November 2004
 Sheppard Pratt Gives Nurses a Voice
in Decision Making
When Sheppard & Enoch Pratt Hospital clinical director
Kay Sienkilewski heard her nurses complaining about communication issues, she
decided to step up and reorganize. In February, the 322-bed psychiatric
hospital, applied for magnet status--a nationally recognized gold standard
awarded to hospitals with the best nursing management, philosophy, and
practices.
“When you’re applying for magnet status, you
assess all of your processes,” said Sienkilewski. “When I assessed
nurse input at our hospital, so much was dependent on nursing managers.”
A 16-year veteran of the Baltimore hospital, Sienkilewski
decided that all Sheppard Pratt nurses needed access to information and needed
to be able to have more direct input in decision making. Sienkilewski created
four nursing councils: Practice, Education, Leadership, and Research. She
placed 8-10 nurses and nurse managers on each council who assumed
responsibility for changing different aspects of the clinical environment.
The Practice Council participants oversee models of nursing,
participate in research on nursing practice, and evaluate the credentials that
nurses should have. Along with the Education Council, the Practice Council is
implementing a new staff development model where the hospital will sponsor
nurses to get continuing education units through the American Nurses
Credentialing Center (ANCC). The council also had five open forums in May 2005
to learn more about the recognition and benefits of further professional
competency.
The Practice Council also started a specific nursing
newsletter called Notes, Quotes & Antidotes—a publication to
keep nurses up-to-date on council activities and an open forum for nurses to
publish their own articles.
The Education Council is currently looking at developing a
career ladder for promoting nursing staff using the Registered Nurse Certified
(RNC) credentialing as a factor. “Questions being asked are:
- Do we need to require charge nurses to have RNC
credentialing?
- Do we need to change the qualifications?
- Should all preceptors have to attend formal programs?
“We’re looking at all of this,” said
Sienkilewski. In order to develop the career ladder, the general focus of the
Education Council is to review and evaluate all of the position descriptions
and assess the requirements of nurses for certain positions.
The Education Council is also involved in making educational
courses readily available to the nursing staff. The Council recently bought new
software with 500 nursing courses online. Using the software, nurses can get
their ANCC credit for continuing education courses.
The primary goal of the Leadership Council is recruitment
and retention. The group just finished a survey of all nurses at the hospital
and got an outstanding 60 percent response rate. One of the nurses’ main
responses was that they wanted improved doctor/nurse relationships. As a
result, Sienkilewski created a joint committee of doctors and nurses with a
goal of communicating and improving relationships.
The Research Council’s main task is oversight of eight
newly created Evidence-Based Practice Teams which would research individual
nursing practices that need improvement. The teams include mental health
workers, nurses, doctors, occupational therapists, and drug counselors. They
are currently researching non-pharmacologic interventions for patients with
chronic pain and developing a patient education group where patients will be
taught to use guided imagery and relaxation in order to control their chronic
pain.
The Evidence-Based Practice Teams are also researching best
practices for dealing with male adolescents who come in depressed and suicidal
from the criminal justice system and are admitted to the hospital. In addition,
the groups are looking at behavioral interventions for geriatric patients with
cognitive deficits and ways for children to maintain control in their lives.
In December, all eight teams will present research to the
Research Council and the Practice Council will then make recommendations. If
these councils approve the recommendations, Sienkilewski will take the final
recommendation to the hospital board.
“Magnet Status is a big deal and a huge honor for our
nurses,” said Sienkilewski. “With our new structure, nurses have a
voice in the decision-making process for their own practice in the most
effective and most efficient ways.”
Ultimately, Sienkilewski’s goal is to get the councils
to a point where they can function independently without being overseen by a
manager.
“Instead of top-down communication, we’ve moved to
bottom-up,” said Sienkilewski, who adds that the nurses seem to be
responding extremely well. “There’s a real positive response and
morale has been boosted. They’re excited.”
Contact:
Kay Sienkilewski
Clinical Director
Sheppard and Enoch Pratt
(410) 938-3505 (Back to the top)
 Chesapeake Registry Program:
Providing Quality Staffing Solutions
Hospitals routinely go through cyclical changes that create
a need for supplemental staffing—opening new units, nurses and other staff
taking leave or vacation, to name a few. To address hospitals’ concerns
regarding the availability of quality supplemental staff, the Maryland Hospital
Association (MHA) searched for a creative solution and developed the
Chesapeake Registry
Program.
The Chesapeake Registry Program, launched in April 2004,
allows hospitals in Maryland and Washington D.C. to post their staffing needs
on a Web site. Agencies that are registered and approved by the Chesapeake
Registry Program are then sent e-mails alerting them to hospitals’ needs.
Agencies can then respond with information about their staff and set up an
assignment with the hospital in a timely fashion.
Not only has the program helped fill the gap created by
workforce shortages, it has greatly increased the quality of supplemental
staff.
“There are staffing agencies out there, but there
really wasn’t a way for hospitals to ensure quality,” said Alison
Burrows, director of the Registry.
Since its launch, the Registry Program has grown to include
two programs that address different hospital needs. The Travel Nurse Program
kicked off first and includes supplemental nursing staff who typically work in
13-week stints. The Per Diem Nurse Program kicked off last July and provides
for short-term and day-to-day supplemental nursing staff.
Initially, the Chesapeake Registry Program issued request
for proposals to personnel agencies and had a great number of agencies respond.
Certain agencies were selected and ultimately asked to participate.
“When we choose staffing agencies we look for certain
criteria such as quality assurance standards and the availability of the agency
to meet staffing needs in a geographical area,” said Burrows.
The Registry currently includes15 hospitals and 27 agencies
participating in the Travel Nurse Program and 16 hospitals and 22 agencies
participating in the Per Diem Program.
“The Registry benefits everyone involved because the
hospital has one place they post their needs. There is a master contract with
multiple agencies, and they can get their supplemental staff at competitive
rates,” said Burrows.
Using the Registry, hospitals can quickly post their needs
and get responses in a matter of minutes. Agencies have the ability to get
information about hospitals or units where their staff can go. The Web site
contains usage reports as well as general contact information about all of the
agencies.
“It’s great being able to post our needs on the
Web and get monthly reports,” said Lil Banchero, RN, manager of Patient
Access and Admissions at Anne Arundel Medical Center. The hospital uses mostly
traveling nurses to fill their needs. “We’ve had great results in
quality and it’s been easy for us now to just deal with one person.”
The Chesapeake Registry Program is modeled after the Arizona
Hospital and Health Care Association’s program which has been in place for
17 years. The Chesapeake Registry Program does on-site audits of each agency,
checking employee files, quality assurance standards, and organizational
mobility, making sure the agency meets all criteria.
With access to participant-approved staffing agencies,
hospitals know they are getting the best help they can.
“The Registry staff is always accessible and the
customer service is superior,” said Pam McGrath, director of Client
Services for Richmond-based American Critical Care Services. “Even though
there’s a virtual aspect, there is a definite human touch as well.”
The Registry is in the process of developing an allied
health workers program that will launch in early 2005, and will include
supplemental workers in radiology, respiratory therapy, rehab therapy, lab, and
other ancillary disciplines.
Along with providing a more efficient utilization of the
workforce, the Registry Program provides a commitment to their customers.
“We want the hospitals and agencies to work together in
a way that will benefit the hospital and build relationships,” said
Burrows.
Working together, hospitals have the ability to develop
favorable contracts with staffing agencies saving time and resources.
“How can we best get our needs met?” is the
question that we hope to answer for participating hospitals, said Burrows.
Every six months, the Registry program reviews the contracts
with participating hospitals.
“We’re always looking at the program and finding
ways to make it better for the participants,” said Burrows.
Contact:
Alison Burrows
Director
Chesapeake Registry Program
410-379-6200
aburrows@mhaonline.org (Back to the top)
 Holy Cross Provides Incentives for
Employees to Mentor Students
On a monthly basis, Carla Halik, RN, who heads the Holy
Cross Hospital Explorers Program, invites as many as 42 teenage students to her
work place. Halik brings students age 14 through 20 to the hospital to expose
them to various health careers in hopes of recruiting them into a health
profession of their choice. “Forty-two teenagers is quite a handful,”
she says, especially when you’re bringing them into a hospital.” When
the program first started 14 years ago, Halik would seek out her fellow
hospital employees to assist in getting the students around the hospital with
minimal disruption while ensuring that they had an engaging and educational
experience. It was often difficult to get staff to volunteer their time to take
students on a tour. Now Holy Cross Hospital has an Exceptional Contributions
Pay Program that incentivizes its employees to participate in the Explorer
Program. Since the implementation of the incentive program three years ago,
Halik reports that she now has employees coming to her to find out how they can
help with the Explorer Program.
“The Explorer Program is just one of many programs in
which our employees can participate to earn points through our Exceptional
Contributions Pay Program,” says Judy Greaver, Senior Nurse Recruiter. The
program allows employees in any department at any level to earn points that are
exchangeable for increases in hourly wages. A point value is associated with
each of the activities in which employees participate.
Before they can participate in the program, employees must
first meet a minimum requirement of having a satisfactory performance rating
and they must excel in at least two of five performance areas. Once this
requirement is met, the employee has a wide range of activities in which they
can participate to earn exceptional contribution pay ranging from the Explorer
Post to Hospital Week activities; inservice activities such as blood pressure
screenings, and advanced education activities. “Without a doubt, employee
participation in our Explorer Program has increased significantly since the
implementation of the incentive program,” explains Greaver.
The Holy Cross Explorer program was initially designed for
managers to host students on a monthly basis. Halik took over the program a
year after Holy Cross Explorers started, and took it to another level. She now
hosts students twice a month and hospital staff members at all levels get
involved. Halik is currently working with a group of five employees from
varying levels of the endoscopy and eye surgery department who will be
developing a program on the various occupations associated with this division
of the hospital. “We will first show the students the equipment and then
some pictures of various procedures,” said Everie Weathers, an LPN who is
a participant in the Exceptional Contributions Pay Program. Weathers
enthusiastically expressed delight with the Explorer Program adding “the
increase in pay is just an added bonus.” Joyce Collins, a manager in the
endoscopy department says, “It’s great because employees don’t
simply do their jobs and go home.” “This kind of involvement builds
morale.”
One of Halik’s former Explorer students who started the
program in 1993 is Monisha Chohda, RN, who is now a part time Labor and
Delivery nurse at Holy Cross. Even before she participated in the Explorer
Program she knew she wanted to be in the health care profession. “Besides
finding a specialty area I enjoy, the program introduced me to volunteerism
from which I learned life skills that have been invaluable,” said Chohda.
A former president of the Holy Cross Explorer Program, Chohda received
recognition for her outstanding participation in the program and continues to
participate in the program as a mentor. Halik sees Chohda as one of the shining
examples of why the Explorer Program and the employee incentive program are a
good combination and a worthy investment.
Contact:
Judy Greaver
Senior Nurse Recruiter
Holy Cross Hospital
301-754-7036
greavj@holycrosshealth.org
(Back to the top)
|
