11.3 Describe the orientation and continuing education developed for clinicians, administrators and other nursing role specialties at all levels of the organization. Orientation Orientation at Mass General Hospital (MGH) is a multi-pronged process designed to provide all employees with the knowledge required to navigate through their initial period of entry into the organization. The process includes New Employee Orientation, Central Department of Nursing Orientation and Unit and/or Role Specific Orientation. • New Employee Orientation This 1.5 day mandatory orientation to the Hospital is meant to introduce the new employee to the major topics of concern for all members of the MGH community. Organized by the Human Resources (HR) Department, presentations include information on Police and Security; HR Policies and Procedures; available benefits; HIPAA training; and customer service training (attachment 11.3.a). • Central Department of Nursing Orientation The Norman Knight Nursing Center for Clinical & Professional Development (Norman Knight Nursing Center) staff welcome all new employees to the Department of Nursing (DON). Building the foundation for practice, The Norman Knight Nursing Center orientation team, in partnership with leadership, introduces new employees to: ♦ Patient focused values ♦ Professional Practice Model ♦ Safe and caring patient and staff practice environment ♦ Helping Abuse and Violence End Now (HAVEN) ♦ Culturally competent care/Medical Interpreters ♦ Life-long learning environment ♦ Policies and procedures ♦ Collaborative Governance ♦ Resources and regulatory information ♦ Collaborating departments ¾ Materials Management 35
Transcript
11.3 Describe the orientation and continuing education developed for clinicians, administrators and other nursing role specialties at all levels of the organization.
Orientation
Orientation at Mass General Hospital (MGH) is a multi-pronged process designed to
provide all employees with the knowledge required to navigate through their initial period of entry
into the organization. The process includes New Employee Orientation, Central Department of
Nursing Orientation and Unit and/or Role Specific Orientation.
• New Employee Orientation
This 1.5 day mandatory orientation to the Hospital is meant to introduce the new
employee to the major topics of concern for all members of the MGH community. Organized
by the Human Resources (HR) Department, presentations include information on Police and
Security; HR Policies and Procedures; available benefits; HIPAA training; and customer service
training (attachment 11.3.a).
• Central Department of Nursing Orientation
The Norman Knight Nursing Center for Clinical & Professional Development (Norman
Knight Nursing Center) staff welcome all new employees to the Department of Nursing
(DON). Building the foundation for practice, The Norman Knight Nursing Center orientation
team, in partnership with leadership, introduces new employees to:
♦ Patient focused values
♦ Professional Practice Model
♦ Safe and caring patient and staff practice environment
♦ Helping Abuse and Violence End Now (HAVEN)
♦ Culturally competent care/Medical Interpreters
♦ Life-long learning environment
♦ Policies and procedures
♦ Collaborative Governance
♦ Resources and regulatory information
♦ Collaborating departments
Materials Management
35
Bio-medical Engineering
The primary goal of DON orientation is to provide a broad overview including the
department mission, vision and values; organizational structure; professional practice model;
resources; and a review of key policies and procedures. The orientation program introduces role
responsibilities based on departmental standards of practice, support role socialization, and
integration into the MGH culture and environment (attachment 11.3.b).
Registered Nurses attend an additional three days of orientation, which includes a review
of essential policies, procedures and equipment review; a medication assessment; and a basic
arrhythmia review (attachments 11.3.c and 11.3.d). Support personnel (Patient Care Associates,
Operations Associates, and Unit Service Associates) receive additional job-related training.
The central program lays the foundation for staff to report to their work areas to begin unit
specific orientation. All employees are assigned a unit-based preceptor or coach to assist them
in completing their orientation.
• Unit Based Orientation
The New Graduate in Critical Care orientation program has been discussed in Force
11.2. Full details of course objectives, content and slide presentations are available on site.
Orientation to the general care units is based upon a standardized set of minimum expectations
for the orientee (attachment 11.3.e). The unit-based orientation plan is designed to facilitate
achievement of those expectations within approximately 8 weeks. In addition to the precepted
orientation experience, didactic classes in patient acuity, respiratory care and care of the patient
during bedside emergencies are also offered. Each patient care area may identify additional
expectations and goals for orientation based upon the unit’s specific patient population(s).
• Role Specific Orientation
A role-specific orientation process has been developed for those employees assuming
the role of Nursing Director, Clinical Nurse Specialist, or Advanced Practice Nurse. Guidelines
have been developed that build upon the New Employee Orientation and the Department of
Nursing Orientation and are meant to guide the employee in assuming the relevant role
responsibilities. The Nursing Director (attachment 11.3.f) and Clinical Nurse Specialist
(attachment 11.3.g) orientations focus on exposure to the functions of the departments and
services within and outside of the Department of Nursing and Patient Care Services; the roles
36
and functions of unit/service staff members; the identification of resource manuals containing
DON policies, procedures and standards. Additionally, the Nursing Director Orientation
provides information and training in the use of the various information systems integral to their
work.
The Advanced Practice Nurse Orientation (attachment 11.3.h) shares some similarities to
that of the CNS and Nursing Director, but also focuses on the information technology specific
to that role.
Continuing Education
MGH is an approved provider of continuing education by the Ohio Nurses Association, an
accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.
Nurse planners from The Norman Knight Nursing Center work with Staff Nurses, Clinical Nurse
Specialists, Collaborative Governance committees, leadership and, as needed, other organizations to
ensure the continuing education needs of nurses are met. Learning needs are continually assessed,
planned and evaluated as discussed in Force 11.1. Most continuing education programs are
marketed via The Norman Knight Nursing Center’s website calendar of events (attachment 11.3.i).
In addition, role specific continuing education programs are developed such as the Nursing Director
Leadership Development Program (attachment 11.3.j) and the Clinical Nurse Specialist Leadership
Development Program (attachment 11.3.k).
37
Attachment 11.3.a
Massachusetts General Hospital MGH Human Resources – Training and Education
New Employee Orientation Agenda
Day 1 8:15-8:40 Check in (Coffee, Tea and Juice) 8:40-8:55 Welcome by Facilitator 8:55-9:15 Group Exercise/Ice Breaker 9:15-9:45 MGH Overview/ Administrator Guest Speaker 9:45-10:00 Health and Safety Overview 10:00-10:10 Employee Assistance Program 10:10- 10:35 Police, Security and Parking (include t-pass program) 10:35-10:50 Break 10:50-11:00 Photo ID Process/Distribution 11:00- 11:15 Emergency Management 11:15-11:50 Infection Control 11:50-12:30 HR Policies and Procedures
12:30 – 1:30 Complimentary Be Fit Lunch for all new hires
** Employees working less than 20 hours have completed Day 1
1:30-1:35 Association of Multicultural Members of Partners (AMMP) 1:35-1:45 Blood Donor Center 1:45-2:00 Tuition/Perks/Employee Services 2:00-2:05 Pick up Benefits Information 2:05-3:30 Benefits Overview/Questions & Answers 3:30-4:30 Wrap Up and Collect Paperwork Day 2 8:15 Sign in (Coffee, Tea and Juice 8:30-8:55 HIPAA Overview 9:00-11:30 Customer Service Training – Service MGH 11:30-12:30 Bank of America; Citizens Bank, Harvard Credit Union 12:00-1:00 PeopleSoft sign-on (Computer Labs)
Additional Orientation
Fire and Safety Training To be completed within 90 days of your hire date http://intranet.massgeneral.org/ehs/ehs_programs_trainingprogram.htm#8 Orientation ends at this time for all staff with exception to the departments listed below have additional training. Please contact your supervisor if you are unsure of where to go. Day 2 Department Specific Training 1:00 Outpatient Practice Support Essentials at the Yawkey Center 1:30 (Biweekly)
Department of Nursing Orientation at Charles River Plaza
CONTACTS New Hire Coordinator: Mina Choe – 724-7635
NEO Facilitator: Kevin Cotter – 724-3368
MGH Training & Workforce Development
38
Attachment 11.3.b
39
Attachment 11.3.c
40
Attachment 11.3.d
41
Attachment 11.3.d continued
42
Attachment 11.3.e
43
Attachment 11.3.e continued
44
Attachment 11.3.e continued
45
Attachment 11.3.e continued
46
Attachment 11.3.e continued
47
48
Attachment 11.3.e continued
Attachment 11.3.e continued
49
50
Attachment 11.3.e continued
Attachment 11.3.e continued
51
Attachment 11.3.e continued
52
Attachment 11.3.e continued
53
54
Attachment 11.3.e continued
55
Attachment 11.3.e continued
Attachment 11.3.f
The Knight Center for Clinical and Professional Development Department of Nursing
Massachusetts General Hospital Nursing Director Orientation
Name: _____________________________ Employee Number: Unit: ______________________________ Date: Directions: This is intended as a guide and builds upon the General Hospital and Department of Nursing orientations. Your preceptor will work with you to individualize your orientation experience.
56
Content Area Learning Resource 1. Describe the mission, vision, guiding principles
and philosophy of the Department of Nursing and Patient Care Services.
2. Describe the functions of the departments and
services within the Department of Nursing and Patient Care Services including:
Administration Clinical Services Integrated Clinical Support Systems
Patient acuity system Nursing Personnel Database One Staff
Office of Patient Advocacy Nursing Financial Management Systems
Resources/Expenses Evaluation/Analysis PeopleSoft/Document Direct Personnel management Management Support Office
Department of Nursing orientation Department of Nursing orientation Executive Director, PCS Operations Associate Chiefs, Nursing Practice Director, Patient Advocacy, PCS Information Systems and PCIS staff Director, Patient Advocacy, PCS Information Systems Director, PCS Financial Management Systems and staff Director, Systems Improvement Director, Patient Quality & Safety Director, Diversity Program
Attachment 11.3.f continued
Content Area Learning Resource 2. (Continued)
The Knight Nursing CeProfessional Developm
development and implementation Collaborative Governance
Education
Research and Evaluation Student
nment Survey
tment
t Nursing Center for Clinical and pment and staff
NActivity: Coordinate Clinical Supervisor shadow experience N ent A Nursing Director, IV Team
nter for Clinical and ent
Director, The KnighProfessional Develo
Program overview Standards/policies/procedures
Orientation, Training, Continuing
Credentialing Clinical Recognition Program
Affiliations Patient Family Learning Center Staff Perceptions of the Professional
Practice Enviro
Central Resource Team (CRT) Clinical supervisors Rapid Response Program
Emergency Depar
Interface with the ED
IV Team
ursing Director, Central Resources
ursing Director, Emergency Departmctivity: Coordinate ED observation experience
3. Describe the roles and functions of unit/service A
Activity: Coordinate appropriate direct care and support staff shadow experiences
staff members. ssociate chiefs and nursing director preceptor
4. Identify resource manuals containing MGH and nd standards.
Nursing director preceptor
DON policies, procedures, a
57
Attachment 11.3.f continued
Content Area Learning Resource 5. Describe the fu t Care Services
ent of Nursing
rvices
Blood Transfusion Service
Select as contact person either the director of the epartment, or the appropriate service/unit
irector, Respiratory Therapy irector, Social Services irector, Speech/ Language Pathology
ppropriate MD service leaders ssigned Human Resource Generalist irector, Admitting irector Biomedical Engineering or designee irector, Transfusion Service
nctions of Patiendepartments outside the Departmrelevant to your role responsibilities including:
Chaplaincy Occupational Therapy Physical Therapy Respiratory Therapy Social Service Speech Language Pathology
6. Describe the functions of departments/se
outside Patient Care Services: Physicians Human Resources Admitting Biomedical Engineering
drepresentative. DD DDD AADDD
inCl ical Care Management Unit Case Management
Nutrition and Food Services Health Information Mana e
Director, Case Management & Unit-based CM Select as contact person either the director odepartment, or the appropriate service/unit epresentative. r
7. Demonstrate use of information systems including:
Outlook CAS Document Direct Peoplesoft OneStaff C-beds
8. Review and identify Nursing Director development needs with Associate Chief.
Resources for more information available at the following link: http://www.massgeneral.org/pcs/ccpd/Documents/PDF/Nurse_Manager_Leadership_Program_Orientation_Manual.pdf
Orientation has been completed: ____Yes ____No (If No, identify issue(s) and plan).
_________________________________ _______________________________________________________________________________________________________________________________________ ________________________________________ __________________________ Nursing Director ______________________Associate Chief, Nursing P
59
Attachment 11.3.f continued
The Knight Center for Clinical and Professional Development
Department of Nursing Massachusetts General Hospital
Nursing Director Orientation
Name: ____ Employee Number: ______ Unit: ____ Date: Following is a timeline for orientation. It is intended only as a guide that will be modified based on the individual needs of each Nursing Director.
Weeks 1 & 2: Hospital/Departmental Focus Attend new employee aMeet with Associate Chief and Nursing Director preceptor to plan orientation. Schedule meetings with appropriate hospital and departmental leadership/resource staff Meet with unit staff Attend Patient Care Services Executive Committee meeting Attend Nursing Director meetings Attend Collaborative Governance leadership and committee meetings: Practice, Quality, Ethics, Diversity, Research, and Patien
nd hospital orientation
t Education
al Nurse Specialist and Operations Coordinator ttend appropriate meetings related to product line
rm ion sy
Weeks 4 & 5: Unit Focus Shadow staff nurse on all shifts Develop knowledge of documentation systems Develop knowledge of systems for managing emergencies Observe function of all unit-based staff Develop understanding of unit operations Week 6 Identify and develop a plan to meet own learning needs. NOTE: The Partners Training Department sponsors Leadership Development programs as well as a New Manager Orientation program that includes topics related to human resources, safety, materials management, police and security, employee assistance program, telecommunications, and JCAHO. To receive a schedule of upcoming programs, please contact the Training Department at 726-2230.
Week 3: Service Focus Meet with ClinicAShadow nursing triage supervisor for ½ day Gain proficiency with relevant info at stems
60
Attachment 11.3.g
The Knight Ce Development
nter for Clinical and Professional
Department of Nursing Massachusetts General Hospital
anager Orientation program that includes topics related to human resources, safety, aterials management, police and security, employee assistance program, telecommunications, and
CAHO. To receive a schedule of upcoming programs, please contact the Training Department at 26-2230.
F lowing is a timeline for orientation. It is intenon the individual needs of each CNS.
Weeks 1 & 2: Hospital/Departmental Focus Attend new employee and hospital orientation
tor to plan orientation. Meet with Nurse Manager/ precepSchedule meetings with appropriate hospital and departmental leadership/resource staff Meet with unit staff
ttend Patient Care Services Combined LeaAAttend Clinical Nurse Sp
ttend Collaborative GoADiversity, Research, and Patient Education Week 3: Service Focus
eet with Nurse Manager and Operations CoordinaMAttend appropriate meetinShadow nursing triage supervisoGain proficiency with relevant information sys Weeks 4 & 5: Unit Focus Shadow staff nurse on all shifts
evelop knowledge of documentation systeDDevelop Observe function of all unit-based staff
evelop understanding of unit operations D Week 6 Identify and develop a plan to meet own learning needs. NOTE: The Partners Training Department sponsors Leadership Development programs as well
s a New MamJ7
61
The Knight Center for Clinical d Professional Development
Advanced Practice Nurse Orientation
Name: _____________
anDepartment of Nursing
Massachusetts General Hospital
________________ Employee Number:
nit: ______________________________ Date: U
ita tme t of e your orientation
Directions: This is intended as a guide and builds upon the General Hosp l and Depar n
ursing orientations. Your preceptor will work with you to individualizNexperience.
Content Area Learning Resource 3. Describe the mission, vision, guiding principles
d Patient Care Services.
ces including:
Nursing Management Systems ement
Quality & Safety
The Knight Nursing Center for Clinical and pment
Education, Professional Development
Credentialing
Research and Evaluation
Department of Nursing orientation
rtment of Nursing orientation
Associate Chief for Nursing Practice Systems
and PCIS staff Director, PCS Management Systems and staff Director, Systems Improvement Director, Patient Quality & Safety
Director, Diversity Program Associate Chief, The Knight Nursing Center for Clinical and Professional Development and staff
and philosophy of the Department of Nursing an
4. Describe the functions of the departments and Depa
services within the Department of Nursing and Patient Care Servi
Clinical Services Integrated Clinical Support Systems Office of Patient Advocacy
Professional Develo Program overview Standards/policies/procedures
development and implementation Collaborative Governance Orientation, Training, Continuing
Clinical Recognition Program
Student Affiliations Patient Family Learning Center Staff Perceptions of the Professional
Practice Environment Survey
Attachment 11.3.h
62
Attachment 11.3.h continued
3. Describe the staff member
roles and functions of unit/service s.
Nurse manager/ preceptor
3. Understands and dem
Discharge
arge summary Use of house officer manual
onstrates the following: NP preceptor
Writing orders
Tapers Hold orders Insulin orders One time orders
Completing front sheet Writing disch
6. Describe the fun t Care Services
py
g
Select as contact person either the director of the unit
ctions of Patiendepartments outside the Department of Nursing relevant to your role responsibilities including:
Chaplaincy Occupational Thera Physical Therapy Respiratory Therapy Social Service Speech Language Pathology
7. Describe the functions of departments/services
outside Patient Care Services: Physicians Human Resources Admitting Biomedical Engineerin Blood Transfusion Service
department, or thepresentative.
e appropriate service/r
6. (continued) Clinical Care Management Unit
Case Management Nutrition and Food Services
Materials Management Buildings and Grounds
epartment, or the appropriate service/unit presentative.
Process for putting in consults
TPN and tube feeding orders Health Information Management Infection Control Occupational Health Interpreter Service Volunteer Department Pharmacy Public Relations Radiology Treadwell Library Environmental Services
Select as contact person either the director of the dre
63
Attachment 11.3.h continued
7. Demonstrate use of information systems including:
Department of Nursing Massachusetts General Hospital
anced Practice Nurse Orientation Additional i ation
The Knight Center for Clinical and Professional Development
Adv
nform em
Email access Peoplesoft access
try (all levels ning.
1. The new hire coordinator notifies Information Syst Computer Login #
s (IS) and pharmacy of RN hires to initiate:
PCIS/CAS – for access to results inquiry, patient lists and (POE) Provider Order Enexcept order writing). Department of Nursing (DON) orientation includes POE trai
2. POE access to write orders Is turned on by IS after credentialing privileges are granted Contact Carol McMahon at extension 6-6788 for POE order writing training.
3. To Obtain MGH Provider #
Complete Non-MD Database form and fax to Teri Spadea at 6-9099
nonmdform.doc
4. To Obtain Electronic Signature Access (ESA) Complete Access Request Form for ESA and fax to R.J. Bilodariya at 6-1088
ESA FORM APPLICATION.dot
5. To Obtain Access to other Partners hospitals lab results
Call IS Helpdesk (6-5085) to request that the other Partners hospitals be added to CAS lab review screen.
6. To Obtain Warfarin Dose Adjuster ID Number
Contact Lynn Oertel, CNS, Anticoagulation Management Services, at extension 6-6955.
7. To Obtain Pager Communications Office (White 14)
elepho e Authorization Card8. To Obtain T n
Communicat fions Of ice (White 14) 9. To Order Lab Jackets
lab oat ord r form t aughto at extension 6 Complete MGH c e and fax to Mat N n -5394
Lab Coat Order Form.doc
10. To Obtain Discharge Express Ac )cess (Dex
65
Attachment 11.3.i
66
A
67
Attachment 11.3.i continued
67
AttachmenAttachment 11.3.i continued
68 68
Attachment 11.3.j
69
Attachment 11.3.k
ctober 26, 2006 Negotiation: Maximizing Gains by Pursuing Shared InterestsMike Wagner, NLA faculty Suzanne O’Connor, RN, CNS, MGH This workshop, at the Holiday Inn, was attended by 45 CNSs. NLA faculty facilitated the morning session. (NLA is offering 1/2 –day sessions only.) After lunch, we enlisted MGH’s Suzanne O’Connor, RN, to present an application piece to reinforce the morning’s content and allow CNSs opportunities for practice. This program received high marks from CNSs who appreciated the opportunity to reflect upon their roles as leaders and try out new skills.
January 8, 2007 Reflections on Transformational Leadership Dorothy Jones, RN, EdD, FAAN To continue the discussion on transformational leadership, we invited Dr. Jones back for more dialogue during a
regularly scheduled CNS meeting. This forum provided many opportunities for reflection about professional leadership and role.
February 1, 2007 Communicating for Influence
Mike Wagner, NLA faculty Suzanne O’Connor, RN, CNS, MGH Building on the success of our last NLA offering, we invited Mike Wagner back for a second workshop on communication. This was followed by an application session by Suzanne O’Connor, RN. This, too, received very high marks. Attendance was 40.
The task force continues to meet monthly or bimonthly, as needed, to evaluate the workshops and to plan upcoming events. Written course evaluations are reviewed and consensus is reached regarding the course offerings. Diane Carroll, RN, has stepped down due to her new duties in the Mu n Center for Nursing Research. The task force is seeking a replacement member. CNS Leadership Competencies The CNS Group desired to integrate the PCS leadership competencies with their specific, professional role, as the nurse directors had done. In order to guide that process, the CNSs began by articulating a vision and mission statement (see page 5). The CNS Group will continue to examine and revise this
d draft leadership competencies over the summer of 2007.
Clinical Nurse Specialist Leadership Development: A Progress Report
2006 - 2007
O
n
work an
70
Attachment 11.3.k continued
2007-2008 Program Planning
The CNS Leadership Developm luating feedback from the first year’s offerings to guide curriculum pla schedule is below:
• 9/6/07 FacilitaBoth dithe syne to attend as dyads. T facilitated by Mike
• 10/4/07 Voices
nd Professional
4 CNSs. This nted to the nurse directors, was very well
mplary
• 10/11/07 Manag Performance
anagi the Staff Perceptions Survey. nderstand the common sources of
dispute and the impact of conflict on performance as well as uncovering and alig eement.
• 11/1/07 Voices
Rosalieon 10/42008.
ias, and identifying how diversity influences relationship building, communication, and decision-
ill increase leadership effectiveness in an environment ients, staff, and physicians encompass diversity of age, ethnicity,
ent Task Force is currently evanning for the second year. The proposed
ting Effective Teamwork—Combined workshop. rectors and CNSs agreed that this topic lends itself to rgy of directors and CNSs, who will be encouraged his workshop has been booked through NLA and will be Wagner.
of Wisdom I Rosalie Tyrell, RN, Norman Knight Center for Clinical a
Development, will facilitate this workshop for 6 to 1program, previously presereceived. The workshop will focus on the five practices of exeleadership described by Kouzes and Posner.
ing Conflict: Bridging Differences for ImprovedM ng conflict is a need identified in
. This workshop will help participants to u
ning underlying interests to generate agr
of Wisdom II Tyrell, RN will facilitate part II with the same group of CNSs as /07. Additional programs could be offered in spring and fall of
• 2/7/08 Managing Amidst Diversity: More Effective Leadership of an Evolving
Staff Understanding the benefits and pitfalls of either minimizing differences or emphasizing differences, recognizing inherent b
making wwhere patnational origin, religion, and socioeconomic and cultural background.
