State of the Department of Nursing Welcomes Special Guest
Mayor Thomas Menino joins Jackie Somerville as she presents the State of the Department of Nursing address.
Senior Vice President of Patient Care Services and Chief Nursing Officer Jackie Somerville, PhD, RN, spoke about the power of the nurse-patient relationship during her first State of the Department address in May. To illustrate the importance of that relationship, she invited a surprise former patient to talk about his own personal experience with BWH nurses: Mayor Thomas M. Menino.
“To me, the nurses are the most important part of a hospital,” Menino said, as he sat down for an “Oprah-style” interview with Somerville in the front of the Bornstein Amphitheater. “I have had some tough days here as a patient, and the nurses always lift up your spirits. Nurses have such composure and compassion, and they do so much to help you.”
Menino spoke of several experiences as an inpatient at BWH. “I always thought the nurses were here, not just because it’s their job, but because they really want to make a difference,” he said. “At 3 a.m. when you’re sick, the person who comes to your bedside is a nurse. I just want to say thank you.”
Menino’s appearance was one of the highlights of Somerville’s first State of the Department of Nursing presentation during Nurse Recognition in May. In her address, she also detailed past accomplishments and the goals of the Department of Nursing for the coming years.
“As a chief nurse, my role is to witness the practice, celebrate it, maintain the gains and collectively, help us continue on the path to clinical excellence,” she said of her transition to the role of chief nurse this year. “After four months at BWH, I have come to realize that I have the best job in the world.”
She cited the Institute of Medicine’s “Future of Nursing” report recommendations and examples of how she has seen these principles brought to life by nurses at BWH.
Nurses should practice to the fullest extent of their licenses. At Brookside Community Health Center, family nurse practitioners independently manage panels of patients, including entire families, in advancing their health and the well-being of the community.
Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic programs. At BWH, 68 percent of nurses are bachelor’s-prepared or have earned higher degrees.
Nurses should be full partners with physicians and other health care professionals in redesigning health care in the U.S. “As we reflect on Partners HealthCare’s Care Redesign initiatives, this is certainly the case, and I have learned this principle is consistent with the values of BWH,” Somerville said.
Four Pillars of Strategic Goals
During the next year, the Department of Nursing will focus on four goals: advancing an inclusive environment; developing the best people; ensuring care is affordable for all; and advancing a culture of patient- and family-centered care.
Advancing an Inclusive Environment
Somerville emphasized the need for all staff to approach differences with curiosity and a desire to understand the values, contributions and perspectives of others to advance an inclusive agenda. “Creating this kind of environment is our vision,” she said. “Our work involves defining what an inclusive environment looks like, educating ourselves about existing disparities and the role we as nurses can play to eliminate them. We, as nurses, have the talents and capacity to take a leading role in this work.”
Developing the Best People
Somerville said the department will focus on the skills nurses need to be successful in a rapidly changing environment and how to support nurses in obtaining those skills.
Ensuring Care is Affordable for All
“We as a department must participate and lead the development and realization of our vision for value and the best outcomes and affordable care for all,” she said. “We must think about what we do every day—the supplies and the practice—to identify every opportunity to remove cost or waste that does not add value to the patient and family experience.”
In the coming year, the Department of Nursing will work on two initiatives to help achieve this goal: matching resources to the needs of patients and leading and advancing participation in the design of innovative care units. “We will maximize the contributions of all the members of the care team and ensure effective and seamless hand-offs in communication from one provider to another, from one unit to another, and from the hospital to the community,” she said. “This will eliminate unnecessary readmissions and visits to the Emergency Department.”
Advancing a Culture of Patient- and Family-Centered Care
At a minimum, Somerville said, patients come to BWH expecting to receive exquisite technical care and to be kept safe. “In addition, they also want to feel known beyond the label of their disease or diagnosis,” she said. “They want to be seen as a person in the context of their life and their world, not just in ours.”
The department’s work in “Defining the Good” has helped to establish that one of the characteristics of excellent BWH nurses is that they know their patients, and their patients feel known and cared for. The department will continue the work of “Preserving and Extending the Good” in the coming year.
Accomplishments of the Department of Nursing 2010 – 2011
Jackie Somerville, PhD, RN, detailed just a few of the major accomplishments of nurses and the department as a whole in the past year during her State of the Department of Nursing address.
Patient satisfaction: BWH opened fiscal year 2011 with all-time high scores in the nurses and visitors and families categories on the Press Ganey Inpatient Satisfaction Survey. Nursing scores were in the 99th percentile.
Integrative therapies: The Integrative Therapy Program, which offers a number of complementary therapies, continues to enhance care. In 2010, 82 reiki volunteers conducted more than 5,000 reiki treatments for patients and staff throughout the hospital.
Care Coordination: Care coordinators participated in a CMS demonstration project aimed at keeping high-risk patients well and out of the hospital. Preliminary results demonstrate a 10 percent reduction in cost, as well as enhanced quality of life and wellness.
Patient safety: In conjunction with Pharmacy and Information Systems, nurses helped design and implement an electronic administration record (eMAR) system to ensure the safest care for newborns. The eMAR system, which was rolled out throughout the Connors Center this spring, includes bar code reading of medications and human milk to verify right medication and right milk to the right baby.
Acute Care Documentation: 46 clinical nurses and nurse educators from BWH have participated in the development of clinical content for Acute Care Documentation (ACD), which will automate the documentation of assessments, notes and flow sheets for all inpatient nurses. 30 bedside nurses continue to meet monthly to provide feedback on the design of the system. A pilot of ACD is expected to begin in the MICU and Tower 11 early in 2012. The roll-out organization-wide will follow.
Reducing costs and waste: The Product Utilization Review Committee, which includes representation from nurses and other Patient Care Services staff, identified more than $3.3 million in potential savings through implementing environmentally friendly, waste-reducing and cost-effective products and practices throughout the hospital.
Education: Among other educational efforts, the Center for Nursing Excellence staff redesigned the transition program for newly-licensed nurses (NLNs) to reflect the department’s commitment to helping to retain and support NLNs. In the first year of this program, BWH oriented 75 NLNs and saw a retention rate of 96 percent. In addition, curricula has been developed to teach and evaluate computer skills for patient care assistants in preparation for the roll-out of Acute Care Documentation.