Tag: "Patient Care"

How Do You Create an Effective Hospital Culture?
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How Do You Create an Effective Hospital Culture?

iStock 000019180736XSmall How Do You Create an Effective Hospital Culture?It’s proven that hospitals with an effective culture provide better patient care and outperform competitors.  To achieve a desired hospital culture, you must identify what kind of culture you currently have, decide what you want your culture to be, and shift everyone toward the preferred culture.

The easiest way to assess current culture is to simply observe. How does your staffing act? Are they respectful toward higher authority? Do they have the patient’s best interest in mind? How is the temporary staff being treated? Look for common conduct and visible signs. Listen to what your nurses, doctors and patients are telling you. Read reviews of your hospitals. Surveys. And more surveys. Performing initial in-depth surveys for patients is the easiest way to evaluate your culture. Then, continue to conduct follow-up surveys to evaluate progress. These will all give you an idea of what your current hospital culture is like.

What did you learn from your observations? Did you find that your hospital values safely, effective care, respecting the dignity of all who come through your doors? If you said yes to all these, then your hospital is on the right track. If not, then you certainly have some work to do. From here, you can decide what you like about your current culture and, of course, what you need to change.

Things to strive for in a hospital culture:

  • Ensuring patient safety
  • Attitude of teamwork and open communication
  • Equality of staff
  • Comfortability in reporting potential hazards without fear of reprimanding

After you’ve decided on a solid hospital culture, it’s now time to move your staffing in that direction. This is definitely a difficult task in the healthcare staffing world with a plethora of temporary staffing and travel nurses coming and going.  These are some steps to start with:

  • Have a staff meeting. Clearly communicate the culture to your employees and the results you’d like to achieve, and then over communicate and remind them daily.
  • Have fun with it by providing incentives for complying with the hospital culture.
  • Make the staff feel like they are personally responsible for the successfulness of the hospital.
  • Be the leader! The culture will not survive if the authority is not setting the example

Keep it up. Your culture isn’t something you start and then ignore. A strong culture is a result of care and enforcement. How do you know that you are progressing in the right direction? Go back to step 1. Observe, listen and survey. Hopefully you will see the progression from where you started.

Remember you can create the idea of the culture you want, but only your staff can make it a reality.

 

 

 

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Improve patient care?

Hire more nurses. Could it really be that simple? http://ht.ly/2JxpM

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Solve the nursing shortage by caring for patients?

I just read an article about an initiative in New Jersey led by the New Jersey Hospital Association’s Institute for Quality and Patient Safety, in partnership with the Robert Wood Johnson Foundation aimed at educating and supporting nurses so they can increase the amount of time they spend at with patients and in the process improving their job satisfaction. In turn this should help address the nursing shortage by stopping or at least slowing down the leaving of nurses from the profession.

The hope is that by giving nurses, particularly more experienced ones, a chance to stay connected to patient care they will stay passionate about caring for others and stay in the profession. The program is receiving a substantial funding of a $732,000 grant and will focus on three goals:

  • Give performance improvement education and training for front-line staff nurses to help give them the tools needed to make improvements in their units and determine and test changes in their units
  • Give staff nurses the ability and power to make changes needed to improve how much time is spent on direct care in their unit
  • Make training and education available for nurse managers so they can help facilitate their nurses’ work and make the leadership decisions needed to make positive changes to the way their unit works
  • I must admit I had never thought about this connection before, that of nurse satisfaction improving the closer a nurse can get back to delivering patient care. This is very understandable. The extra duties that that get added to nurses’ jobs are most often not what motivated them to get into nursing in the first place. So why not address the burnout problem by letting them do what drew them to the profession in the first place.

    What about your state or hospital for that matter? Are there any initiatives underway to help nurses get closer to the patient? What about on a more micro-level? What are you doing in your nursing units?

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    Gel (Good Experience Live) Conference Promotes the Patient Experience

    I posted about this over at TravelNursingBlogs.com too, but thought it would also be worth mentioning here too.  

    The Gel (Good Experience Live) Conference is on Thursday, October 22, 2009 (and optional 2nd day: Fri, Oct 23) in New York City. It brings experts on the patient experience together to put on a series of talks on the patient experience, focusing especially on:

    • Who’s improving it?
    • How are they improving it?
    • What approaches are being taken in various healthcare disciplines?

    This is the conference’s seventh year. It looks like a great list of speakers will be there, so if you’re in the New York City area you should check it out.

    Here is a video made available from last years conference.

    Bridget Duffy at Gel 2008 from Gel Conference on Vimeo.

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    Can special talents of your nurses improve patient care?

    I came across an article on HealthLeadersMedia.com the other day about nurses at Arundel Medical Center using their artistic touch to liven up patients rooms that were undergoing renovations, by painting uplifting scenes on the windows that were covered top protect patients from viewing the bright lights from the welders. Staff, patients and visitors all said the paintings help improve the atmosphere of the floor.

    But it made me wonder what other ways could nurse managers give the nurses a chance to use the talents of the nurses in their unit to help improve patient care and the atmosphere of their unit. Making crafts? Writing stories? Being a clown?

    Is there anything you have done or our doing? Let’s hear ‘em.

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    Can you manage a robot?

    When I was a kid I was promised by the media and entertainment industries two things, we would all wear the same clothes with metallic rings around the shoulders and we all would have robots helping us by the year 2000. I am still waiting on the uniform, but the robot thing may be getting closer.

    In an aim to help alleviate their nursing shortage, researchers at Japan’s Institute of Physical and Chemical Research have created a teddy bear looking robot nurse that can help lift and move patients that weigh up to 135 lbs. The robot is called RIBA (Robot for Interactive Body Assistance) and is an upgrade from a previous model that could only lift 40lbs.

    It has a soft skin and can recognize voices and faces. It will also follow spoken commands and is built to maneuver in tight spaces, like a hospital room.

    I can see where this would be a big help in reducing the nursing shortage here in the United States if it lifted more than 135 lbs (which I imagine is in the works). People under 135 lbs is a very small percentage of American patients. But overall think of all the nurses who could stay in the field longer and the new ones that may enter it if were not for the physical strain nursing can place on a body. This means that nurses would be able to spend more time focusing on the clinical level of patient care.

    I don’t know about how much one of these robots costs, but you would think there have to be some substantial cost savings that would come from this. Between retraining staff, lost time and Workman’s comp cost from injuries from lifting and the ability to need less nurses and nurses aids to move patients, the savings would seem to be there.

    Over at Reality Rounds is a pretty funny response to the idea. What about you? Would you like to see this at your hospital?

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    Can temporary nurse staffing help in lean hospital management?

    A recent article in the USA Today talked about hospital CEOs’ efforts in cutting out wasteful spending to not only increase the efficiency and profitability of their hospitals but also help lower the cost of healthcare, an obviously hot topic right now.

    It discussed waste in supplies and use of staff’s time and how some hospitals are reducing inefficiencies using Toyota’s lean management system and reducing costs in patient care by 25% in one example. In fact, experts weigh in and say that if all hospitals could do save similar amounts it would save $400 billion on Medicare and another $1.3 trillion on the non-Medicare side. Those are huge savings and really what industry couldn’t probably do the same by being more efficient?

    It leads me to think about the role of temporary staff in running a lean hospital. Just like you wouldn’t want supplies to go to waste (like the article mentions) and would be able to save money by having supplies on demand, you wouldn’t want to be overstaffed when your patient level doesn’t call for it and conversely understaffed when your patient numbers have increased. Having nursing staff on demand could be a huge savings and, if approached right, a huge efficiency increase.

    Industry research has shown that hospitals are reluctant to use contingent staffing and will usually often only use it as a last resort. And some of the reasons listed are, training and orientation, staff cohesiveness and high costs.

    Those reservations are understandable, but if you approach staffing as a lean management item it may make sense to take a second look at each area of reservation and create systems to deal with each one to take advantage of the cost savings that travel nursing staff can provide instead of seeing them as obstacles to nursing and allied health staff on demand. This could help you create a better work environment for your nurses and other healthcare professionals and in turn care for your patients better. And what a competitive advantage for your hospital that would be.

    This post made me think of a few more related topics so keep an eye out. And I would love to hear your thoughts too.

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    Work life balance for nurse managers

    We have seen a lot of interest in nursing staff burnout lately, both through searches that find this blog and our other blog (TravelNursingBlogs.com), but also in the media and healthcare blogosphere in general, and in nursing forums and social networks. It is obvious that the economy and change in working conditions for nurses is taking its toll and nurses may be nearing the tipping point, when their physical and emotional health concerns outweigh their financial concerns. Let’s face it, people can only work 50-60 hours a week for so long.

    But this post is about you the nurse manager. How many hours are you working? Are you sacrificing your work life balance at the expense of your emotional and physical well being? If you are, stop. You may be hurting patient care just as much as your burned out staff.

    How? As a their manager, your nurses take their behavioral cues from you, so if you are stressed and burned out, that is going to impact them and the patient care they give. It is pretty simple:
    Happy Manager + Happy Staff = Happy Patient

    And we all know that happy patients come back to your hospital and recommend you to their family and friends, increasing hospital revenue and making your hospital CFO and CMO happy. Plus when hospital revenue is up, so many other good things happen, new programs that help patients can be implemented, additional staff can be brought on to improve nurse to patient ratios and so many other side benefits that come with being a financially sound hospital.

    So the real question is how do you achieve that work life balance as a nurse manager with so many people relying on you, your spouse, your kids, your parents, your employees? That is where you have to get creative. And where this series should help, over the next couple of posts I will be bringing you a series of articles to help you find work/life balance as a nursing manager. Stay tuned.

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    Alphabet staffing?

    Over at HospitalImpact.org was a great post about emotionally intelligent patient care using DISC personality profiles (Dominant, Influential, Steady, Conscientious). The thought of personality types in a hospital unit is intriguing for a couple of reasons.

    The first being the impact on patient care on an individual basis and being able to recognize what your patients are, which Nick Jacobs’ post talks about.

    But it is also interesting to look at it from an intra-unit teamwork aspect. When building a team you have two choices, build it by design or build it by chance. I would prefer to build it by design and by evaluating my current staff and their personality types when I hire new staff I can look for someone who not only meets the clinical requirements for the job, but who also rounds out my unit and/or meshes well with our existing strengths and weaknesses. For example, if I were running an imaging unit I may already have a “Conscientious” X-ray tech “Steady” MRI tech and need to round it out with an “Influential” Ultrasound tech.

    It is used in other industries and is definitely something that healthcare providers could use to determine the what kind of patient care a nurse may give or the attention to detail of a tech. Here are some good resources that explain how the DISC personality profiles work.

    ChangingMinds.org
    ProfilesGlobal.com

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    Overtime and hospital staff burnout

    In the current economy we are seeing many hospitals relying on their own perm staff to fill a lot more overtime hours than in the past. For some nurses and therapists this is a welcome boost to their paycheck, while for others it may be something they feel obligated as caregivers to do. No matter the circumstances it will eventually start to wear them out. There is plenty of research available showing the negative effects of too much overtime, everything from nurse burnout, to costs associated with nurse turnover, to putting patients at risk. So what can you do as a unit manager to help ease the effects of overtime on your staff?

    Your ability to help them through hiring more nurses or therapists may be limited unless you can convince the financial decision makers of the savings that come with being adequately staffed. But there are things you can have an impact on.

    Since you know that too much overtime is going to eventually lead to burnout, you will want to keep an eye on the signs of burnout among your staff. It is also important for you to avoid burnout yourself, so that you can be there for your staff when you sense that they are stressed and give them advice and tips for managing their stress. Below are some links that give you practical advice on how to spot and respond to you and your staff’s burnout.

    Battling Burnout: Maintaining Enthusiasm in a Challenging Environment
    StressedOutNurses.com
    Times flies, but you don’t have to
    Help staff handle stress by boosting resiliency
    Nurse retention through meditation
    Nursing Burnout Prevention
    Why Emotions Matter: Age, Agitation, and Burnout Among Registered Nurses

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