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 our physicians, employees and community members. Provider of choice Educator of choice Employer of choice
Crittenton Organizational Values • C ompassion • A ccountability • R espect • I ntegrity • N eighborly • G rowth
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 • outpatient 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)
The Role of Values in Your Life - (7 Distinct Tiers) Values reflect your beliefs, attitudes & Tier 7 - Unity 2012 CHCM Findings expectations: Tier 6 - Wisdom • They direct the priorities you live by • They focus your attention, influencing Tier 5 - Intention what you see • They filter your thoughts, influencing Tier 4 - Transformation your interpretation of issues and events • They guide the thoughts and actions, Tier 3 – Self-Identity influencing the choices you make • They fall into 7 categories or “Tiers”, Tier 2 - Relationships each a theme, or center of attention, for a certain aspect of your life Tier 1 - Safety • A balanced life has values across the 7 Tiers
Results/Outcomes: Organizational Culture Values 3-Year Trend 2010 2011 2012 (419) (227) (494) Compassion Compassion Caring Caring Teamwork Teamwork Teamwork Accuracy Accuracy Respect Respect/Honesty Dependable Dependable/Responsible
Results/Outcomes: 2012 Role-Based Professional Values Leaders Managers Staff (110) (21) (320) Compassion Compassion Caring Caring Teamwork Teamwork/Problem Solving Teamwork Respect/Trust Respect Respect Dependable/Responsible Responsible
Sub-Culture Profile Top 5 Values Nursing Administration 2012 CHMC Employees 2012 Wholeness 2011 Wholeness Value Level Value Level Intuition Intuition Intention Intention 1. Teamwork 4 1. Teamwork 4 2. Caring 5 2. Wisdom 6 Active Intelligence Active Intelligence 3. Compassion 7 3. Cont. Learning 5 4. Cont. Learn 5 4. Compassion 7 5. Make a Diff 5 5. Caring 5 Competence Competence Relationships Relationships Safety Safety
Sub-Culture Profile Top 5 Values OR 2012 CHMC Employees 2012 2011 Wholeness Wholeness Value Level Value Level Intuition Intuition Intention Intention 1. Respect 2 1. Prob. Solving 4 2. Teamwork 4 2. Integrity 4 Active Intelligence Active Intelligence 3. Caring 5 3. Organization 1 4. Compassion 7 4. Humor/Fun 4 Competence 5. Accuracy 3 5. Authenticity 5 Competence Relationships Relationships Safety Safety
Sub-Culture Profile Top 5 Values Cardio/Telemetry 2012 CHMC Employees 2012 2011 Wholeness Wholeness Value Level Value Level Intuition Intuition Intention 1. Teamwork 4 1. Efficiency 3 Intention 2. Prof Growth 3 2. Fairness 1 3. Compassion 7 3. Respect 2 Active Intelligence Active Intelligence 4. Honesty 2 4. Dependable 1 Competence 5. Competence 3 5. Responsible 1 Competence Relationships Relationships Safety Safety
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 • “ Truly going in with one • Intentional and goal: caring for the patient Purposeful Cultural mentally physically and Change emotionally.” – “Get what you pay attention too” • “Hopefully I will be a more – “Energies flow in the intentionally caring nurse.” direction of attention” • “…I should try to think of • Reflection myself as a leader, I work • Dialogue very hard but have never • Journaling felt like a leader.” • Storytelling • Sustaining
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
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