JOuRNEy TOwARd NuRsING INTEGRATION - Cleveland Clinic · 2013-12-20 · JOuRNEy TOwARd INTEGRATION...

INTEGRATIONJOuRNEy TOwARd NuRsING

[ ]The Stanley Shalom Zielony Institute

for Nursing Excellence

ANNuAl REpoRT 2009

A New Era in Cleveland Clinic Nursing[ ]

“2009 was a year of unparalleled professional opportunities and growth

for The stanley shalom Zielony Institute for Nursing Excellence and a

pivotal time for nursing at Cleveland Clinic.”

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Cleveland Clinic

Nurses —

delivering on

the Promise of

world-Class Care

Cleveland Clinic created the position of Executive Chief Nursing Officer. For the first time, governance for the all of the system’s nurses was under a single leadership team. The approach ushered in a new and vibrant environment of collaboration and cooperation between nurses and physicians. We now have a cohesive, energetic and creative team of leaders with the talents to identify the possibilities for growth and improvement – and to make those possibilities realities.

Last year also saw the naming of the institute. The generous sup-port of Stanley Shalom Zielony provided an identity around which all nurses can rally and in which they can take pride.

Ours was the first of 26 institutes to integrate systemwide opera-tions, policies, procedures and staff. Integration involved more than 11,000 nurses at our main and nine regional hospitals, Cleveland Clinic Florida, an affiliate hospital in Ashtabula, and 15 family health centers.

Before we began to align policies and procedures, before we took that first step in strategizing integration, we knew our work was about rela-tionships: building trust, strengthening collegiality, empowering and aligning our people to create and build a vision together. We identified four imperatives: standardized clinical practice; communication; continuous performance improvement; and leadership development.

Once the strategic course was set, we brought it into focus with a vision of “Delivering on the Promise of World-Class Care” symbolized by an image of a hand cradling the world.

I am proud of the way our nurses and nursing support personnel rose to the challenges with a willingness to embrace change. We could not have achieved so much without their support and engagement.

We see the results daily – in the faces and positive comments of our patients and their families and in the ever-improving patient satisfaction scores. Those are the real measures of our success.

Sarah Sinclair, RN, BSN, MBA, FACHEExecutive Chief Nursing OfficerStanley Shalom Zielony Chair for Nursing AdvancementChair, The Stanley Shalom Zielony Institute for Nursing Excellence

journey toward integration

Hundreds of interviews with nurses helped

formulate the plan’s key areas of focus.

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CLEVELAND CLINIC THE STANLEY SHALOM ZIELONY INSTITUTE FOR NURSING EXCELLENCE

In July 2009, hundreds of Cleveland Clinic nurse leaders gathered for the unveiling of an innovative strategic plan focusing on the systemwide integration of nurses, best practices and policies. The main objective of the plan was to ensure delivery of the same level of nursing care at every Cleveland Clinic facility.

The strategic plans continuing advancement of patient outcomes — both clinical (safety), experiential (patient satisfaction) and operating (clinical processes) — are driven by Nursing Management’s belief that good patient experience cannot be driven from the top, but must come from a point of contact with the patient — one of which is at the bedside.

Hundreds of interviews with nurses helped formulate the plan’s four key areas of focus:

• standardizationofclinicalpractice

• communication

• continuousperformanceimprovement

• leadershipdevelopment

After the kickoff meeting, teams were assembled to develop Nursing Standards of care, procedures and policies supported by evidence-based research and expert opinion. At the same time, a program was started to clearly define and standardize across the system the responsibilities of all caregivers on the healthcare team.

Elaborated in this report are many important pieces used to implement the strategic plan’s ongoing standardization and simplification of policies and staffing within the health system.

The Zielony Institute is committed to the established goals of the strategic plan that will guide us on our journey to a new destination — Cleveland Clinic’s new era in integrated nursing.

JOuRNEy TOwARd INTEGRATION

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“Nurses are the heart and soul of our medical

team. your intelligence, compassion and

dedication to patients continue to build our

legacy of success.”

delos M. Cosgrove, MdCEO and President, Cleveland Clinic


Standardization of Clinical practice[ ]While every patient is unique, how they are treated should be consistent. Cleveland Clinic

health system spans not only Northeast Ohio but also international borders — making

establishing consistent standards of Clinical Practice particularly challenging. Below are

listed a few of the programs designed to enforce consistent treatment based on best

practices across the system.

NuRSINg pRACTICE CouNCIl FINE-TuNES pRACTICES ACRoSS ThE CoNTINuum oF CARE

As 2009 began, the Zielony Institute leadership created a systemwide Nursing Practice Council to ensure that standardization of clinical practice resulted in the same level of nursing care delivery at every Cleveland Clinic facility.

The systemwide Nursing Practice Council facilitates input from all Cleveland Clinic nurses related to processes and decisions that affect nursing practices and nursing care delivery. To meet goals, the council is implementing nursing standards of care, procedures and policies supported by evidence-based research and expert opinion across the system. At the same time, roles and responsibilities of all caregivers onthe healthcare team are being clearly defined and standardized.

“We found that there were almost 800 different job descriptions within the system, and staffing models varied widely,” says Mary Kennedy, RN, MBA, BSN, Chief Nursing Officer, Lutheran Hospital. “The council is working toward collapsing similar jobs and streamlining policies and procedures to eliminate redundancy and confusion.”

Becoming more in tune with the hum of everyday workings within each unit can be daunting, but a shared governance approach is making the difference, according to Kelly Hancock, RN, MSN, NE-BC, Nursing Director, Sydell and Arnold Miller Family Heart & Vascular Institute.

“We receive input from frontline care providers who address issues like line care or use of restraints. We have many nurses who are certified in specialty care, allowing us to be rich in ‘expert knowledge’ resources that are used to guide us toward better outcomes across the system,” Hancock says.

By standardizing roles, responsibilities, staffing plans and staffing models, the council is achieving many goals, including guiding nurses throughout Cleveland Clinic to coordinate clinical practice initiatives with appropriate other disciplines, committees, task forces and medical staff.

Nurses across the

Cleveland Clinic

health system are

caring for patients

in 4,868 beds

and 200 operating

rooms.

Cleveland Clinic

has more than

4 million patient

visits per year.

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journey toward integration6

Standardization of Clinical practice continued

AN AFFINITy FoR BRIdgINg ThE pRACTICE gAp

Because communication among nurses, management and physicians is so important to making standardized practice work, existing Affinity Groups have been expanded and given a more visible role. Representing nine key nursing specialties, the Affinity Groups convey information and ongoing education throughout each department systemwide to integrate standardization of nursing practices.

Sponsored by a Chief Nursing Officer or Associate Chief Nursing Officer liaison, the Affinity Groups represent Surgical Services, Critical Care, Wound Care, Enterprise Nursing Documentation Collaboration, Oncology Nurses, Women’s & Children, Behavioral Health, Medical Surgical, Advanced Practice Nursing, and Emergency.

“We are working to standardize our policies and procedures for all Cleveland Clinic hospitals. Our goal is to provide the same standard of nursing care no matter where our patients enter the system. This process includes consolidation of policies, incorporating best practices and clari-fying expectations for better efficiency and improved patient care,” says Deborah Small, RN, BSN, MSN, NE-BC, Associate Chief Nursing Officer, Clinical Practice & Research, and liaison, Oncology Nurses Affinity Group.

Through monthly meetings, the Affinity Groups create informative networking forums for nurses across the system to collaborate and form alliances by sharing experiences. The payoff of pooling resources is evident in wound care, which has seen a 43 percent decrease in hospital-acquired pressure ulcers systemwide through implementation of pressure ulcer prevention, interventions and treatment. The Surgical Services Affinity Group is also making an impact, with 75 percent of their policies and procedures standardized throughout the system.

“Our group has existed for five years, and throughout this time we’ve instituted a sponge count initiative, which all facilities will be compliant with, and the use of the World Health Organization safety checklist,” says Cynthia Rosa, RN, BSN, MS, Chief Nursing Officer, Marymount Hospital, and liaison, Surgical Services Affinity Group.

“We found that information flows more easily from facility to facility through a council structure,” says Sue Collier, RN, BA, BSN, MSN, CNS, Associate Chief Nursing Officer, Care Management and Social Work, and former Chief Nursing Officer, South Pointe Hospital, and liaison of the newly formed Critical Care Affinity Group. “A key person at each hospital, participating on the affinity group, allows us to stay informed and not overlap or duplicate efforts throughout the system. It provides for input from all hospitals, giving everyone a voice.”


NuRSINg INFoRmATICS:INNovATIoN ThRough TEChNology

Technology is dramatically altering the ways in which nurses diagnose, treat, care for and manage patients. The Zielony Institute’s mission is to utilize technology solutions to support evidence-based nursing practice, improve patient outcomes and enhance nursing communication, documentation and efficiency.

The Department of Nursing Informatics is playing an essential role in defining and implementing the strategy for innovative technological systems and processes. A key step was implementation of the electronic medical record through the Epic system, which enables systemwide examination of any patient record across the continuum of care. This application includes computerized physician order entry (CPOE), nursing care documentation, medication administration record, allied health documentation and results reporting.

“We found that there were different versions of nursing documentation across the system. Our implementation of Epic software is a tremendous tool to support standardization of clinical practice,” says Susan Stafford, RN, BSN, MPA, MBA, Associate Chief Nursing Officer, Nursing Informatics.

Patients also benefit from the technology being utilized. They can access their medical records through Cleveland Clinic MyChart. MyChart allows Cleveland Clinic patients the ability to securely manage prescriptions and appointments online, as well as receive test results and important preventive health reminders and recommendations.

Future systemwide technology initiatives for nursing include implemen-tation of radiofrequency identification (RFID) technology, personalized electronic scheduling and automated patient acuity classification. “The future of technology for nursing is exciting, but nursing informatics should not drive the practice — it should be a support of quality patient care,” Stafford says.

More than 100

nurses from

across the system

collaborated in

designing a process

for a single nursing

documentation

format in 2009.

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“Frequent two-way communication helps each of us

to fully recognize how we fit into our organization

and carry out our mission of providing quality care.”

debi Jones, RN, Ms, NEA-BC, FACHEChief Nursing Officer, Cleveland Clinic main campus


A robust two-way system of communication is required to not only communicate clinical

practice standards and patient information but to also make sure that nurses continue to

give input on improving standards and maximizing patient care.

STRATEgIC CommuNICATIoNS

To enhance nurses’ daily experiences and professional growth, the Zielony Institute implemented several methods of systemwide communication that include:

• a consistent identity — The Stanley Shalom Zielony Institute for Nursing Excellence — around which all nurses can rally and in which they can take pride

• a central intranet with single access for the Zielony Institute to share ideas and connect with others across the entire health system

• “60 Seconds with Sarah,” bi-monthly podcasts by Executive Chief Nursing Officer Sarah Sinclair delivered via the intranet

• networking forums for nurses across the system to collaborate and form alliances by sharing experiences

opERATIoNAl CommuNICATIoNS: mINI-mEETINgS

In a nonstop work environment, attending hour-long staff meetings can

seem impossible for most nurses. What results is the elimination of the

meeting and, often, not hearing the important information that would

have been delivered during it. To meet both the needs of nurses’ schedules

and the need for timely delivery of essential information, the Zielony

Institute rolled out “Mini-Meetings” throughout the system.

A 10-minute weekly meeting, the Mini-Meeting is a venue for nursing staff

to stay informed about what’s going on and what is expected of them. Just

as important, Mini-Meetings provide an opportunity for nurses to ask

questions and verbalize feedback to their managers.

SBAR: CREATINg A BETTER “hANdoFF” Tool

A standardized approach to information sharing is used to ensure that patient information is consistently and accurately imparted, especially during critical events, shift handoffs or patient transfers. SBAR — Situation, Background, Assessment and Recommendation — creates a shared mental model for effective information transfer by providing a standardized structure for concise factual communications among clinicians, whether it’s nurse-to-nurse, doctor-to-doctor or nurse-to-doctor. Other tools such as critical language, psychological safety and effective leadership are central to providing safe care.

Communication[ ]

Nurses launched

an internal website

to provide a

streamlined way

of communicating

with each other

across the system.

Executive Chief

Nursing Officer

sarah sinclair

began delivering

bi-monthly webcast

messages to her

staff as well.

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“Our falls rate is consistently below national

benchmarks, but with the lessons learned from

Falls Huddle rounding, we anticipate further

decreases in the overall fall rate and repeater

fall rate.”

Monica weber, RN, MsN, CNs-BC, CICNursing Patient Safety Officer/Magnet Program Manager, department of Nursing Quality


Continuous performance Improvement[ ]One of the greatest resources that medicine has is the ability of nurses to continually

advance everyday medical care. The Zielony Institute is dedicated to giving nurses the

tools and support they need to continuously improve care. Below are just a few examples:

KEEpINg SCoRE oF BEST pRACTICES

The Zielony Institute now utilizes an Integrated Scorecard Metrics software that includes a snapshot of patient experience (HCAHPS scores), quality (core measures), patient safety, staffing effectiveness (Human Resource Information System), and a financial/productivity operating statement. The scorecard technology is a strategic online tool that will aid with system-wide planning and priority setting for nursing, as well as monitoring the achievement of objectives of all nursing staff.

“We developed our scorecard to measure outcomes and give us an enterprise-wide standardized approach for best practices,” says Jessica Korman, MNO, former System Director, Nursing Operations & Planning. “This allows us to look at nursing across the system, in addition to offering data that enables proactive efforts by our Chief Nursing Officers.”

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The Zielony Institute

started help us Support

healing (huSh) to provide

a restful, healing environ-

ment and to improve the

patient experience. huSh

steps include:

dimming lights after 9 p.m.

limiting work activities

near patient rooms

Fixing noisy doors, cart

wheels and loud toilets

Closing doors as appropri-

ate after 9 p.m.

Reminding co-workers to

reduce noise

Ensuring patient monitors

and alarms are set on the

lowest and safe levels

[


Continuous performance Improvement continued

TRACKINg QuAlITy’S ImpACT

The departments of Nursing Quality at each Cleveland Clinic hospital facilitate the improvement of patient outcomes and promote the quality of nursing care. Through the coordination of collecting, analyzing and reporting on multiple nursing quality indicators, Nursing Quality is involved in major activities that heighten awareness to improve patient care and nursing practice.

“During the last two years, restraints have decreased by about 60 percent and pressure ulcers have decreased by about 40 percent. Our falls are also consistently below national benchmarks,” says Dana Wade, RN, MSN, CNS, CPHQ, Director, Nursing Quality, Cleveland Clinic main campus. “Use of trending reports by clinical directors and nurse managers help to visualize documented improvements/accomplishments and areas where we need to place ongoing additional efforts.”

Results from nursing quality initiatives can be seen at Hillcrest Hospital. The Ohio Perinatal Quality Collaborative recognized Hillcrest Hospital’s Special Care Nursery for its best-practice outcomes with central line main-tenance bundles. Hillcrest achieved a reliability score of 100 percent in November 2009, and a zero percent infection rate for late-onset catheter-associated bloodstream infections. These quality achievements placed Hillcrest as the top Special Care Nursery in Ohio for all of 2009 ineliminating bloodstream infections in high-risk infants who are 22- to 29-weeks’ gestational age.

Hillcrest also implemented a best-practice campaign for hand hygiene.

The Ohio Perinatal

Quality Collaborative

recognized Hillcrest

Hospital’s special Care

Nursery for its best-

practice outcomes

with central line

maintenance bundles.

Falls,

2009[

CLEVELAND CLINIC THE STANLEY SHALOM ZIELONY INSTITUTE FOR NURSING EXCELLENCE 13

Lakewood Hospital promoted and implemented national standards of care and innovative quality improvement processes by improving The Joint Commission’s Core Measure results for acute myocardial infarction, heart failure, pneumonia and surgical care patients. To do this, daily huddles are used as a means of identifying Core Measure patients, documentation requirements are monitored, new admissions are screened and nursing staff facilitates just-in-time education.

huddlES oFFER INSIghT FoR FAllS pREvENTIoN

The Zielony Institute met a primary goal of promoting the prevention of falls in 2009. A Falls Huddle Team formed at Cleveland Clinic’s main campus to bring forward insight and direction, leading to a new systemwide falls protocol.

A Falls Huddle is facilitated by a nursing director, clinical nurse specialist, pharmacist, nurse manager and nursing staff from the unit.

“Our falls rate is consistently below national benchmarks, but from lessons learned and the daily Falls Huddle rounding, we anticipate further decreases in the overall fall rate and repeater fall rate,” says Monica Weber, RN, MSN, CNS-BC, CIC, Nursing Patient Safety Officer/Magnet Program, Manager, Department of Nursing Quality.

These results were accomplished through various multidisciplinary interventions.

Falls

With Injury,

2009[

2009 hand hygiene

overall Compliance:

Ashtabula: 91%

Euclid: 78%

Fairview: 85%

hillcrest: 94.1%

huron: 96%

lakewood: 76.4%

lutheran: 80%

main: 90%

marymount: 82%

medina: 90%

South pointe: 85%


Continuous performance Improvement continued

CollABoRATINg FoR SKIN CARE NEEdS

The Zielony Institute formed a Skin Care Collaborative Project in 2008 that focused on continuous education and monitoring of treatments and trends in patient care and pressure ulcer prevention strategies — an effort that led to a 43 percent decrease in hospital acquired pressure ulcer rates by the end of 2008 that were maintained throughout 2009.

The Skin Care Collaborative Project implemented several initiatives including education, documentation, weekly pressure ulcer prevalence and simplifying policies and procedures.

“Our quality improvement project began in response to elevated hospital-acquired pressure ulcer NDNQI rates. Through the collaboration of clinical educators, clinical nurse specialists, certified skin care nurses and nursing quality coordinators, we were able to merge 13 different skin care policies into one and begin mandated education classes,” says Dana Wade, RN, MSN, CNS, CPHQ, Director, Nursing Quality, Cleveland Clinic main campus. “Efforts were associated with a decrease in hospital-acquired pressure ulcer rates from 7 percent in the first quarter of 2008 to a sustainable rate of 3 to 4 percent currently.”

“Daily rounds on patients with pressure ulcers, weekly skin care prevalence and monitoring documentation were the focuses for evaluation. As a result, pressure ulcer prevalence rates decreased, documentation compliance increased and several units outperformed NDNQI benchmarks for organizations with more than 500 beds,” Wade says. “Our system hospitals have initiated the same efforts, and our goal is for systemwide integration of the skin care collaborative practices, protocols and products through the Wound Care Affinity Group’s communication efforts.”

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Through collabora-

tion, 13 different

skin care policies

were merged into

one, and educa-

tion classes were

mandated.


ShIFTINg CulTuRE To pREvENT BloodSTREAm INFECTIoNS

In 2009, the Zielony Institute joined hospitals across the country to improve patient safety by adopting the Central Line Bundle. This nationally recognized evidence-based practice consists of five steps to reduce central line infections: cleaning hands, selecting the best insertion site, using proper skin preparation, using maximal barrier precautions and removing the catheter as soon as possible. Intensive care units follow CLABSI prev-ention as part of the Comprehensive Unit-based Safety Program (CUSP), a 10-state collaborative, funded by the Agency for Healthcare Research and Quality (AHRQ).

To ensure timely and consistent dissemination of important education and national patient safety goals regarding CLABSI and CUSP, Cleveland Clinic has instituted a systemwide initiative through its intranet. Videos, presentations, articles and standard guidelines are available at all times for all employees. Employees are also instructed on the SAVE That Line Campaign for line maintenance, developed by the Association for Vascular Access, which includes scrupulous hand hygiene, aseptic technique, vigorous friction to catheter hubs and ensuring patency of the device.

“Education is the key to best practices,” says Mary Oden, Senior Director, Infection Prevention, Quality and Patient Safety Institute. “By January 2010, we had systemwide collaboration. Through standardization, training and understanding offered from our intranet and educational initiatives, our employees are making a difference.”


“Our success is built on knowledgeable, inspired leaders

who create and lead exceptional teams. we encourage and

support life-long learning, as rapid change and technological

advances require a workforce that is constantly evolving and

generating new evidence-based practices.”

Joan Kavanagh, RN, BsN, MsNAssociate Chief Nursing Officer, Clinical Education & Professional Development

The continual development of nursing leadership that can keep up with the developments

in today’s technology and strategic thinking is one of the most important steps in achieving

world-class care. The Zielony Institute is fortunate to have the best and the brightest avail-

able and is dedicated to making sure every worker has the opportunity to achieve his or

her potential. The following are just some of our programs.

ClINICAl lAddER ENCouRAgES, REWARdS ExCEllENCE

Through the implementation of the clinical ladder in 2007, nurses have a formal mechanism to advance in their practice and be recognized for their accomplishments.

Designed specifically for nurses who work with patients in the inpatient and ambulatory settings, the clinical ladder has five levels (Professional Nurse I through V) that describe key competencies and accountabilities. New hires begin at Level I or II, depending on whether they have a year or more of experience. To progress beyond the first two levels, nurses must apply for each level in order and show performance, experience and education as they climb. Each advancement on the clinical ladder is associated with a designated raise in addition to the nurse’s annual salary increase.

“The clinical ladder gives bedside nurses a chance to shine and own their practice,” says Debi Albert, RN, MSN, MBA, NEA-BC, Chief Nursing Officer, Fairview Hospital.

The application and review process begins in the fall and takes about eight months, with promotions announced each May. Since the clinical ladder has been implemented, 165 Cleveland Clinic nurses have been promoted.

leadership development[ ]

The Zielony Institute offers a Tuition Reimbursement program that provides an annual maximum reimbursement of up to $7,500 for graduate nurses and up to $5,000 for undergraduate nurses. Cleveland Clinic honors career development and recognizes performance through many opportunities including in-house education programs; a clinical career ladder leading to potential additional pay; reimbursement for certifications; and regional, national and international career opportunities.

Encouraging

Career

development[

Of the more

than 11,000

nurses working at

Cleveland Clinic

in 2009, 850

were advanced

practice nurses.


leadership development continued

“Our model provides career growth at each nurse’s pace. They can climb each level subsequently or take several years to move up each level — we encourage the ability to pick and choose when and how they want to move forward,” says Albert. “The main goal is to provide career growth while celebrating their accomplishments.”

ACAdEmy INvESTS IN mANAgEmENT dEvElopmENT

To help create an environment of support for nurse managers’ growing list of responsibilities, the Zielony Institute developed the Nurse Manager Academy in the fall of 2008.

The 16-week program is offered three times annually and is based on lead-ership competencies from the American Organization of Nurse Executives (AONE). The course begins with a self-assessment through a number of skill indicators including finance and business, and interpersonal and conflict management. Additional topics covered include organizational and system thinking skills, strategic planning skills and employee hiring and retention.

The Academy is conducted off-site during regular shift hours. Online modules are also available, with a post-self-assessment emphasizing the Academy’s overall education.

“Nurse managers set the tone for their units and serve as the backbone of the organization. They are frequently expected to be financial gurus, ensure the quality of patient care and clinical competence across the continuum, and exhibit leadership and strategic management skills,” says Dawn Bailey, RN, BSN, MAOM, Chief Nursing Officer, Euclid Hospital. “There is also a delicate and subtle art to being a nurse manager: balancing tension between quality and cost, encouraging and inspiring staff, and implementing processes to ensure that the care delivered is individualized and compassionate. The Nurse Manager Academy is a highly effective venue for meeting these advanced educational needs of our nurse manager staff.”

The Zielony Institute

attracted almost

$12 million in phil-

anthropic support

in 2009 that will

provide enhanced

education resources,

scholarship oppor-

tunities and techno-

logical advances.

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The systemwide vacancy rate for bedside nurses at Cleveland Clinic in 2009 was about 5 percent.

Cleveland Clinic systemwide nurse engagement was higher in 2009 than in the previous year, according to the results of Cleveland Clinic’s Gallup Employee Engagement survey. (An engaged employee is someone who is involved in and enthusiastic about his or her work. The employee engagement survey measures the extent to which the conditions that lead to engagement for each employee are being met.)

With a differential of only 0.01, overall nurse engagement was very close to the overall engagement of all employees at Cleveland Clinic. The national average differential is 0.18.

Nurse

Engagement

Scores[

RollINg ouT ThE REd CARpET FoR NuRSES

Cleveland Clinic recognizes the importance of retaining, recruiting and inspiring nursing students and nurses by engaging them at various stages of their relationship with the organization. A key component of the Zielony Institute’s commitment to this effort is the Red Carpet Program, which engages nursing students and staff, enhances their career opportunities and experience, and draws them into the culture of the organization.

Throughout their clinical experience, nursing students are encouraged to be active learners and to integrate with and become valued members of the healthcare team. Students may also work as Nurse Associates in their senior year in a unique program designed to enhance their skills and clinical knowledge under the direction of a registered nurse preceptor.

“Our staff takes pride in mentoring new nursing professionals,” says Kelly Bryant, RN, MS, BSN, Director, Nursing Education, Student/Faculty On-Boarding. “We are pleased to offer many exciting opportunities for growth and development for future nurses entering the complex world of healthcare today.”

When a nurse is hired at Cleveland Clinic, he or she enters into a formalized orientation program. A three-phase process allows further development of skills and knowledge. All new nurses are assigned a primary preceptor and are provided learning opportunities in the classroom, clinical practice setting and simulation/skills lab — “one of the best learning environments where new nurses are afforded the opportunity to learn and practice newly acquired skills in a safe and supportive setting,” according to Georgian Massa, RN, MSN, Senior Director, Clinical Education/Professional Development.

In 2009, the

stanley shalom

Zielony Endowed

Chair for Nursing

Advancement,

a first-of-its-

kind for a chief

nursing officer

at a healthcare

institution, was

created.


Nurses and residents practice lifesaving procedures together

in the simulation skills lab in the stanley shalom Zielony

Plaza on Cleveland Clinic’s main campus.


dEvElopINg ‘SmART’ RoomSTo opTImIZE CARE

Timely responses are required for optimal care and

Cleveland Clinic nurses are starting to implement

“smart” room technology to enhance and improve

patient care. The smart room concept streamlines

care through improved communication between

all members of the healthcare team, in addition to

increasing patient safety and satisfaction. Rooms

would be technologically equipped with computer

screens that display vital signs, medications and

other personal information, and even identify

health professionals as they enter the room.

“Nurses spend only 25 to 30 percent of their time

delivering patient care — technology will reduce

the time spent hunting and gathering supplies or

equipment, as well as improve communication.

This in return will provide increased efficiency

and safety at the point of care,” says Holly Reilly,

MBA, FACHE, System Executive Director/Nursing

Operations & Integration.

Connected directly to a patient’s electronic

medical record, the smart room computer system

will present a wide range of information including

reminders to patients to ask for help in getting

out of bed if they are at risk of falls. Displaying the

patient’s schedule, which may include medication

reminders, will be another feature of smart room

technology.

Planned for implementation throughout a

designated unit at Cleveland Clinic’s main

campus, the smart rooms will be studied for

18 months. While nurses at the main campus

anticipate the technology’s development,

Fairview Hospital is already reaping benefits

through its own “Innovation Unit.” Based on

a similar principle, the Innovation Unit is a

medical-surgical unit used to trial, evaluate and

develop best practices in technology, nursing,

interdisciplinary care and medicine.

Winner of the Best Practice Award at the 2009

ANCC National Magnet Conference, Fairview

Hospital’s Innovation Unit was praised for its

ability to bring ideas, technology and concepts

together for nurses and their patients. Capitalizing

on the latest healthcare innovations and ideas

from the interdisciplinary team led to sustainable

and transferable best practices, such as patient

activity carts; digital screens for patient, family

and staff education; a unit-based pharmacist; and

strategies to improve HCAHPS scores.

“Fairview is at the forefront of smart room

technology and they’re showing how it can benefit

our overall system,” says Susan Stafford, RN,

BSN, MPA, MBA, Associate Chief Nursing Officer,

Nursing Informatics. “The biggest opportunity

with the smart room at the main campus will be

the chance to think outside the box. It’s a living

laboratory that will lead to limitless discovery.”

NuRsING INNOVATION

Cleveland Clinic nurses are proud to be part of a healthcare organization that has a

reputation as a leader in innovation. And the nurses themselves are earning that same

reputation by leading the way with initiatives such as the following:

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STudENT NuRSE poRTAluNIFIES EduCATIoN oN ThE EmR

Taking further steps in assuring standardized

care, the Zielony Institute launched the Student

Nurse Portal (SNP) in 2009, providing nursing

students access to online courses regarding the

electronic medical record (EMR). The SNP was

created as a virtual educational site for nursing

students to provide a solid understanding of the

EMR, enabling the student to see it as more than a

platform for the simple documentation of facts.

A development made possible through

collaboration of the Deans’ Roundtable Faculty

Initiative and University Hospitals, the SNP

is accessible to all nursing students from 14

area schools that are members of the Deans’

Roundtable.

“We went live with the SNP in the fall of 2009,

with courses that are not specific to any one

computer system. The theories and principles can

be applied to any EMR regardless of the system

being utilized,” says Anna Mary Bowers, RN,

MSN, Nursing Education Director, Technology &

Simulation, Nursing Education and Professional

Practice Development. By offering online

education with decreased classroom instruction,

the SNP offers cost-effective EMR education for

nursing students that will increase patient safety

and result in high-quality patient care. “We’re

looking forward to making the portal available to

all current nursing staff, as well,” Bowers says.

About 1,500 nursing students

are precepting at Cleveland

Clinic on any given weekday.

Cleveland Clinic nurses

remained active in the deans’

Roundtable, a consortium

of deans and directors from

Northeast Ohio schools of

nursing in partnership with

other Northeast Ohio hospital

systems. The group formed in

2005 to address the nursing

and nursing faculty shortage in

Northeast Ohio.


ENhANCINg NuRSES’WEll-BEINg

Nurse wellness has a direct impact on the quality

of daily care nurses provide, and the Zielony

Institute recognizes how important this is for its

nurses. Taking a holistic approach to wellness,

Cleveland Clinic addresses the key areas of

nourishment, movement and self-management

of stress through a variety of programs focused on

employees’ health.

Through the wellness program that began in

2008, nurses and other employees enrolled in the

hospital’s employee health plan (EHP) have access

to free Weight Watchers® meetings and nutrition

counseling. Also available are free memberships to

Curves®, Cleveland Clinic fitness centers and yoga

classes. Help with stress management is available

through Health Services’ Code Lavender, a rapid

response team approach to stressful experiences of

patients, families and employees.

Code Lavender’s Healing Services Team responds

within 30 minutes of a request with chaplains,

touch therapists and the employee assistance

program. The Healing Services Team’s focus

is on being supportive and also on using touch

therapies, such as Reiki, Healing Touch, massage,

spiritual support and counseling, snacks and

therapeutic presence, among other techniques. A

Nursing Refresh Center for night-shift staff is also

available, in addition to a virtual sanctuary space

with massage cushions and guided imagery CDs,

which is available on most nursing units.

“Our Total Rewards Program is designed to help

us care for our caregivers,” said Matthew Majernik,

Executive Director, Total Rewards, Human

Resources. “Our benefits reach beyond employees

to their dependents, as well.”

To enhance the benefits of healthy living,

Cleveland Clinic began offering the Healthy Choice

Rebate Program in 2010. Employee Health Plan

Total Care employee members (not dependents)

who demonstrate that they are successfully

managing their own health may qualify for a

Healthy Choice rebate toward their EHP Total Care

premium. A voluntary program, the Healthy Choice

Rebate Program offers more than 20 coordinated

care programs, but targets only six diagnoses

that are impacted by lifestyle choices, including

four primary diagnoses: weight management,

diabetes, asthma and tobacco/smoking. The

secondary diagnoses include hypertension and

hyperlipidemia. Demonstrating improvement of

any one of these targeted, controllable chronic

diseases offers employees the opportunity to

reduce their healthcare premiums and continue

with this rate into the next year.

“By taking a proactive approach to our health,

we can take better care of our patients. And the

extra benefit is that our employees can keep their

healthcare premium costs down,” Majernik says.


Community flu shots are part of the many

community outreach services Cleveland

Clinic nurses offer each year.


COMMuNITy OuTREACH

ASHTABULA COUNTy MEDICAL CENTER (ACMC)

• OB nurses taught health reproductive

education in the middle and junior high

schools in the community.

• A former (now retired) PRN nurse from the

Skilled Nursing Unit offered free blood

pressure screenings every month at the

Ashtabula Senior Center.

• ACMC nursing staff participates in the

ACMC Block Party each summer, providing

education and free health screenings.

• The Skilled Nursing Unit hosted a monthly

stroke support group for younger patients who

have had strokes.

CLEVELAND CLINIC Main Campus

• For the third year in a row, nurses collected

and delivered more than 5,000 school supplies

to students at an elementary school.

• Nursing employees collected, sorted and

organized 16,000 pounds of medical supplies

shipped through MedWish International.

These supplies were sent to four hospitals

in the southern provinces of Iraq and will be

used to help the Iraqi citizens served by these

facilities.

• On the second Tuesday of every month,

Cleveland Clinic nurses helped out at

University Settlement House in Slavic Village.

Employee volunteers spend two hours serving

a hot meal and preparing grocery packs for

neighborhood residents.

• Nurses helped administer flu shots provided

by the Cleveland Department of Public Health

at a number of locations throughout the city.

EUCLID Hospital

• A multidisciplinary hospital group led

by nurses developed and implemented

effective education and wellness initiatives

for an elementary school’s Day of Health

and Wellness. More than 380 students

participated in this event.

• About 750 people attended the “Take Charge

of your Health” health fair in collaboration

with the Willoughby Hills Family Health

Center. Attendees received complimentary

health screenings, health information,

refreshments and a presentation by Michael

Roizen, MD, Chief Wellness Officer.

• Several Euclid Hospital nurses represent

Euclid Hospital on the Board of Directors

of the Euclid Hunger Center. During Nurses

Week, a 50/50 raffle raised more than $600

for the Hunger Center. Euclid Hospital

formed a community partnership with the

Euclid Hunger Center and provides volunteer

opportunities and other fundraising efforts

throughout the year.

FAIRVIEW Hospital

• Five vaccine clinics were held at Fairview

Hospital Wellness Center; 1,600 total

vaccinations were given.

• “For Men Only: A Game Plan for Life” was

put on to educate men 30 to 60 years old

on the benefits of exercise, weight control

and fitness in preventing cancer and cardio-

vascular disease. Ninety men attended; 60

participated in screenings for cholesterol,

blood pressure and BMI.

Nurses throughout the Cleveland Clinic health system provide important and compassionate services

and outreach in the communities in which they live and work. The following are just a few of the many

community programs to which our nurses contributed in 2009.

25


• Nurses designed collection devices and

donated food for the annual Harvest for

Hunger campaign. The Nursing Admin-

istration Office won the award for collecting

the greatest number of pounds of food.

• Fairview Hospital nurses took the lead in

coordinating the annual Cleveland Heroes

Run, stuffing goodie bags, and running in the

race that raises money for fallen police and

firefighters.

• Nurses volunteered at the Stella Maris home,

serving meals and helping with fundraisers.

Stella Maris provides quality chemical depen-

dency treatment and mental health services.

HILLCREST Hospital

• Many of the nurses spoke, organized,

coordinated and/or participated in programs

such as Hillcrest yMCA Kids Fair, Cuyahoga

Community College’s East Campus Fall

Parenting Fair, Knit-a-thon for Women’s

Cancer Awareness, KidsFest at Legacy Village,

American Heart Association Heart Walk,

March for Babies, Pedal to the Point, United

Way Fashion Show, 3-Day Walk for the Cure,

Greater Cleveland Kids Triathlon, Vision

Walk, Diabetes Association Walk, and Spirit of

Women.

• Forensic Nursing Service Coordinators

conducted Prevention of Sexual Violence and

Healthy Relationship Education sessions to

1,500 high school students.

• EMS nursing staff volunteered at H1N1

community vaccination clinics and the

“Mock Prom” Crash — Drinking and Driving

Awareness event at two schools, and gave

121 TB tests, 264 flu vaccines and 75 H1N1

vaccines.

HURON Hospital

• Nurses held six diabetes support groups and

health screenings at various health fairs, and

the Lennon Diabetes Center partnered with

10 organizations to educate communities on

diabetes management.

• Many nurses were involved with Harvest for

Hunger by contributing items for a basket

raffle to raise money; many also support the

hospital’s own Employee Food Bank.

• Emergency Department nurses set up a

collection box for coats and blankets for the

homeless; together with many others they

collected and distributed more than 250.

Nurses also distributed warm clothing to

people on the street and supported Harbor

Lights, which provides substance abuse

treatment.

• Work is being done with community churches

to implement a Parish Nurse Program in

which nurses will work with the congregation

nurses to set up health screenings,

educational opportunities and programs.

• Nurses also were involved in The Crowns

of Life Cancer Education and Awareness

program; the Men’s Health Conference;

the Living Fit and Staying Healthy in East

Cleveland programs; and Know your Numbers

healthy heart screenings.

LAKEWOOD Hospital

• Nurses organized a successful school supply

donation drive to benefit a local elementary

school.

• Nurses staffed the local Relay for Life First Aid

station.

26


LUTHERAN Hospital

• Through raffles, bake sales and logo clothing

sales, nurses in the Center for Behavioral

Health regional hospitals (Euclid, South

Pointe, Marymount, Huron, Lakewood and

Lutheran) raised more than $3,000 for the

National Alliance on Mental Illness Walk in

2009.

• Eight nurse leaders gave more than 350

volunteer hours in Civic and Community

Health and Education events, including

community health fairs and screenings, and

work benefiting Malachi House (a nonprofit

that cares for terminally ill people with limited

financial resources) and Transitional Housing

(which assists homeless women).

MARyMOUNT Hospital

• Marymount’s second annual “Go Red for

Women” wellness event raised $1,716 for

the American Heart Association’s research

programs.

• Marymount Hospital staff participated in

Live to Cook, a complimentary health fair

and seminar featuring Chef Michael Symon.

More than 600 people attended the fair,

which featured more than 60 information and

screening tables and healthy snacks.

• More than 100 employees were involved in the

27th annual Helping Hands campaign, which

resulted in 177 holiday food and gift baskets

being delivered to the community.

MEDINA Hospital

Medina Hospital’s staff nurses participate in

the Medina Health Ministry, which serves the

healthcare needs of Medina County’s unin-

sured citizens. It is the only free clinic in

Medina County and provides general medical

care including diagnosis, treatment and refer-

ral, cooperating with existing social services

and health agencies and seeking additional

opportunities for those people in need.

SOUTH POINTE Hospital

South Pointe Endoscopy performed colorec-

tal cancer risk assessments; conducted a

diabetes fair; provided health screenings for

teachers and staff at a local school district;

offered information on BMI, heart health and

nutrition at a community event; sponsored a

community senior health fair; and conducted

blood pressure screenings and education at a

local school district open house.

CLEVELAND CLINIC FLORIDA

Two nurses spoke at an elementary school for

career day regarding nursing as a profession;

nurses staffed first aid stations along the route

of the A1A Marathon; a nursing team provided

blood pressure screenings, and dietitians

provided education on BMI and proper

nutrition at the Women’s Heart Health Day;

and nurses assisted physicians in performing

examinations and assessments (including

histories and vital signs) during Stroke Day.

27

For a complete listing of all of Cleveland Clinic’s hospitals and family health centers, visit

clevelandclinic.org. Click on Locations & Directions.


Two of Cleveland Clinic’s hospitals have earned magnet status — the highest national recognition awarded to a hospital or medical center for excellence in nursing. Having first earned Magnet status in 2003, Cleveland Clinic’s main campus was redesignated a Magnet hospital by the American Nurses Credentialing Center (ANCC) in 2008. Cleveland Clinic Fairview Hospital nurses also were granted Magnet status in 2009.

Magnet status is accepted nationally as the gold standard for patient care. It provides patients with a benchmark to measure quality of nursing care.

“Magnet designation elevates our profession and is one more tangible example of our commitment. It verifies what we already know about the outstanding caliber of our nurses and the quality of their work,” says Dana Wade, RN, MSN, Director, Nursing Quality. “It shows our patients that we have the highest qualified, most compassionate nurses, in addition to highlighting our commitment to a better environment for nursing through a more collaborative work setting and educational growth opportunities.”

Other hospitals in the Cleveland Clinic health system are also preparing for the Magnet journey or are involved in The Pathway to Excellence Program®, which is another ANCC program that recognizes the essential elements of an optimal nursing practice environment.

Achieving

magnet®

Status[

ClEVElANd ClINIC (main campus) | FAIRVIEw HOsPITAl


AWARdS, puBlICATIoNS, pRESENTATIoNS, NATIoNAl BoARdS

Cleveland Clinic nurses are active on local, national

and international committees, councils and task

forces. They also are involved in editorial work on

leading professional journals and have been invited

to lecture nationally. Some of our nurses have

received national recognition for their work.

Introduction to Critical Care Nursing, 5th edition,

received the Book of the year Award by the

American Journal of Nursing in the category of

Critical Care-Emergency Nursing. The book was

edited by Deborah Klein, RN, MSN, CCRN, CS, of

Cleveland Clinic, along with Mary Lou Sole, PhD,

RN, CCNS, CNL, FAAN, and Marthe Moseley, PhD,

RN, CCRN, CCNS.

Kathy Hill, MSN, CCNS, CSC, a Cleveland Clinic

Clinical Nurse Specialist in the surgical ICU, was

awarded the 2010 American Association of Critical

Care Nurses (AACN) Circle of Excellence Award.

This award recognizes and showcases the excellent

outcomes of individuals in the care of acutely and

critically ill patients and their families.

The numbers:

• 42 of our nurses are members of or hold

positions in national and international

committees, councils and task forces.

• 29 are involved in local/regional task forces.

• 13 are involved in journal editorial work.

In 2009, Cleveland Clinic nurses authored

62 journal articles, two books and 11 book

chapters.

• In 2009, Cleveland Clinic nurses delivered 70

presentations and presented 21 posters.

AwARds ANd ACCOMPlIsHMENTs

Cleveland Clinic nurses are recognized both within the Cleveland Clinic health

system and externally for their achievements and expertise.

Lori Zielinski, RNCleveland Clinic Home Care/Hospice

Helen Cooper, RN, ANMEuclid Hospital Emergency Department

Holly Engel, RN, CCRNEuclid Hospital Critical Care Unit

Mary Black, RNFairview Hospital Oncology and Women’s Health

Sheila Struble, RNCFairview Hospital Neonatal Intensive Care Unit

Karla Mintus, RNHillcrest Hospital Special Care Nursery

Shaheen Rahman, RNANM, Hillcrest Hospital Neuro/Trauma Unit

Nancy Beth Alexander, RN, CENHuron Hospital Emergency Department

Michele Jackson Lyons, RN, BSNHuron Hospital Medical Intensive Care Unit

Susan Moran, RN, BS Lakewood Hospital Progressive Care Unit

Lynne Schaefer, LPN, ORTLakewood Hospital Surgery Department

Kathleen Meyers, RN, BSNLutheran Hospital Intensive Care Unit

Megan Vorndran, RNLutheran Hospital Adult Behavioral Health

Joan Licata, RNC, BSNMarymount Hospital Cardiac Rehabilitation

Darleen Myers, RNMarymount Hospital Medical/Surgery Unit

Elizabeth Bielawski, LPNSouth Pointe Hospital Medical Telemetry Unit

Michelle Olson, RNSouth Pointe Hospital Post-Anesthesia Care Unit

Jodi Calaway, RN, BSN, EMTPAshtabula County Medical Center Emergency Department

Doris Harper, RNAshtabula County Medical Center Medical/Surgical Unit

NuRsING HAll OF FAME AwARd

Since 2002, Cleveland Clinic and its regional hospitals

have honored deserving nurses with the Nursing Hall of

Fame Award. The annual award celebrates nurses who

demonstrate special skills, dedication and compassion

in delivering bedside patient care. Nurses are nominated

by hospital employees, physicians and volunteers. Two

nurses are chosen from each hospital, and all winners

and their guests attend an award dinner and ceremony.

2009 award winners were:

ClEVElANd ClINIC (main campus) | FAIRVIEw HOsPITAl


lEAdERsHIP

The Stanley Shalom Zielony Institute for Nursing Excellence

Sarah Sinclair, RN, BSN, mBA, FAChEExecutive Chief Nursing OfficerStanley Shalom Zielony Chair for Nursing AdvancementChair, The Stanley Shalom Zielony Institute for Nursing ExcellenceCleveland Clinic

James Bryant, RN, BSN, mSN, CEN, CCRN, NEC-BCAssociate Chief Nursing OfficerEmergency Services

Sue Collier, RN, BA, BSN, mSN, CNSAssociate Chief Nursing OfficerCase Management & Social Work

Joan Kavanagh, RN, BSN, mSNAssociate Chief Nursing OfficerClinical Education & Professional Development

holly Reilly, mBA, FAChESystem Executive DirectorNursing Operations & Integration

deborah Small, RN, BSN, mSN, NE-BCAssociate Chief Nursing OfficerClinical Practice & Research

Susan Stafford, RN, BSN, mpA, mBAAssociate Chief Nursing OfficerNursing Informatics

Scott dwyer, BSE, mSE, mBAInstitute Administrator

Jill prendergast, modHR Business Partner

lindsay muns, mBA, mhSADirector, Business Development CCAR

CHIEF NuRsING OFFICERs

merilee Rebera, RNAshtabula County Medical Center

dawn Bailey, RN, BSN, mAomEuclid Hospital

debi Albert, RN, mSN, mBA, NEA-BC Fairview Hospital

peggy mcdonald, RN, BSNHillcrest Hospital

Sheila miller, RN, mSN, mBAHuron Hospital

Judy Johnson, RN, BSN, mS Lakewood Hospital

mary Kennedy, RN, BSN, mBALutheran Hospital

debra Jones, RN, mS, NEA-BC, FAChE Cleveland Clinic main campus and Children’s Hospital

Cynthia Rosa, RN, BSN, mSMarymount Hospital

Sonda Burns, RN, mSNMedina Hospital

Susan Sturges, RN, mSNSouth Pointe Hospital (Interim)

Kerry major, RN, BSN, mSNCleveland Clinic Florida

Teresa mchargue Ray, RN, mSInternational - Sheikh Khalifa Medial City

30

The Stanley Shalom Zielony Institute for Nursing Excellence, one of 26 institutes at Cleveland Clinic, includes more than 11,000 nurses, about 850 of whom are advanced practice nurses. All collaborate to provide high-quality patient care on specialty-based nursing units within inpatient, outpatient and operating room settings at several locations in Northeast Ohio, Florida, Nevada, Canada and Abu Dhabi. Cleveland Clinic hospitals strive for Magnet status (the highest recognition of excellence in nursing by the American Nurses Credentialing Center). Two hospitals received redesignation of this prestigious award in 2008. Cleveland Clinic is a nonprofit, multispecialty academic medical center, consistently ranked among the top hospitals in America by U.S.News & World Report. Founded in 1921, it is dedicated to providing quality specialized care and includes an outpatient clinic, a hospital with more than 1,300 staffed beds, an education institute and a research institute.


To view this annual report online or for more information about the

Stanley Shalom Zielony Institute for Nursing Excellence, please visit

clevelandclinic.org/NursingReport.

To contact us regarding any of the information in this book, email

[email protected].

As integrators of care, we value:

critical thinking, advocacy, integrity,

innovation and compassion.

— Zielony Institute vision statement

Zielony InstituteAnnual Report Committee

Cyndy Boyton, BHAAdministrative Director, Specialty Services, Marymount Hospital

Christine dalpiaz, RNEuclid Hospital

Ken Frame, RNMedina Hospital

Regina Griffin, RN, MSN, CNORDirector of Surgical ServicesHuron Hospital

Kathy Holley, RN, BsNDirector of Nursing, Behavioral Health Services, Lutheran Hospital

dianne Magnani, RN, MsNDirector of Women’s and Children’s Services, Fairview Hospital

Kiran Rai, RN, BsNInterim Director of Nursing, South Pointe Hospital

Vanessa Rodriguez, RN, MsNNurse Manager and EducatorCleveland Clinic Florida

Janet Rogers, RN, MsN, CNADirector of Critical Care and Emergency Services, Hillcrest Hospital

Mary Runyan, RNAshtabula County Medical Center

deborah small, RN, BsN, MsN, NE-BCAssociate Chief Nursing Officer, Clinical Practice & Research

Christine staviscak, RN, BsNPathway to Excellence CoordinatorLakewood Hospital

Monica weber, RN, MsN, CNs-BC, CICNursing Patient Safety Officer/Magnet Program Manager, Department of Nursing Quality

Production Team

Christine HarrellManaging Editor

Amy Buskey-woodArt Director

Tom Merce, steve Travarca, don Gerda,yu Kwan lee,will Hernandez, Russell Lee, Barney Taxel, Toni Greaves/Getty ImagesPhotographers

lori J. schmitt, RNMarketing Director

Keith JamesonManagerMarketing & Communications/Nursing

Mandy BarneyMarketing Manager/Nursing

Beth KapesWriter

31


Zielony Gifts Create Opportunities for Nurses

PHIlANTHROPy

Stanley Shalom Zielony approaches life with a

passion for progress and innovative problem

solving. An Israeli émigré, Mr. Zielony trained as an

engineer and worked with electric motors before

moving to the United States in 1955. Once there,

he cast an engineer’s eye on streamlining shipping

processes in the newsprint and publication

industries.

As in his own professional life, efficiency, effective-

ness and innovation are what impress the Long

Island, N.y., resident most about Cleveland

Clinic, as well as its patient-centered approach.

In particular, he admires the professionalism

and compassion of the nursing staff, which led to

his making significant gifts supporting advanced

nursing education, research and clinical practice.

“Cleveland Clinic has become for me an essential

location,” he says. “From day one, I was amazed by

its efficiency and how dedicated the doctors are to

their patients. I like the facilities, the operations,

the innovation — everything here is unique.”

Mr. Zielony built a career on the concepts of effi-

ciency and innovation. Not long after emigrating,

he tried to solve the newsprint industry’s wood

pulp shortage by designing a machine that peeled

bark from otherwise unusable wood. However, it

was deemed too expensive. He had better success

with his new way of stacking wood on ships so

that twice as much could be transported. Next, he

improved the way the wood was hoisted onto ships

by designing a sliding hook that was safer than

the existing cable-and-hook sling and required far

fewer people to operate.

But it was his novel idea for mailing scientific

journals by air rather than using ground trans-

portation that led to his financial success. In 1967,

he created a new international mail system for

publishers of scientific journals, and today Mr.

Zielony is President of Publications Expediting

Inc., headquartered in Long Island, with

worldwide distribution of medical and scientific

journals.

The irresistible draw of new challenges — a nation

with a nursing shortage and rising unemployment

— helped motivate him to support Cleveland

Clinic’s Nursing Institute.

Early in 2009, he made a gift establishing the

Stanley Shalom Zielony Center for Advanced

Nursing Education, expected to help more than

1,000 Cleveland Clinic nurses pursue under-

graduate and advanced nursing degrees. At the

end of 2009, he made a second significant gift

including the Stanley Shalom Zielony Endowed

Chair for Nursing Advancement, with Sarah

Sinclair, RN, BSN, MBA, FACHE, Executive Chief

Nursing Officer, as the first chair holder, and

support for improving technology that nurses use

at the bedside.

He says he hopes these opportunities will bolster

the newly named Stanley Shalom Zielony Institute

for Nursing Excellence’s recruitment efforts and

help people find jobs in a tough economy.

“Cleveland Clinic is serious about nursing and

encouraging progress,” he says. “People are

looking for new careers, and we need to spread

the word so people know about the opportunities

here.”

Through supporting scholarships and new

educational opportunities, his gifts will transform

nursing programs, propel nurses’ careers and

improve patient care at Cleveland Clinic, says

Sinclair. “We plan to look at building ‘the unit of

the future,’ applying research and technology to

drive the best processes that put the patient at

the center of everything we do and make it easier

for nurses to practice,” she says. “Mr. Zielony is

helping us realize these plans.”

32

The Stanley Shalom Zielony Institute for

Nursing Excellence would like to thank the

following donors for their generosity:

Paul J. Everson

Mr. and Mrs. Robert B. Hartless, II

Maria and Sam Miller

John P. Murphy Foundation

The Steris Foundation

Stanley Shalom Zielony

09-NUR-041

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