Displaying Clinical Excellence on Hospital Units:Transparency Drives Interdisciplinary Approaches to Improving Patient Care Outcomes

Purpose:
This 726 bed facility created a process to enhance nurses' understanding of empirical outcomes as its third Magnet designation approached. Clinical Excellence Boards (CEB) were established hospital wide as an innovative, transparent strategy.

Relevance/Significance:
CEBs were implemented through shared governance structures to improve nurses' overall understanding of nursing quality data (NDNQI. Using Clinical Excellence Board exhibits, data was visually translated into actionable terms and pictoral graphs as a result of assessed need for nurses and intraprofessional staff to understand, interpret, and translate data into patient care improvement practice.

Strategy and Implementation:
Clinical Excellence Boards were designed, standardized, and displayed in 100% of nursing units and placed where staff frequented. Nurses worked with their Unit Based Councils (UBC) to customize their CEB display in order to enhance meaning of data for staff. CEBs exhibited 8 quarters of benchmarked data, including unit specific performance outcomes, NDNQI data, nursing engagement results, and professional development metrics. Green stars placed above the graphs denoted data sustaining "above the benchmark" on each unit in order to easily clarify data's meaningingfulness. Data translation education was provided by clinical nurses, educators, and chanmpions, working through shared governance structures to develop goals and establish processes to improve outcomes. Inter-disciplinary teams toured 100% of nursing units and engaged staff to validate understanding of the data. Monthly, during council meetings, all levels of nursing review CEB data, simply summarized on a singe-page scorecard.

Evaluation:
In 2014, 85% of the UBCs reported improvements in clinical practice and patient satisfaction, in particular, Nurse Communication, Quietness, and Teamwork. Also, 60% of the UBCs improved outcomes related to RN career advancement,RN certification (55.43%) and RN Education-BSN rate (49.28%).A shared governance evaluation (2014) showed 100% of UBCs established specific, measurable goals from data.

Implications for Practice:
Positive results occur due to nurses' understanding of data that is easily accessed, trended, and benchmarked. Hospital and unit level CEB data is reviewed systematically throughout the year. Interprofessional councils annually set practice improvement goals and interventions based on data.