Optimizing Action Plans to Enhance a Culture of Safety and Improve RN Satisfaction

Purpose:
This quality improvement initiative utilized the chosen action planning model to create and implement an interdisciplinary plan based on NDNQI RN Satisfaction Survey results. The goal: improve units work environments to build unit culture and improve patient safety, quality of care, and outcomes.

Significance:
Multiple components measured through the RN Satisfaction Survey, such as RN-RN Communication, RN-MD Communication, and teamwork, can impact the environment of practice on nursing units. Work environment effects RN satisfaction, quality of care, and patient safety.

Strategy and Implementation:
Inpatient nursing units at this organization were educated on interpreting NDNQI RN Sat Survey results, the action planning model, internal and external benchmarking, and the development of an unit-based action plan. Interdisciplinary collaboration was encouraged when possible for the plan. Support was provided to the units in a variety of settings including: introductory presentations, intranet reference materials, and one-on-one consultations and quarterly follow-up between unit leadership and a member of the Nursing Quality department. Required elements of the action plan included: 1) summary of 2011 RN Sat Survey results and process for reviewing/soliciting feedback from frontline staff regarding the 2012 RN Sat results, 2) 2-3 areas of opportunity for improvement in CY2012, 3) baseline and 'SMART' goal for each area of opportunity, 4) actions/measurable steps to achieve goals, 5) specific who and when for each action, and 6) metrics to be measured to demonstrate progress of plan.

Evaluation:
Evaluation of units action plans are measured via process and outcome metrics in their plan and revision of actions as appropriate during implementation of initiatives. Additionally, effectiveness and success will be measured by achievement of goals for 2013 survey as outlined by the action plans.

Implications for Practice:
Action plans created by individual units increases accountability and buy-in at the unit level for achieving the chosen aims. This model provides a sustainable process for developing short- and long-term goals to impact RN satisfaction, quality of care, and patient safety.