Title Here Subtitle Here The Rebirth of a Caring Culture: From - - PowerPoint PPT Presentation

Title Here

Subtitle Here The Rebirth of a Caring Culture: From Distrust and Disunity to Compassion and Joy

Crittenton Hospital Medical Center is dedicated to enhancing the health status of the individuals and communities we serve in partnership with

• ur physicians, employees and community

members. Provider of choice Educator of choice Employer of choice

Crittenton Organizational Values

• Compassion
• Accountability
• Respect
• Integrity
• Neighborly
• Growth

Core Competencies

• Service excellence
• Clinical excellence in Orthopedics and

Cardiovascular Specialties

• Relationship Based Care
• Strategic Partnerships
• Community Involvement

Compelling Motives for Professional Nursing

• The Future of Nursing: Leading Change,

Advancing Health

• Keeping Patients Safe: Transforming the Work

Environment of Nurses

• Crossing the Quality Chasm
• To Err is Human
• Nursing: Scope and Standards of Practice

Essential component in journey to attain High Reliability

– consistent excellence over a long period of time

Trust

• Employee Engagement
• Patient Satisfaction
• Physician Perception of Excellence
• RN Retention

Trust

• Clinical, Ancillary, and Support

Relationships

• Accreditation Status
• Accountability

Clarity

• Our engagement in Relationship Based Care will

transform Crittenton’s culture to create an environment of caring and collaboration between healthcare workers and the patient and family.

• Patients and families will trust us to provide the

best patient care evidenced by continuity, best practices, and benchmarking.

Inspired

• Knowledge
• Evidence
• Understanding Personal and Organization

Value alignments

2007

• Crittenton Hospital Medical

Center Endowed Professor in Nursing at Oakland University

Intent of the Endowment

• Integrate the science of nursing with practice
• transform patient care at the bedside
• improve patient outcomes
• monitor and improve quality of care

Intent of the Endowment

• Develop standards of care for acute illness and

managing complex health problems

• inpatient care
• utpatient care
• Develop and shape education landscape
• Nursing students and future employees
• Current Crittenton Employees

Values

• Values reflect the beliefs, attitudes &

expectations which direct the priorities people live by; they are the language of a collective culture.

• Every organization has a set of core values

that guide the Mission/Vision/Goals of the institution, and also establish the parameters of its workplace culture.

Values

• Values are the driving force and motivation for

the choices and actions that guide our life.

• Values create a framework for professional

development.

• Advancing stages of professional development

increase the depth & breadth of our core values.

(Koerner, 2010)

Understanding Values

A values-based culture holds the key to employee loyalty and commitment. Lack of congruence between personal and work- place values decreases satisfaction and effectiveness, leading to burnout, turnover and poor performance.

(Joellen Koerner)

Values Standards of Professional Performance

Leininger: Five Theoretical Assumptions on Caring

• Therapeutic nursing care can only occur

when cultural care values, expression, or practices are known and used explicitly

• Nursing is a transcultural care profession

and discipline (1994)

2012 CHCM Findings Values reflect your beliefs, attitudes & expectations:

• They direct the priorities you live by
• They focus your attention, influencing

what you see

• They filter your thoughts, influencing

your interpretation of issues and events

• They guide the thoughts and actions,

influencing the choices you make

• They fall into 7 categories or “Tiers”,

each a theme, or center of attention, for a certain aspect of your life

• A balanced life has values across

the 7 Tiers Tier 7 - Unity Tier 6 - Wisdom Tier 5 - Intention Tier 4 - Transformation Tier 3 – Self-Identity Tier 2 - Relationships Tier 1 - Safety The Role of Values in Your Life - (7 Distinct Tiers)

Organizational Culture Values 3-Year Trend

Accuracy Compassion

2010 (419) 2011 (227)

Results/Outcomes:

Teamwork Caring Dependable Accuracy Teamwork Respect Dependable/Responsible

2012 (494)

Caring Teamwork Respect/Honesty Compassion

2012 Role-Based Professional Values

Compassion

Leaders (110) Managers (21)

Results/Outcomes:

Teamwork Caring Respect/Trust Teamwork/Problem Solving Respect Dependable/Responsible

Staff (320)

Caring Teamwork Respect Compassion Responsible

Top 5 Values Nursing Administration 2012 CHMC Employees

Value Level

1. Teamwork 4 2. Caring 5 3. Compassion 7 4.

• Cont. Learn 5

5. Make a Diff 5 Safety Active Intelligence Relationships Competence Intention Intuition Wholeness

Value Level

• 1. Teamwork 4
• 2. Wisdom 6
• 3. Cont. Learning 5
• 4. Compassion 7
• 5. Caring 5

Safety Active Intelligence Relationships Competence Intention Intuition Wholeness

2012 2011

Sub-Culture Profile

Top 5 Values OR 2012 CHMC Employees

Value Level

1. Respect 2 2. Teamwork 4 3. Caring 5 4. Compassion 7 5. Accuracy 3 Safety Active Intelligence Relationships Competence Intention Intuition Wholeness

Value Level

• 1. Prob. Solving 4
• 2. Integrity 4
• 3. Organization 1
• 4. Humor/Fun 4
• 5. Authenticity 5

Safety Active Intelligence Relationships Competence Intention Intuition Wholeness

2012 2011

Sub-Culture Profile

Top 5 Values Cardio/Telemetry 2012 CHMC Employees

Value Level

1. Teamwork 4 2. Prof Growth 3 3. Compassion 7 4. Honesty 2 5. Competence 3 Safety Active Intelligence Relationships Competence Intention Intuition Wholeness

Value Level

1. Efficiency 3 2. Fairness 1 3. Respect 2 4. Dependable 1 5. Responsible 1 Safety Active Intelligence Relationships Competence Intention Intuition Wholeness

2012 2011

Sub-Culture Profile

Intention

• Intentional Transformational Journey
• Importance of all roles
• Accountable to the Relationship-Based Care

model and behavior

• Relationships as drivers for improvement
• Reigniting the Spirit Caring

2008 Reigniting the Spirit of Caring

• Intentional and

Purposeful Cultural Change – “Get what you pay attention too” – “Energies flow in the direction of attention”

• Reflection
• Dialogue
• Journaling
• Storytelling
• Sustaining
• “Truly going in with one

goal: caring for the patient mentally physically and emotionally.”

• “Hopefully I will be a more

intentionally caring nurse.”

• “…I should try to think of

myself as a leader, I work very hard but have never felt like a leader.”

Empowerment

• Collaborative Shared Governance Model

– Unit Practice Council – Professional Nursing Practice Council – Professional Nurse Leader Council – Results Council

“Our Sanctuary”

• Unit Practice Council Members determined elements of self-care

practices to include in Our Sanctuary

• Meditation
• Lighting
• Guided Imagery
• Aromatherapy
• Sound
• Colors
• Reflective journaling

Sanctuary

An ever open door Peace within Dwelling there Like a living thing A place to kneel and pray Where the soul can soar Heavenwards Like a bird on the wing Refuge and rest A quiet happiness Contentment and love Beyond compare A haven in the world of care ~Elizabeth Anderson

Sanctuary Outcomes

• 93% of the nursing staff have reported that they “Strongly agreed” that the time they have spent

in Our Sanctuary was beneficial to “your ability to care for your patients with a more intentional, healing presence.”

• 6% of our nursing staff have reported that they “Somewhat” felt the time they have spent in Our

Sanctuary was beneficial to “your ability to care for your patients with a more intentional, healing presence.”

• “Just taking a moment out of the busy day has re-centered myself, renewed my energy to

complete/finish out the day-Thank you”

• “The music had a very calming effect on me”
• “A perfect place-helps to relax, calm, reflect, even if you are having a good day!”
• “Spending a few minutes in this room reminds you of why you do this job- for all of the challenges

we face, it reminds you of all of the good there is”

• “This is a good way to re-group, I feel fortunate to have this room”

Caring Moments

• Primary Nursing
• Intentional Moments
• Sharing Stories

Vision Statement for Primary Nursing

Primary Nursing at Crittenton Hospital Medical Center is the framework for collaborative practice with the patient and family at the center of care. By establishing a therapeutic relationship between the nurse, patient and family, every patient will know their Primary Nurse by name. Will improve patient satisfaction

• Continuity of care
• Caring and healing environment
• Patients feel at the center of care

Vision Statement for Primary Nursing

Will improve staff / physician satisfaction ฀ Strengthened teamwork and relationships ฀ Nurses taking ownership of practice ฀ Continuity of care / decreased workload ฀ Physicians view nurses as professionals ฀ Physician / Nurse collaboration Will improve quality and safety ฀ Known as a facility of choice in Southeastern Michigan for patients, staff and physicians Will increase research / evidenced-based practice ฀ Education ฀ Skills and knowledge

Elevator Speech for Primary Nursing

Our project is about Primary Nursing which is a care delivery system that establishes a Primary nurse for each patient. It’s important to do because it supports our mission as an organization. When we’re successful, patient, families and other health care providers will know who their Primary Nurse is by name. What we need from you is your trust, support, and commitment.

Compassion

• Introduce yourself to the patient and family and

explain your role

• Call the patient by his preferred name
• Use touch appropriately
• Direct care givers sit at the bedside for at least 5

minutes

• Reinforce the mission, vision, and values

(Dingman,1999)

Getting to Zero

Getting to Zero

Average Door-To-Balloon Times

75.38 77.18 64 54.9 48.9 10 20 30 40 50 60 70 80 90 2008 2009 2010 2011 2012 2013 As of Dec 31, 2012

The key to sustaining any new vision for change is persistent focus, dogged determination, resiliency, continuity, and the integration of the individual efforts that specifically advance that vision.

• Jayne Felgen

Transformational Leaders Behaviors

• Emotional Intelligence

– Empathy – Lasting Relationships – Intuition – Inspire – Passionate – Trust

Courage, Compassion, Commitment

• What have I done today to demonstrate the

values that are important to me?

• What do I need to do more of to fully express

my values?

• Have I inadvertently demonstrated a value is

not for me?

Capacity Building

• Cultivate knowledge, skills, and abilities
• Embrace Imperfection
• Intentional Gift of Healthy Relationships
• Abandon “Victim” “Sacrifice”
• Trust and Transparency

Capacity Building

• Reclaiming time to think
• Willing to be disturbed
• Listening
• Ending our silence – share the knowledge

through your story

Hope is the thing with feathers, that perches in the soul, and sings the tune without the words, and never stops at all.

EMILY DICKINSON

Vision Statement for Primary Nursing

• Primary Nursing at Crittenton Hospital Medical Center is

the framework for collaborative practice with the patient and family at the center of care. By establishing a therapeutic relationship between the nurse, patient and family, every patient will know their Primary Nurse by name. – Will improve patient satisfaction

• Continuity of care
• Caring and healing environment
• Patients feel at the center of

Compelling Reasons for Primary Nursing

• Supportive of organizations core values
• Elevates quality and safety
• Increases joy
• Promotes the positive potential
• Specific effect
• Recruitment and retention

• Dear Meg,

Thank you for reviewing the Primary Nursing materials prior to attending your educational session. In response to your comment, our organization has and will continue to embrace the Relationship-Based Care (RBC) professional model of nursing care delivery. The RBC model allows the nurse ownership and actualization of the values, beliefs and standards that support safe and quality nursing care in this organization. As an interdependent profession we must strive to practice the concept of meeting the needs of the patients first. We believe that continuity of care through partnering, pairing, and creating a repeatable schedule will enhance the continuity and quality of the nurse patient relationship, provide fewer hand-

• ffs, and create a sequential-partner model as we strengthen this infrastructure.

We appreciate your commitment to engage in the future of nursing at Crittenton through supporting the RBC journey and the Primary Nursing

• concept. We strive to be pragmatic, not perfect. There will always be
• pportunity to revisit decisions that we have made today in the future, always

learning how to commitment our nursing selves more explicitly to our patients.

Silence is something more than just a pause; it is the enchanted place where space is cleared and time is stayed and the horizon itself

• expands. In silence we often say

we can hear ourselves think; but what is truer to say is that in silence we hear ourselves not think. In silence, we might better say, “we can hear someone else think.” Pico Iyer