Educational Posters

Creating a Healthy Work Environment and Improving Nurse Retention

Marian Altman, Clinical Practice Specialist, American Association of Critical Care Nurses

Nurse turnover rates are high. Without improvements in the work environment, nurses will continue to leave in search of more meaningful, rewarding and sustainable work. One organization created an academy to empower direct-care nurses as clinician leaders and change agents whose initiatives improve the work environment in order to improve nurse retention. The 12-month experiential innovation training academy leverages a nurse’s expertise to enhance the work environment, supporting that expertise with leadership skills developed through team education, coaching and mentoring. This display will share insights, strategies, tools and project outcomes from the academy.

Innovative and Cost-Effective Strategies for Improving Acute Care for the Elderly

This presentation will highlight innovative strategies implemented at Atrium Health Cabarrus (AHC) aimed at improving acute care for the elderly. Explore the need for care tailored to those 65 and older as this population continues to grow and their health care needs expand. Learn about the steps the team took internally to identify opportunities and goals, and their vision of AHC to become an “ACE (Acute Care for the Elderly) Without Walls (AWW),” facility — a prepared environment and model of care for elderly patients regardless of location or department within the hospital — and the steps taken to get there. Walk away with practical suggestions for getting started on your own Age-Friendly journey to improve acute care for the elderly.

Baylor Scott and White Health and Wellness Center Model for Reducing Chronic Health Disparities in Underserved Communities in South Dallas, Texas

Andrea Harris, PhD, RD, LD, Director of Programs, Baylor Scott and White Health and Wellness Center

The Baylor Scott and White Health and Wellness Center (BSW HWC) combines clinical care, nutrition education and exercise classes under one roof to make diabetes control and chronic disease management available, convenient and affordable to clients residing in Dallas’ southern sector. The Center provides community support through its “Circle of Care” population health model — providing access to primary care health services, evidence-based healthy lifestyle and disease management programs to over 6,000 participants per year through trained community health workers and on-site physicians.

Positive changes documented among participants include:

• Reduced weight, waist circumference, BMA and HbA1c.
• 21.4% reductions in ED use, with an associated cost decrease for 34.5%
• 36.7% reductions in inpatient care, with an associated cost decrease of 54.4%.

FirstTouch: Bridging the Gap from ER to PCP

Stephen Kapa, Physician Assistant, FirstHealth of the Carolinas

Because of primary care provider (PCP) shortages, increasing patient populations in certain communities and/or transportation issues, it’s often a challenge to get patients with no PCP who present at the emergency department (ED) or urgent care (UC) to follow up with a PCP. FirstHealth’s FirstTouch program bridges that gap. Patients seen in the ED or UC who have no PCP are seen by a virtual provider via a telemedicine video visit within 72 hours. This provider can review labs, imaging studies and previous records, then start the patient on any new medications and come up with a care plan. The patient is then plugged into the system and assigned a PCP near them for a face-to-face visit a few weeks later.

Promoting Prostate Cancer Screening Equity: Findings From a Quality Improvement Education Initiative Implemented in Three Primary Care Sites

Roxanne Leiba Lawrence, Vice President Primary Care and Community Medicine, Luminis Health

Compared to Caucasians, the incidence of prostate cancer in Black men is about 60% higher and the mortality rate is two to three times greater. Furthermore, Black and Hispanic people with cancer are more than three times less likely than Caucasians to follow their doctor’s recommendations regarding diagnostic testing because of the cost. Learn how, to increase screening for Black men in three primary care sites, Luminis Health Primary Care (LHPC) partnered with Prostate Health Education Network and National Minority Quality Forum to provide educational material to providers and patients on the prevalence of prostate cancer in the Black community and on their screening options. They also provided standardized screening guidelines to help improve provider screening practices and referrals.

Hospital-Based Certified Nurse Aid Training Program Improves Health Care Staffing Crisis

Marsha Deckman, Director, Clinical Professional Development, Mather Hospital Northwell Health

Mather Hospital has developed a Nurse Assistant Training Program approved by the New York State Department of Health. It provides underserved community members with entry to a health care career, while also building a talent pipeline to fill much-needed Certified Nurse Assistant (CNA) vacancies. Trainees who successfully complete the four-week program are eligible to become certified after s passing the New York State CNA exam. The training program uses the American Red Cross’s curriculum that’s been amended so Mather’s nurse educators teach all trainees in-person. Mather has committed financially to sponsoring trainees’ program tuition, compensating them throughout their training, and guaranteeing them full-time employment upon successfully becoming a CNA. CNA’s familiarity with Mather will make them more likely to stay. Tuition sponsorship draws more candidates into this profession (Mileski et al).

Implementing Duress Alarm Badges Using BluFI™ Technology at a Large Academic Hospital

Timothy Wallerich, RN, MBA/HCM, Registered Nurse, Mayo Clinic

Workplace violence against health care professionals is frequent and constitutes a real concern in health care, plaguing all employers and employees. Using the latest technology to help ensure staff safety, Mayo Clinic implemented a silent duress alarm system using BluFi technology and HID badges equipped with silent alarms. Activation of the badge silently alerts the security command center to dispatch officers to the exact location of the staff member using real-time location system beacons. An alert is simultaneously sent to coworkers who are present on the unit, all creating an immediate response for assistance. Mayo Clinic successfully implemented the system over six months thanks to a strong partnership across hospital operations, security, and IT.

REMODI – REimagining Medical Oversight Through Digital Innovation at Mayo Clinic

Desiree Ahrens, Senior Project Manager, Mayo Clinic

Reimagining Medical Oversight through Digital Innovation (REMODI) is a strategic initiative within the Department of Medicine at Mayo Clinic, focused on caring for patients in new ways to reduce hospital length of stay, prevent ED visits and reduce hospital readmissions. REMODI facilitates collaboration between the clinical practices and Mayo Clinic’s Center for Digital Health to create novel service lines leveraging remote-based care. In 2020, the department identified an opportunity to partner with Gastroenterology & Hepatology and Endocrinology to extend remote-based care for patients with medical complexity to enable early intervention for patients with worsening conditions. Based on the success of these initial service lines, REMODI grew into a multidisciplinary program that collaborates with practice service lines to identify new opportunities that may include remote monitoring, different workflows or repurposed roles, and transitions of care to support patients.

Leveraging Data to Improve Transitioning Complex Patients Across the Care Continuum

Amber Kavan, Quality & Performance Improvement Advisor, Nebraska Hospital Association

Holding patients who are medically cleared in a hospital setting is a significant issue in Nebraska that the pandemic exacerbated and still continues. It is restricting hospitals’ workflows and hindering patient care. To help identify gaps and barriers and plan for improvement, the Nebraska Hospital Association formed a Transitions of Care Council consisting of stakeholders from large health systems, rural hospitals, critical access hospitals, post-acute settings, the Nebraska Department of Health and Human Services, the Nebraska Health Care Association, and legislative leaders. The Council launched a monthly survey September 2022 which indicated over 200 patients were waiting post-acute setting placement >7 days in hospitals across the state for several consecutive months. Based on continuing throughput data, the Council is now working on short- and long-term solutions.

Expanded Wound Nurse Program to Reduce Hospital-Acquired Pressure Injuries

Sheila Wade, Performance and Operations Manager, Northwestern Memorial Hospital

Stage 3 and greater pressure injuries (PSI-03) are included in the CMS Hospital-Acquired Condition (HAC) Reduction Plan. At Northwestern Memorial Hospital (NMH), PSI-03 is the greatest opportunity to improve the hospital’s overall performance and reduce the HAC penalty for the organization. After NMH conducted a gap analysis comparing Certified Wound Ostomy Nurse (CWON) best practices within the NM system and the University of Alabama, NMH expanded its CWON program to 6.2 full-time employees to give each CWON a 1:144 patient ratio, and implemented a model of care aimed at preventing pressure injuries. Each full-time CWON is assigned to and immersed in a critical care unit to optimize their prevention and treatment skillset and to develop rapport with clinical teams. Since implementing this model of care in January 2022, NMH has seen a 38% reduction in PSI-03s.

The Importance of Leveraging "On-the-Ground" Observations

Luke Dettlo, Northshore - Edward-Elmhurst Health (NS-EEH)

The NorthShore – Edward-Elmhurst Health (NS-EEH) Process Improvement (PI) team conducted on-site workflow observations of the medical assistant and nursing roles at a primary care site. They found the clinical team was frustrated with new prescription medication prior authorizations because of the additional paperwork and time-consuming calls to payers. Leveraging Lean Six Sigma principles and through collaboration with the clinical leadership, clinical informatics and EMR support teams, the PI team investigated solutions. A clinical informatics team member identified an Electronic Prior Authorization (EPA) tool already built in to the organizational EMR system that the clinical team was underutilizing due to lack of awareness and education. The PI team developed an education plan to help them use the tool. Identification of this workflow opportunity highlights the need for consistent on-the-ground workflow observations and analysis to help identify opportunities for improvement.

Compassion at Scale: Achieving Health Equity Through Storytelling

Michael Drummond, Chief Communications Officer, Providence

This presentation showcases Providence’s Hear Me Now storytelling/listening program, founded in 2016 initially in partnership with StoryCorps. It’s mission: humanize health care through storytelling and listening. The program is designed to improve the health care experience for patients and caregivers, particularly for Black, indigenous and people of color (BIPOC) and LGBTQIA+ communities. Learn how your own health system can plan and launch a basic, dedicated and scalable storytelling program, with a focus on addressing diversity, equity and inclusion in health care. Find out about costs for operations and equipment, optimal staffing/volunteer levels, workflow best practices, and testimonials from clinicians and patients.

Using Change to Drive More Change: Reducing Waste in Peer Review Process in Light of Workforce Challenges

Amber Phung, Clinical Quality Improvement Specialist, UCLA Health

In 2021, UCLA Health transitioned from a paper-based peer review system to an electronic system named PEER. One of the first to use the system was the UCLA-SMH OB-Perinatal Department. This department receives the highest volume of cases sent for peer review, requiring extensive administrative support to screen cases, write up case summaries, assign reviewers and deadlines, and navigate the technical tasks of the PEER system. The number of personnel managing the process went from four down to two due to budget and departmental role changes. Learn how UCLA streamlined the PEER workflow so that after just four months, the process required 50% less administrative time than before.

Multi-modality Solution to Multi-staffing Challenges

Saba Hansen, Senior Imaging Manager, University of Texas Medical Branch

Just like most institutions across the nation, University of Texas Medical Branch (UTMB) was faced with staffing challenges both during and after the COVID-19 staffing crisis. The UTMB imaging department had to be innovative to address not only its short-term needs but also its long-term staffing challenges. To overcome these workforce staffing challenges, UTMB applied three different strategies:

• Identifying and fulfilling the most critical positions with new candidates at higher comp-ratio.
• Creating different partially benefited positions.
• Creating a career ladder for radiographers into CT and MRI scanning.

Instituting an Ambulatory Oncology Rapid Response Team for Emergent Situations

Karen Donato, BSN, RN, OCN, University Hospitals Cleveland Medical Center Seidman Cancer Center

Emergencies are not uncommon in the ambulatory oncology setting due to the high acuity of cancer patients and the high-risk medications administered. The merging of two ambulatory oncology satellite clinics at this comprehensive cancer center prompted re-evaluation of the Emergent Situation policy. Separately, each site consisted of a smaller team, and in the event of an emergency, it was "all hands on deck." When the staff doubled, most team members continued responding to emergencies, leaving the remaining patients uncovered. Leadership decided to form a Rapid Response Team to increase reliability, clarify roles and responsibilities, and streamline the process. Learn how creating a Rapid Response Team can be tailored to any mid- to large-sized outpatient medical center, especially those where procedures are performed or therapies are administered at no additional cost.

Health Care System’s Internal Staffing Agency Design and Implementation

Paola Buitrago, Assistant Vice President, Wellstar Health System

Learn about a system's creation and implementation of a successful internal staffing agency program. Gain insight on the importance of investing in a transformational leadership model to influence the recruitment and retention of a contingency staffing pipeline.

Health Care System’s Internal Staffing Agency Design and Implementation

Paola Buitrago, Assistant Vice President, Wellstar Health System

Learn about a system's creation and implementation of a successful internal staffing agency program. Gain insight on the importance of investing in a transformational leadership model to influence the recruitment and retention of a contingency staffing pipeline.

International Nurse Program: Moving From Pilot to Best Practices

Nichole Johnson, MSN, RN, CCRN, NE-BC, Director, Wellstar Health System

With the ever-increasing demands for nurses in the United States, Wellstar has been focused on innovative solutions to stabilize its core and contingency workforce. In 2018, it introduced its International Nursing Program, bringing in 56 international registered nurses to work within the health system. The program has grown, with international nurses working across the health system in a variety of specialties. The program takes a multidisciplinary approach to ensuring onboarding success and the retention of the nurses at the end of their contracted period. Learn about its cadence of rounding, completion of stay interviews, and nurses’ early engagement with the system’s talent acquisition team to assist them in transitioning to core staff.

Fika: A Swedish Tradition for Stress Reduction and Resilience

Miranda Robb, Lean Transformation Director, Yukon-Kuskokwim Health Corporation

Fika is a Swedish tradition essential to every Swede's workday, no matter the profession. The research around taking a break and informally connecting with co-workers suggests benefits in reducing overall stress, recovery time from stress, and building resilience in the workforce. Fostering social support to cope with stress and overcome challenges is key to workforce resilience. Gain an understanding of the practical application of fika and the benefits of fika based on the bio-psycho-social model of health and well-being. Learn how fika creates resilience in a team, the long-term health benefits of a quick break to recharge, and the overall reduced stress an individual experiences through a short break in the workday.

No Improvement Is Too Small for Transformative Change

Koko Mikami, Transformation Consultant, NorthShore – Edward Elmhurst Health

The Elmhurst Neuroscience Institute (ENI) Physical Medicine and Rehabilitation (PM&R) clinic at NorthShore – Edward-Elmhurst Health (NS-EEH) is a practice that utilizes a versatile approach treating patients with acute or chronic conditions. NS-EEH leverages Vizient to benchmark their performance on key performing indicators as compared to their peer healthcare organizations. Two key outcome metrics include utilization and labor efficiency. In this case, Vizient’s Labor Efficiency report indicated that PM&R was over-staffed by 4 Full Time Equivalent (FTE). Data shows PM&R appointment volume and Relative Value Units (RVUs) are increasing, however pressure to improve efficiency and reduce staffing persists. Leaders recommended assessing opportunities to align capacity, demand, and increasing RVU margins.

Through the collaboration and work of PM&R and PI, current state was accurately assessed, and opportunities were identified to positively impact labor efficiency at the ENI PM&R clinic. Leaders took accountability to make changes by dividing implementation of possible solutions into different phases, communicating these steps to the office staff, and following up for feedback. By implementing simple changes, the office became more efficient and reallocated energy to other tasks.