Enhancing Professional Practice in a Community Hospital- Development of a DREAMS Professional Practice framework
To provide a professional practice framework to encourage discovery & innovation, respect & collaboration, excellence in clinical practice, accountability & autonomy, mastery & learning and system transformation using frontline leadership and shared governance, while encouraging continuous learning.
Relevance/Significance:
This DREAMS Framework relates to each of the conference goals. Our lean management philosophy at the organization includes continuous practice improvements, and using best practices to drive changes to current practice which has been incorporated. A portion of the framework encourages the use of technology and innovation. The unit councils have changed how information is disseminated and how change is implemented, along with encouraging staff engagement.
Strategy and Implementation:
The framework was designed using a lean management approach by the professional practice team with feedback from other stakeholders. DREAMS encourage concepts of D- discovery and innovation, R- respect and collaboration, E- excellence in clinical practice, A-accountability & autonomy, M-mastery & learning, and S-system transformation. The first priority was to build unit councils in every program with action plans based on local priorities, ideas, and practice issues developed by frontline staff. Continuous initiatives and ideas to come up with prevention strategies to help decrease the nursing sensitive indicators rates include development of frontline champions. One gap identified was that the hospital is paper based, with the lack of electronic systems available for staff and clinical leaders. Self-learning modules were converted to electronic. The system went live for new staff orientation to help keep track of completed competencies.
Evaluation:
The framework has been a success. Tracking the number of unit councils, centres of excellence, e-learning modules, staff ideas have all increased. 72% of the units have councils. Decrease time spent by leaders manually collecting and marking learning package quizzes and competencies by having 49 of the paper self-learning competencies are available electronically.
Implications for Practice:
Building of local expertise, fostering team engagement, creating accessible learning modules and spaces, collaborating to improve practices, documentation, and a way for staff to keep up with competencies and transforming the system all have an impact on nursing practice.