful, and setting up structures that create focus and discipline in order to achieve exceptional results.

Significance:
The current health care environment has seen a shift in the public, political, and healthcare cultures to a vigorous analysis of practice and prevention of adverse events. In order for nursing to meet these new challenges we must excel as strong practitioners of the science of nursing.

Strategy and Implementation:
In order to create a culture where nurses valued metrics as a tool to enhance patient care this organization undertook a strategic approach in order to create a organizational structure that supported and promoted evidence based practice, real time reporting, peer review, transparency, and autonomy. Utilizing seven key structures this organization was able achieve exceptional outcomes. The key structures utilized were: Organizational cultivation of the conceptual model Unit Based Councils Unit Based PI Analysts Enhanced Reporting Mechanisms leveraging the electronic medical record CACNP- Committee for Advanced Clinical Nursing Practice Collaborative Practice Committee Nursing M&M (Mistakes and Misjudgments) These structures allowed this organization to empower the direct care providers to rapidly assess, identify interventions, implement change, monitor for improvement, and celebrate success.

Evaluation:
We have evaluated our success by our nursing sensitive indicators. This organization has made statistically significant improvements as evidenced by decreasing the rates of patient falls by 33 % and pressure ulcers acquired by patients during a hospital stay by 60 % over three years.

Implications for Practice:
Through the adoption of seven key organizational structures we have engaged our nurses to become empowered to own and implement change resulting in significant improvements in nurse sensitive quality indicators.