How the CNL Role Facilitates Other Healthcare Quality Initiatives - PowerPoint PPT Presentation

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How the CNL Role Facilitates Other Healthcare Quality Initiatives

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Identify Key Characteristics of your Care Model Partnership Care Delivery Model Key ... Nurse collects home medication CNL oversees process ... – PowerPoint PPT presentation

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Title: How the CNL Role Facilitates Other Healthcare Quality Initiatives


1
How the CNL Role Facilitates Other Healthcare
Quality Initiatives
  • CNL Education-Practice Partnership
    Meeting Marjorie S. Wiggins, RN, MBA
  • Denver, Colorado Vice President of Nursing/Chief
    Nursing Officer
  • June 1, 2006

2
Quality The Elusive Goal of All Healthcare
Providers
3
The Mandate
  1. JCAHO Patient Safety Goals
  2. National Quality Forum Nurse Sensitive
    Indicators
  3. 100K Lives Campaign
  4. Patient Family Centered Care
  5. IOM Redesign of Care
  6. Etc, Etc, Etc

4
The Obstacles Fragmented Care
DAY 1
DAY 2
DAY 3
Pre Admission
Surgery
Step-Down Unit
Recovery Room
Intensive Care
Home with Visiting Nurse
DAY 4
Surgery Unit
Next Step on The Continuum
Rehabilitation
Nursing Home
Case Manager Hand off
5
The Obstacles Complexity
Technology
Information Svs
Telecommunications
Blood Bank
Pharmacy Med Dist
Radiation Therapy
Radiology
Decreased Reimbursement
OR
Bio Med Engineering
Materials Mgmt
Pharmacists
Respiratory TX
OT
PT
Residents
Anesthesiologists
Medical Records
Chronicity
Attendings
Nurse Practitioners
Linen
Financial Svs
Laboratory
Telecommunications
Chaplains
Clinical Specialists
Transport
Admitting
Dieticians
Blood Bank
Speech Therapy
Cardiac Cath
Social Workers
Food Services
Care Coordinators
EKG
HVAC
Shorter Hospital Stays
Sleep Lab
Labor Shortages
Environmental Svs
Engineering
Public Relations
Marjorie S. Wiggins, RN, VPN/CNO Maine Medical
Center
Acuity
6
The Obstacles Time Institutional Energy
7
Clinical Nurse Leader Roles Contribution to
Quality
8
How the Elements of the Role Intersect with
Quality Safety
9
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10
Develop a model to facilitate the CNL role,
promote the quality agenda, and maximize the care
to optimal patient outcomes
11
Designs of care today are not by design, but by
default
12
The Partnership Care Delivery Model One Approach
13
Identify Key Characteristics of your Care Model
14
Partnership Care Delivery Model Key
Characteristics
  • Safe Patient Family Centered Care
  • Outcome Oriented
  • Continuity of Plan Provider
  • Interdisciplinary Approach to Care
  • Evidence-Based Practice

15
Identify required structural process changes
measures of success
Involve the Clinical Staff in the design ALWAYS
16
Identify Best Practices / Evidence-Based Practice
17
Safe Patient Family Centered Care Medication
Reconciliation
18
Medication Reconciliation
Key Characteristics Structure Process Measure
Safe Patient Family Centered Care Policy for Medication Reconciliation Medication Reconciliation Forms Identification of accurate medications on admission, transfer discharge Accurate medication list reconciled and agreed upon by patient / family and nurse provider
19
Define Responsibility
CNL oversees process Admission Nurse collects home medication Transferring Nurse enters changes MD reconciles list with orders CNL ensures patient / family understand medication list and discharge medications
20
Interdisciplinary Approach to Care
Key Characteristics Structure Process Measure
Interdisciplinary Approach to Care Daily Interdisciplinary Rounds CNL / MD round daily Patient / Family included in rounds Improved communication Increase satisfaction of care providers Increased patient / family involvement
21
Interdisciplinary Approach to Care
Daily Interdisciplinary Rounds
Patient Family included in Rounds
CNL MD rounding daily
22
Define Responsibilities
CNL Leads interdisciplinary rounds Documents decision in progress notes RN Provides daily input of patient response to care Other Disciplines Contribute information of progress to outcomes MD Writes orders as determined by information obtained in rounds
23
Key Characteristics Structure Process Measure
Safe Patient Family Centered Care Patient Advisory Councils Electronic access to medical record Patient/Family involved in rounds Patient/Family recording in record Involvement of Patient/Family in decisions about care Patient knowledge of care plan
Outcome Oriented Documentation system developed to enter progress toward outcomes Shift-to-Shift report discussing progress to outcomes Measurement of progress to identified outcomes
Continuity of Plan Provider Care plan development for continuum of care Identifier in admission system to return patient to same unit Post-discharge phone calls to every patient Consistent assignment of care providers Increased Patient Satisfaction Improved relationship based care
Interdisciplinary Approach to Care Expectation of daily interdisciplinary rounds all on units MD / CNL daily rounds on every patient Improved communication leading to less omissions in care Increased Patient/Family satisfaction
Evidence-Based Care (continuous improvement) Institutional program of applying evidence-based information to practice Clinical Scholars Program Policy updates with evidence- based practices Automatic annual literature review on all policies / procedures Quality improvement project required on every unit annually Dates reviewed on all policies /procedures are within 18 months Number of research / quality projects
24
Evaluate Each Care Delivery Model Change
Amplify Results
Evaluate Each Care Delivery Model Change
Amplify Results
25
Keep Score for All Staff to See
26
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27
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28
The Clinical Nurse Leader together with Care
Delivery Redesign create endless possibilities to
change the healthcare of Patients
29
Questions??
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