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December 17, 2012
Support Service Council Kick off
1. Shared Leadership Model:Taking Flight –Support Service Council (9:00a-9:20a)
2. Ice Breaker (9:20-9:50a)3. BREAK (9:50a-10:10a)4. Vision of this Council (10:10a-10:40a)5. Review Bylaws (10:40a-11:10a)6. Chair/co-chair voting (11:10a-11:40a)7. Wrap up of meeting and first decision—food for next
meeting (11:40-12:00p)8. Next Meeting: January 14, 2013 8am-12noon
Large Board Room
Today’s Agenda
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• Who -- is on this council?• What – are we going to do?• Where -- are we going to do it?• When – are we going to meet?• How– are we going to accomplish things?• Why– are we pulling this council together?
Objectives
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Shelley Watters, DNP, RN-NEBC
Shared Leadership Model:Taking Flight –Support Service Council
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• Promotion of an environment that supports professional practice
• Identification of excellence in the delivery services to patients
• Providing mechanisms for the dissemination of “best practices”
• All departments working together to provide the best care and delivery of services to our patients
Why Shared Leadership?
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Shared Governance is the “Concept”– The shared governance (SG) concept has a 25-year history – Shared governance is a generic term describing any model of
participative management – SG provides the structural framework
Shared Leadership is the result- tangible SG model– Direct patient care nurses have influence in the development of
policies and procedures that affect how patient care is delivered– Not nursing “centric” but members include ALL who affect care– Council involved in decisions that determine the amount and scope
of resources allocated.
UPMC Shadyside Shared Leadership Model– Based / grounded in the concept of Shared Governance
Shared Governance/Shared Leadership
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• What is working what is not• What do our survey results tell us• How can we improve the ability to have staff drive important
issues and own decisions that affect their work• How do we make patients to want to keep coming to our
hospital• WIFM
Burning Questions
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• Promote culture of mutual respect and recognition • Continuous and open communication • Shared ownership and accountability for meeting the
patient’s needs • Providing a proactive learning environment• Supporting autonomy and authority for decision making
Goals & Objectives
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Assumptions• Professionals supervise themselves and need minimal
direction• Professionals can govern themselves through peer review• Steering meets monthly-All Chairs/Co-Chairs and
Facilitators attend
Steering Committee
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• Recognize staff’s knowledge and contributions to patient care
• Collaborative relationships• Freedom to initiate changes• Access to organizational resources• Foster shared decision making
What’s in it for staff?
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Methodology for Practice Change
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CouncilsGroup Purpose Composition Meeting
Frequency
Operations Council
•Strategic Planning•Review Financials•Innovation Updates•Regulatory Updates•Facilities Updates
VP/CNO of Patient care, CD’s, UD’s, Managers, All Ancillary Department ManagersCo-Chairs: VP’s at SHY
8 times/year
Evidence Based Practice Council
•Support Journal Clubs•EBP/ QI Projects•Education/ development issues•Support EBP Resource Nurses at unit level•Evaluate nursing policies related to EBP •Support nursing research
APN’s, Staff Nurses, and representatives from Patient Care services, Ancillary DepartmentsChair: Elected by peers on the council
Once/ month
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Councils
Group Purpose Composition Meeting Frequency
Professional Practice Council
•Practice concerns– Interdisciplinary issues– Patient experience
•Professional Development•Retention & Recruitment
Staff Nurses and representatives from Patient Care services, Ancillary Departments
Chair: Elected by peers on Council
Monthly
Quality Council
•Identifies barriers to providing quality care•Core measure and report card data & NDNQI data review••Evaluate the results of quarterly unit-based performance monitoring •• Identifies and recommends corrective actions to improve patient care
Staff Nurses and representatives from Patient Care services, Ancillary Departments
Chair: Elected by peers on Council
Monthly
CouncilsGroup Purpose Composition Meeting Frequency
Unit DirectorCouncil
•Practice concernsInterdisciplinary issues– Patient & Staff experience
•Professional Development of staff•Retention & Recruitment •Evaluating/supporting work of councils at the Unit level
Unit Directors/Managers
Chair: Elected by peers on Council
Monthly
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CouncilsGroup Purpose Composition Meeting
Frequency
InformaticsCouncil
•Evaluating e-Record work and issues brought up during other council meetings•Ongoing Informatics redesign and education•Decide/Drivers as to how Unit Council will communicate to staff
Staff nursesE-Record staff
Chair & Co-Chair: Elected by peers on Council
Monthly
CouncilsGroup Purpose Composition Meeting
Frequency
Support Services Council
•Perfecting the Patient Experience•Integration with other departments to replicate best practice•TBD-By YOU!
All departments without direct patient care responsibilities
Chair & Co-Chair: Elected by peers on Council
Monthly
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• Review of By-Laws• What’s your purpose• How can Chair/Co-Chair influence change• Facilitator aware of higher level/upcoming system wide
projects• May not be able to “fix” all the problems but can be the
group to determine with the other councils best way to approach
• How is info being pushed to staff in your departments?
Define your Council
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Anthony, G. (2004) Shared governance models: the theory, practice, and evidence. Online J Issues Nursing Available at: www.nursingworld.org/ojin/topic23/tpc23_4.htm. Accessed November 8, 2007
Hess, R. (1994) Shared governance: innovation or imitation? Nursing Economics 1228-34
Pierson, P., Miller, J. & Moore, K. (2007) Engaging staff in the Magnet journey: The key is communication. MEDSURG Nursing, 16 (1), 23-28
Porter-O’Grady, T. (2003) Research shared governance: a futility of focus. Journal of Nursing Administration 3 251-252
Porter-O’Grady, T., Alexander, D., Blaylock, J., Minkara, N. & Surel, D. (2006) Constructing a team model: creating a foundation for evidenced-based teams. Nursing Administration Quarterly. 30(3), 211-220.
References:
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• Grab your tablet and pen• Pick someone you don’t know• Ask them the following questions
1. What is your name2. Where do you work3. When you go to a restaurant, what 3 things determine the size of
tip you give?
Let’s Get to Know Each Other
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Trish George BSN, MSOL, RN-NEBC
Vision of this Council
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Metrics on how we are doing……
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Press Ganey
HCAHPS
PG/HCAHPS/VBP
Value Based Purchasing
PGVBP
Culture of saftey
What is Press Ganey?
neutral 3rd party company that is government approved to distributes, collects and analyzes patient survey responses.
Press Ganey + HCAHPS = Measurement of Patient Satisfaction
Press Ganey/HCAHPS Surveys 101
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• HCAHPS = Hospital Consumer Assessment of Healthcare Providers and Systems
• Tool designed to evaluate the patient’s experience/perception of care
• The HCAHPS survey asks discharged patients 27 questions about their recent hospital stay.
• The instrument asks patients to rate the frequency of events during their care (never, sometimes, usually, always).
Press Ganey/HCAHPS Surveys 101
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• The survey is organized under the following headings: Your Care From Nurses, Your Care From Doctors, The Hospital Environment, Your Experiences in the Hospital, When You Left the Hospital, Overall Rating of the Hospital, About You.
• publicly report hospital performance • The goal of this public reporting instrument, is to provide
consumers with information that might be helpful in choosing a hospital.
Press Ganey/HCAHPS Surveys 101
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• Government payers are basing their payments on survey results. – Bad survey results = lower $$ reimbursement– Good survey results = higher $$ reimbursement
Press Ganey/HCAHPS Surveys 101
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Value Based Purchasing
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When you go to a restaurant, what 3 things determine the size of tip you give?
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PG/HCAHPS/VBP
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Patient Experience Measures Threshold
Data APR
SHY/PUHMAY
SHY/PUHJUN
SHY/PUHJUL
SHY/PUHAUG
SHY/PUHSEP
SHY/PUHVBP YTD
PointsBenchmark
Data
Communication with Nurses 75.79 77/72 75/73 78/72 79/77 76/71 79/76 75 2/10 84.99Treat with courtesy/respect 85/80 81/80 85/79 86/81 84/79 87/82 82Listen carefully to you 74/69 73/69 75/68 75/75 72/68 75/72 72Explain in an understanding way 74/68 70/70 73/69 75/74 73/66 74/75 71
Responsiveness of Hospital Staff 62.21 59/55 54/56 60/56 61/59 57/55 59/59 57 1/10 78.08Call button help when wanted 58/55 52/56 55/54 59/55 56/52 60/55 55Help toileting when wanted 60/55 55/57 65/57 62/63 57/58 59/63 59
Communication with Doctors 79.57 80/76 78/78 78/76 80/80 75/76 79/80 78 2/10 88.45Treat with courtesy/respect 86/84 84/86 87/83 86/85 84/83 86/86 85Listen carefully to you 79/76 75/77 76/74 79/79 72/74 77/78 76Explain in an understanding way 74/69 73/70 72/70 75/76 68/70 75/74 72
Hospital Environment 63.54 52/52 50/54 54/54 51/56 51/52 55/55 53 0/10 78.10Room & bathroom kept clean 57/60 55/62 58/63 55/64 57/57 64/65 60
Area around room quiet at night 46/44 45/45 50/54 46/48 45/47 46/45 46
Pain Management 68.99 70/64 68/66 72/66 70/69 67/64 77/68 68 2/10 77.92Pain well controlled 61/57 61/59 65/59 62/61 60/56 69/62 61
Staff do everything to help w/ pain 78/71 76/73 80/73 78/77 74/72 84/74 75
Communication about Meds 59.85 60/56 59/60 59/58 61/60 57/56 66/63 59 2/10 71.54What new medicine was for 74/73 74/75 71/73 73/74 73/69 82/78 74
Explain medicine side effects 46/39 44/46 47/43 49/47 41/42 49/48 45
Discharge Information 82.72 90/88 85/87 88/87 88/86 90/87 90/88 87 7/10 89.24Discussed about help when you left 80/87 83/83 86/83 85/83 88/84 87/84 85Info. symptoms/problems to look for 92/90 86/90 90/90 90/88 93/90 93/92 90
Overall Rating 67.33 68/65 62/64 68/64 72/71 70/63 70/65 67 1/10 82.55Plus Consistency 11/20
Total 28Red = below 50% Green = at or above 90% (30% of VBP)Yellow = at or above 50%
• Higher satisfaction = lower death rates!– “Whenever everyone works as a team to identify opportunities for improvement, innovate and implement strategies and celebrate successes the clinical outcomes are better”
– “Patient‐reported service quality deficiencies were associated with adverse events and medical errors. Patients who report service quality incidents may help to identify patient safety hazards.”
– “wait times, delays, poor communication between staff, poor communication with patients, and poor coordination of care among staff result in higher mortality rates”
Research supports this concept…..
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Culture of Safety Survey Results…..
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0
10
20
30
40
50
60
70
80
90
100
Communication Openness
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10
20
30
40
50
60
70
80
90
100
Feedback & Communication About Error
Culture of Safety Survey Results…..
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0
10
20
30
40
50
60
70
80
90
100
Frequency of Event Reporting
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10
20
30
40
50
60
70
80
90
100
Hospital Handoffs & Transitions
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Culture of Safety Survey Results…..
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0
10
20
30
40
50
60
70
80
90
100
Hospital Management Support For Safety
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10
20
30
40
50
60
70
80
90
100
Nonpunitive Response To Error
Culture of Safety Survey Results…..
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0
10
20
30
40
50
60
70
80
90
100
Organizational Learning &Continuous Improvement
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10
20
30
40
50
60
70
80
90
100
Overall Perceptions Of Safety
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Culture of Safety Survey Results…..
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0
10
20
30
40
50
60
70
80
90
100
Teamwork Across Hospital Units
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10
20
30
40
50
60
70
80
90
100
Teamwork Within Units
“Nice Trish, but what does this all have to do with this council thing????
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My trip as a patient…….
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My trip as a patient……
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My trip as a patient…….
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My trip as a patient…..
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My trip as a patient…..
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WWTC Staff/Radiology Services Phlebotomy and Lab
My trip as a patient……
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EKG/Non-invasive cardiology Pastoral Services
My trip as a patient……
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Information Desk Cafeteria Services/Dietary
My trip as a patient………
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My trip as a patient……
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My trip as a patient……
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My trip as a patient……
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No one can work unless this team does their job……..
My trip as a patient……..
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At the very end of my trip……..
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Vision for this council…….
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Lisa Donahue, DNP
Bylaw Review
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• Who—who is on this council?• What – are we going to do?• Where—are we going to do it?• When – are we going to meet?• How– are we going to accomplish things?• Why– are we pulling this council together?
Review of Objectives
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January 14, 2013Large Board Room8am-12noonTopic: HCAHPS and Press Ganey– a deeper understanding
Foodideas for next month?
Our 2013/2014 Chair and Co-Chair are…………..
Wrap up
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