This year’s California region GEM Awards finalists are among the best of the best in the profession. They will be recognized at the California GEM Awards Dinner on June 5 at the Hilton Los Angeles/Universal City in Universal City, Calif.
Advancing and leading the profession
Lisa DeLong, BSN, RNC, Advanced clinical labor and delivery, Sharp Grossmont, Santee, Calif.
Excellent computer skills resulted in DeLong acting as a resource and superuser in documentation processes of the EMR Cerner system and then becoming the data abstracter for all Joint Commission perinatal core measures. She exceeded expectations by being the first in her facility to enlist a labor and delivery advanced clinician to collect 100% of the data using the Joint Commission definitions of the perinatal core measures. She was part of the 39 Weeks is Fine taskforce to decrease elective deliveries performed before 39 weeks gestation, which reduces perinatal and neonatal morbidity. This successful reduction in elective deliveries has led to state and national recognition. DeLong also participates in the safety perinatal taskforce, perfecting data abstraction and working with California Maternal Quality Care Collaborative to perfect data collection and correlate it across the State of California. Most recently, DeLong participated in a systemwide project to standardize the collection of data and is the hospital representative at the perinatal safety committee; she also represents the hospital as part of the CMQCC collaborative to standardize and benchmark data across California. She worked with information systems to educate nursing staff on the documentation of an accurate expected date of confinement and to pull a report for the birth certificate recorders so the information is reported accurately to the state. This process has inspired and empowered other nursing professionals to follow suit and to champion this important measure, and is helping other hospitals on their journey toward improving perinatal outcomes.
Pamela Harris, BSN, PHN, RN-BC, HUD-VASH care manager, VHA-Greater Los Angeles/VA, VA Greater Los Angeles Healthcare System
Harris has been a leader in championing a nursing process that supports the veterans’ voices when establishing their own health priorities through health education. She led in the creation of new research-based nursing documentation templates which provide clear documentation of this process using the Public Health Nursing Practice Model. She developed a systemwide performance improvement project that demonstrated the efficacy of interprofessional collaborative practice and increased communication between individual healthcare providers and VASH professional staff. Through educational presentations, Harris improved the knowledge base of social workers and peer support staff on her team regarding the importance of preventive healthcare. She also initiated development of the VASH acuity tool used to identify veterans with the highest resource needs and determine which team is best able to provide those services. Harris established and led the Community Care Interprofessional Collaboration Task Force and the related five-year performance improvement research project, which promotes inclusion of social work case managers in facilitating health-related appointments and overcoming obstacles to care. Her collaboration on a research project using the HUD-VASH acuity tool to abstract variables related to loss of housing revealed one problem that had not been previously identified, It was found that veterans who failed to achieve and maintain housing through the GLA VASH program were twice as likely to have chronic pain issues compared with housed veterans. Clearly, her nominator stated, Harris is a passionate and determined advocate for the role of nursing within the social model of her department.
Jeannine Loucks, MSN, RN-BC, PMH, Manager, Emergency care center ECDU, St. Joseph Hospital, Orange, Calif.
Loucks has an enthusiastic approach toward educating others on the management and care of individuals with psychiatric disorders. Her optimism and support of this underserved patient population extends beyond the walls of her facility. To help the Orange County Police Department better manage increasing contact with individuals with mental health issues, she provided a mandatory eight-hour training session for all officers. Loucks developed additional training on how to maximize field time when encountering an individual in a mental health crisis, with the goal of educating police officers on potential referrals to appropriate community resources instead of the emergency care center. Feedback from the officers has been and continues to be extremely positive. The 24-hour mental health police training curriculum plan she created has been submitted to the American Psychiatric Nurses Association National Board of Directors for review, and is the first nurse-initiated training to receive national recognition. Loucks also helped the police department develop its homeless, engagement, assistance, resource team, which provides assessment and resources for the vulnerable homeless population. In 2014, she was named among the 100 most influential people in Orange County for her work in training officers how to deal with patients with mental illness in the community. Her information has enhanced each officer’s knowledge, skill level and confidence to appropriately interact and refer individuals in crisis to the proper community resource. Loucks also serves as president of the Mental Health Association of Orange County Board of Directors.
Stacy Rosenthal, BSN, RN, PHN, Clinical nurse educator, Veterans Administration Medical Center (GLA), Los Angeles
Rosenthal takes an active role in the patient-centered care strategic goal planning and uses the strategic goals as a guide to her nursing practice at the VA. Her employee training program helps GLA increase access to care through the utilization of the Stigma employee training program, resulting in a significant reduction of negative attitudes toward those with mental illness. She also provides leadership in the application of the nursing process and played a leadership role in the creation and expansion of the Integrative Health and Healing Inpatient Consult. The consult allows easy access to holistic care in the inpatient and outpatient settings. As leader of the interdisciplinary relaxation and meditation group, she facilitated evidence-based practice with a group of veterans, teaching relaxation and meditation techniques and demonstrating how to apply them in their day-to-day lives. Rosenthal was nominated by an administrator to become a member of the Integrated Ethics Leadership Council where she plays a key role in overseeing and supporting local performance and quality improvement goals for the facility IE program. In 2014, she brought a Nurses Week program to all of GLA through the use of electronic technology, including an online brag board that was well received among nursing staff.
Kathleen Ruccione, PhD, MPH, RN, CPON, FAAN, Professor of clinical pediatrics, Children’s Hospital of Los Angeles/University of Southern California
Ruccione stands out for her stellar ability to teach, mentor, role model and attract outstanding people to nursing. As the first Children’s Oncology Group nursing chair, she provided leadership for thousands of nurses involved in the care of children participating in clinical trials. She demonstrated exceptional vision in fostering nursing research in the cooperative group through groundbreaking State of the Science Sum mits. Throughout her tenure, Ruccione ensured that nursing was represented at all levels in COG, ranging from serving on protocol committees to representation on the executive committee. She often has been the sole nurse at the table in pediatric oncology interdisciplinary research activities and strategic planning. For example, she was the only nurse participant in the first St. Baldrick’s Foundation research summit where she successfully advocated for the development of a supportive care category for St. Baldrick’s grants. This proposal has enabled funding of five major studies led by nurse researchers. She has a broader role nationally and internationally as the incoming president of the Association of Pediatric Hematology-Oncology Nurses. At CHLA she created the HOPE Resource Center, keeping it funded by research and philanthropic grants and led a team of content and media experts and patient families in the creation of an award-winning web portal to help patients and families navigate to vetted online resources. Ruccione founded the LIFE Survivorship & Transition Program at CHLA and co-authored a book for childhood cancer survivors and their families. She also is conducting pioneering research on iron toxicity in childhood cancer survivors.
Kayla Weinheimer, BSN, RN, PACU RN, VA San Diego Healthcare System
Weinheimer is described as the person who is able to take a vision and find the road to get there. She was quick to get on board with the VA’s new culture of excellence program, believing that it is the best thing for staff and patients. She clearly wanted to be involved and begin to spread and change the culture at the facility. She assumed the role of chairwoman of the Shared Governance Council, which oversees the entire healthcare system, the unit practice councils and five shared governance councils. She sought a mentor to work with her, and hit the ground running, according to her nominator. “Weinheimer’s presence and leadership on the Shared Governance Council is invaluable. Changes are happening already in the short time she has been in charge, and I have no doubt that there will be many positive outcomes to follow due to her leadership,” said her nominator. Weinheimer also embraced the initiative Team Alert. As team leader, she has organized meetings in the PACU and other perioperative units, and she has given presentations on what team work means and how all staff can come together to better serve one another as well as the veterans. Weinheimer is said to have a special way of putting veterans at ease and the ability to work calmly with patients who are extremely frightened after anesthesia due to PTSD. A dedicated professional, Weinheimer has worked with medical and nursing students in the PACU as well as orienting new nurses to the unit.
Clinical Care Inpatient
Ann (Cathy) Bradish, BSN, MPH, RN, CCRN, CSC, Quality improvement performance improvement specialist, Greater Los Angeles VA Medical Center
With her knowledge of InterQual criteria and utilization management guidelines, she has led and championed processes to improve safe care transitions. Bradish, who manages more than 60 referrals from the VA Desert Pacific Healthcare Network at any given time, has identified numerous patient care and process issues. She also has developed essential relationships with providers and clinicians across the network to provide seamless care, said her nominator. While Bradish leads and directs others in multidisciplinary groups to assure access to and continuity of care, she also is said to systematically enhance patient outcomes. When she began her case manager role, she identified barriers that included poor access to service and incomplete data, and then convened a workgroup of networkwide multidisciplinary staff. As a result of its efforts, the group increased the completion of consult requests. In working to effectively transfer patients for safe and prompt care, Bradish created protocols and contact sheets for the referral facilities to expedite evaluation and transfer. By arranging for cardiac inpatient transfers, the network avoids fee-basing the patient to a community hospital, saving thousands of dollars and improves use of the specialized cardiac services at GLA. Recognized for her dedication and hard work, Bradish won the Secretary of the VA’s GLA and network award for exceptional nursing and is competing for this award nationally.
Aileen Ingles, BSN, RN, PCCN, Clinical nurse IV, St. Joseph Hospital, Orange, Calif.
Ingles knows nursing cannot be defined in purely artistic or scientific terms because it possesses elements of both. She brings many intuitive, innovative and evidence-based practice ideas to committees to improve patient care processes, resulting in better outcomes. Ingles was part of a focus group on the CHF team that transformed the medication reconciliation process and helped develop discharge huddles to ensure streamlined communication and safe patient discharges. She is an active member and co-chair of the hospital’s congestive heart failure clinical excellence team. With her energy and enthusiasm for nursing, she frequently volunteers to be a part of new initiatives or projects. Her nominator said she has a thirst for knowledge and a willingness to step up to the plate to try new things. Ingles recently developed a project to increase medication education HCAHPS scores on the medical telemetry unit, which raised the unit’s scores from below the 50th percentile to the 75th percentile. She also developed an innovative education tool and will present a poster on this project at the National Teaching Institute and Critical Care Exposition this year. She is a trusted resource on the unit, and will take the time to review policies and problem solve as needed.
Cherie Jaynes, BSN, RN, CCRN, Staff RN, cardiac electrophysiology and interventional cardiology laboratories, VA San Diego Healthcare System
A staff nurse in the cardiac and electrophysiology labs, Jaynes cares for veterans undergoing a variety of diagnostic and interventional procedures. One of two staff nurses in the labs, she assists with cardiac procedures, such as pacemaker implantation and cardiac ablation, and also has conducted research related to postprocedure bleeding times and various methodologies for hemostasis. As a result of her work, the time that patients are required to remain flat was shortened, making it better for them and for staff who can then spend more time on patient flow through the cardiac cath/EP labs. Also a leader in setting up a rapid response team, Jaynes implemented the research, put together the plan and educated and trained RN staff members. As a result, out-of-ICU code blues were decreased and patient rescue numbers were increased. Mortality rates and staff satisfaction scores were also improved, and staff became more confident in calling for help when they believed their patients were in distress. Jaynes also looked at how STEMI codes in the hospital were being called. She tracked data, made suggestions on certain processes, and oriented staff pharmacists to respond to these codes. Jaynes is described as “veteran-centered,” always going above and beyond to meet veterans’ needs and advocating for them in ways her nominator says she has not seen before. Jaynes is a committed and respectful advocate, and although not a veteran herself, her passion is caring for those who have served our country.
April Liwag, MSN, RN, CMSRN, PHN, Clinical Nurse IV, St. Joseph Hospital, Orange, Calif.
Because Liwag possesses excellent writing and speaking skills, her participation is requested on multiple committees, task forces, brainstorming sessions and projects. She has received her Green Belt in Toyota Lean Methodology and has served as project leader on multiple rapid improvement teams. She led the clinical nurse IIIs on the unit in designing and sustaining the perfect patient room, following through with discharge medication efforts and improving the HCAHPS scores on the questions pertaining to communication about medications and the quiet healing environment. Prior to implementation of the electronic medical record, Liwag served on a team for care plan design, and continues to work on a health system team to improve the process. Additionally, she is the lead nurse for a unit evidence-based project, and as chairwoman of the diabetes workgroup, she researched the clinical question regarding high dose insulin administration and the use of two syringes to deliver the insulin. Her results led to a prestigious 2014 Excellence in Safety Award for St. Joseph Hospital. Liwag serves as a superuser in electronic documentation, assists in teaching classes, and as an expert in computer documentation on the unit, internally publishing helpful tips and methods for the various functions of electronic documentation.
Susan Walker, BSN, RNC-NIC, RN II, Children’s Hospital Los Angeles
Walker has long been a NICCU preceptor for new graduates of the Versant RN Residency at CHLA. In this role, she has taken great responsibility in preparing new nurses, and is kind, caring and extremely knowledgeable, said her nominator. What makes her special is the way she creates a trusting and judgment-free atmosphere for both her students and colleagues. She provides direct patient care, serves as a backup charge nurse and an extracorporeal membrane oxygenation specialist, and on many occasions, one of the unit’s main resource nurses. She is described as someone who goes above and beyond the call of duty in all of her interactions with patients and parents and is professional and caring at the same time. She is viewed as the person who can be approached at any moment for help and support or as a clinical resource. Walker always makes sure to take care of the families who need the most assistance, bringing compassion, dedication and kindness to each interaction. Her nominator, for whom Walker was a preceptor, said, “I could not have asked for a better preceptor. She made me feel so confident, knowing she was there to help in any way she could.”
Rebecca Wile, MSN, RN, CCRN, Clinical nurse III, St. Joseph Hospital, Orange, Calif.
Passionate about improving patient outcomes, Wile accepted the challenge of leading the device-associated infection prevention team to eliminate CLABSI and CAUTI in the MICU. She devised three simple additions to protocols, which she developed after an exhaustive literature search and after contacting other hospitals that had successfully reduced these infections. She provided ongoing education and biweekly audits for compliance, observing staff demonstrations of procedures. Wile then led the team in conducting a two-week open house to remind staff of needed interventions, and after researching the cause of every CAUTI, the team shared results with staff. Last year, the team conducted a 30-day intensive focus on pericare, with staff re-education, including pre- and post-surveys to provide feedback and remediation as needed. The team developed a standardized Foley removal policy and instructed staff on the policy. As a result of their work, critical care had no CLABSIs for the FY2014, though CAUTIs remained unchanged. Determined to eradicate CAUTI, Wile and the team persisted by providing more education and open house sessions, and their efforts resulted in no CAUTIs in critical care. In addition to the success of this initiative, Wile completed the nursing leadership development program and is seen as a rising star on the unit. Described as someone who is an expert clinician and ready to take on challenges, Wile serves on the rapid response medical emergency team and frequently receives recognition as an MICU angel who provides support for her peers.
Education and Mentorship
Shelly DePeralta, DNP, RN, NP-BC, Nurse Practitioner, VA Greater Los Angeles Healthcare Center
DePeralta is described as someone who goes above and beyond in improving systems and engaging staff in solving problems. She successfully reduced ED wait times by instituting an RN triage protocol, overseeing staff education and measuring outcomes. She created a patient liaison/concierge role that improved throughput and mentored the clinical nurse leader in the ED, helping her to provide women’s ED and mental health education to providers. As the APRN board chairwoman she oversaw the design and implementation of an NP practice evaluation, setting standards, evaluating more than 80 NPs each year and coaching and mentoring them as needed. She has played a pivotal role in helping new hire NPs process through credentialing and APRN board review. To facilitate the flu campaign, DePeralta collaborated with colleagues to submit a public health grant for flu supply stations and a mobile cart to improve vaccination rates at distant sites. As a result of her efforts, the facility’s vaccination scores rose above the average score across the nation. She is said to uphold high ethical standards and has worked with leadership in reducing ED staffing shortages and ensuring staff practice within their scope of practice. Leading by example, DePeralta emphasizes quality of care standards essential to reduce morbidity and mortality and increase satisfaction. In the ED, she serves as a staff advocate when it comes to staffing ratios, quality of care metrics and excellent nursing care.
Shirley Hammers, RN, Clinical analyst, Children’s Hospital Los Angeles
As part of a team of approximately 20 clinical analysts, Hammers works within a larger team of subject matter experts from every department in the hospital. She sets herself apart by being the most accessible and generous with her knowledge, experience and time, and makes herself available around the clock. Hammers has a wealth of knowledge about the electronic medical record and its development history. She extends herself to every newbie and goes out of her way to mentor and nurture newcomers in their roles. She seems to know everyone on campus and takes a genuine interest in their jobs and lives, according to her nominator. She is able to leverage these connections to facilitate system changes. She is described as a remarkable analyst and her breadth of nursing knowledge proves she continues to strive to learn, grow and excel. Her colleagues recognize that Hammers has never forgotten what it means to be on the frontlines and remains a fierce advocate for nurses and patients. She actively participates in the organization’s monthly superusers’ meetings and when an issue is presented by a bedside nurse, Hammers will take personal accountability to make sure the issue is channeled properly and prioritized in the queue. Known as someone who is encouraging, caring and attentive to detail, she often performs inservices for hospital staff. She has been a regular committee member for the employee giving campaign, and she is an ambassador at large for the hospital. Her nominator said her professionalism and dedication are truly exemplary.
Janet Mendis, MSN, RNC-NIC, CNS, Clinical nurse specialist, UCSD Health System
A clinical nurse specialist practicing in a level 3, 49-bed NICU, Johnson is responsible for staff education on the unit. Her nominator, who has worked with her for seven years, said that in the past two years as staff grew by 150%, Johnson coordinated and educated all new hires to the unit. Calling it a tremendous undertaking, she noted Johnson accomplished it “with grace,” and that her efforts resulted in the unit completing 78 new hires’ entrance and education. Her colleagues said it would not have been possible without Johnson. In addition to her work with new staff after hire, Johnson was responsible for the creation of a streamlined education process that facilitated the hiring and training of this large group of new staff. She met with each person, graded their evaluations personally, and served as a tremendous support to all of the managers by helping them evaluate each new staff member’s progress. Johnson, who started as a bedside nurse on this same unit, has been a nurse for more than 30 years and is described as a leader of change and an example of a professional nurse who has continued to develop herself. Johnson accepts all new responsibilities that come her way and continues to enhance her practice. She is said to be a role model and an example to all new clinical nurse specialists who join the organization.
Nancy Kimura, BSN, RN, PHN, Credentialed School Nurse, School nurse, Kings County Office of Education, Hanford, Calif.
Kimura serves severe to moderate/severe disabled students, ages 3–22. In addition to the multiple responsibilities that come with the school nurse role, she provides staff inservice and training on health-related topics such as universal precautions, blood borne pathogens, medications, communicable diseases and student/parent health education regarding health and sex education, hygiene, nutrition and dental care. Dedicated to her staff, she is the supervising nurse for RNs and LVNs who work as specialized healthcare nurses, ensuring that training is complete and consistent. She developed a training manual for the specialized healthcare nurse role and trains new nurses at her school site on specialized healthcare. Collaborative and cooperative, Kimura helps create current health-related policies and procedures for the County Office of Education programs, and she participates on the regional school health advisory panel (in partnership with Children’s Hospital of Central California), facilitating the Kings County nurses’ meetings. Because of the high teen pregnancy rate in the county, Kimura met with the assistant superintendent of special education to discuss a comprehensive sexual health and STD program for special ed students. Determined to make a difference, she collected and compiled data on teen pregnancy rates, reviewed the findings with the assistant superintendent, and presented statistical data to the county board of education. As a result of her hard work, the comprehensive sexual health program was adopted. After a student died from H1N1 flu, Kimura worked with the health department to set up successful flu clinics and certified to teach CPR/AED/basic first aid classes, she has instructed more than 100 individuals in the past year.
Joan “Jodi” Santiago, MSN, RN, Assistant medical group administrator, Kaiser Permanente, Fontana, Calif.
Responsible for 15 surgical specialty departments that include more than 200 surgeons, 15 podiatrists and 600 employees, Santiago leads the perioperative functions and oversees the procedure rooms throughout a large service area spread across two medical center campuses. Passionate about nursing, she stays current in her field of expertise and continually brings new concepts to the professional practice arena. She is said to have an executive presence and outstanding communication skills. Her nominator said Santiago puts the patient at the center of each conversation and situation, and she makes a major contribution to all of the clinical work she is responsible for, as well as to the academic work she does with her students as a faculty instructor. She has led staff in each of her areas of responsibility to record achievements in colon and breast cancer screening and patient safety. Credited with helping to transform the perioperative culture, Santiago was one of the architects of the facility’s Surgical Service Leadership model, which was established last year to address some organizational culture and quality issues. Based on her knowledge, expertise and leadership abilities, she was able to help transform the environment and create a more collaborative, transparent and inclusive one. Her nominator said Santiago’s clarity of vision allowed her to see true transformation could occur only through a restructuring and the creation of a culture that would be supportive of the team and would have a focus on accountability and patient safety. According to the outside expert consultant called in by the organization, this is what was accomplished. Santiago is called a role model for professional nursing.
Elizabeth Winokur, PhD, RN, CEN Clinical dducator, emergency services, St. Joseph Hospital, Orange, Calif./Assistant professor nursing, California State University Los Angeles
Her nominator said Winokur loves teaching and strives to capture every opportunity to share with others, whether in a classroom style with a large number of students or during one-to-one sessions when preparing a nurse for clinical advancement. A large number of employees, former secretaries and technicians, are nurses today because of her guidance and mentorship. She maintains an open-door policy with student nurses. For for the past several years, she has taught the ED residency program for new grad RNs or those new to ED nursing, providing them with the foundation for a successful nursing career. She facilitates meaningful nursing assignments that provide enriching experiences that transition them from nursing student to new graduate. Everyone recognizes that Winokur finds great fulfillment in planting and fertilizing the mentee’s mind and watching the person bloom into a respected registered nurse with concrete critical thinking skills. She maintains her bedside skills in the ED and precepts nurses in triage assessment, and she promotes nursing research studies that have resulted in practice changes and publication in peer-reviewed professional journals. A key writer for the hospital’s Magnet re-designation documents, Winokur gathers quality data for the new knowledge, innovations and improvements section. As a certified ED registered nurse, she provides review courses and study materials for colleagues interested in certification, and because of her encouragement and support, the number of CEN certifications has increased dramatically.
Patient and Staff Management
Faye Cortes, BSN, RN, Nurse manager, Sharp Grossmont Hospital, LeMesa, Calif.
Described as a transformational leader with strong management skills, Cortes has been responsible for advancing her unit from a special care or intermediate unit to an intensive care unit. One of her recent notable accomplishments was the celebration held for families and infants who graduated from the NICU. Cortes wrote a grant to fund the event, then worked with various hospital departments to plan and execute the celebration. Thirty-four graduates, 31 adults plus siblings attended, and Cortes worked with marketing to create a video featuring the experiences of two families who became friends in the NICU. Her nominator said the unit has achieved the best patient satisfaction in the hospital at greater than 90% since Cortes’ hire in the NICU. Cortes monitors all quality indicators to ensure stabilization of very low birth weight infants, reaching 99% the last two years, and ventilator-assisted pneumonia strategies to prevent pneumonia in ventilator-dependent infants has been greater than 95%. An exceptional family advocate, she and her team adopted a family-centered approach to encouraging breastfeeding, involving mothers to keep a pump log and manage their 24-hour breast milk totals. Other projects she has spearheaded in collaboration with the unit practice council are First Touch, Quiet Time in the NICU, and Parent Education in the NICU. Collaborative in all of her work, Cortes participates in marketing efforts, promoting services to women, and has been instrumental in getting her staff to participate in “Baby on the Way” events.
Gail Lighthizer, MSN, RN, CNRN, SCRN, Stroke program manager, Sharp Grossmont Hospital, LeMesa, Calif.
Over the last year, Lighthizer worked closely with ED staff, MDs and educators to streamline the ED stroke code process, successfully decreasing door to needle times and earning the Target Stroke designation and Target Stroke Elite. After the focused intervention, the hospital has met the 60-minute goal 74% of the time, compared to 28% before the intervention. She also helped the hospital maintain “Get with the Guidelines” for Stroke Gold and Gold Plus designations. Tireless in her pursuit of quality, Lighthizer does concurrent and retrospective evaluations of charts and sends staff and physicians opportunities to improve performance. She helps nurses track data and assists them in understanding why the measures are so important. She collects and correlates the stroke quality data in real time, and contacts the tPA patients or their families three months post tPA infusion to check on their status. She has brought stroke education to physicians at grand rounds by inviting national speakers and teaches a class on acute stroke for nursing staff, continually updating education to include the newest guidelines, evidenced-based practice and increasingly technical interventions. Lighthizer was instrumental in bringing AANN SCRN prep courses to the facility, helping others to obtain certification, and inspired one of the unit nurses to be one of the first in the nation to obtain stroke nurse certification. She participates in the county-wide stroke consortium and volunteers at stroke events in the community.
Glenn Pascual, MSN, DHSC, MBA, RN, OCN, RN, Director of operations/service, department administrator, Kaiser Permanente Woodland Hills (Calif.)
Pascual developed a critical challenge initiative called “Standardizing Service Behaviors,” a yearlong initiative that defined the quality of care staff provide and ensured safe and reliable care through improved communication processes. These standardized service behaviors were incorporated in all day-to-day encounters and helped improve patient satisfaction scores. Dedicated to continually improving patient care and outcomes, he started the Patient and Family Focused Care Program, a six-step, evidence-based program that evaluates, transforms and co-designs care in partnership with patients and families. His “Radiology Clinical Pathways to Service” committed radiology managers and techs to check patients in the hallways every 15 minutes to ascertain patient safety. He has incorporated patients in his service meetings and working groups to promote partnership and collaboration. His “Staffing Operations Management” initiative optimizes and proactively involves department managers, staffers, schedulers and clinical directors in resolving staffing issues and has helped eliminate the use of registry RNs and CNAs. Tireless in his efforts, Pascual also initiated a staff development program focusing on fundamental approaches of business ethics and business law that improved ethical discipline in clinical practice. He serves as a member of the national readmission committee to reduce hospital readmission rate, and developed a tool to best manage patients’ smooth transition to home. He outlined specific interventions based on best practices that would move hospital reduction programs toward the intended outcome measure.
Jeanine Pyka, MSN, RNC-MNN, NE-BC, Manager OB/GYN, lactation and parent education, Sharp Grossmont Hospital, LeMesa, Calif.
Described as someone who is committed to practice excellence, Pyka’s unit has the strongest patient satisfaction scores in the hospital, which has been documented in the facility’s Press Ganey Gold report, and the unit she manages is in the top 1-2% of all performers in the nation. This past year, she focused her attention on recognizing and rewarding all of her employees, achieving one of the highest ranking units for all surveys surrounding employee satisfaction. All of her quality measures, including newborn hearing screening, congenital heart disease screening and hyperbilirubinemia, are at a 100%. Pyka is a co-chairwoman of the breast-feeding task force that aims to improve the Joint Commission perinatal core measure of exclusive breastfeeding at discharge. Through her strong leadership, the taskforce successfully raised their scores from a BL of 49.5% to 68.4% in one year. She was an abstract and poster author for “An Interdiciplinary Approach to Exclusive Breastmilk,” which was presented in 2014. Under her dedicated guidance, the unit obtained a First Five grant to finance the nursing staff’s education in their journey to becoming a designated Baby Friendly Hospital. Pyka continues to serve as the point woman for the infant security system and submitted the application for outpatient newborn hearing services. She developed a new vaccine screening process on admission to OB instead of discharge, improving compliance to 100%.
Patrick Sonza, MSN, RN, Care manager, outpatient mental health, VA Greater Los Angeles Healthcare System, North Hills, Calif.
In a community-based outpatient mental health clinic that serves approximately 7,000 patients who are suffering from acute and chronic diagnoses, from personality and bipolar disorders, schizophrenia and major depression to anxiety, PTSD and traumatic brain injury, Sonza works with the interdisciplinary team to provide care management. With strong clinical and leadership skills in managing care and facilitating care for his patients, Sonza works on the VA’s major focus of improving access to care. With national goals calling for patients to be seen within 14 days, he improved access by leading a multidisciplinary team in restructuring consults and appointment management. His clinic is exceeding the goal for established patients and has improved in the goal for new patients by 6%. Motivated to improve other specific aspects of care for his patients, Sonza focused his master’s thesis on a subset of VA-sponsored research on weight management for those taking second-generation antipsychotic medications and dealing with their related metabolic side effects. Implementing a tool to track nutritional values, he assisted in the development of nurse education on nutrition and weight management practices. The study has been submitted to professional journals, it is under review and he has presented it at major nursing research conferences. Sonza also developed a metabolic reminder to prompt providers to monitor metabolic-related lab values in patients on second-generation antipsychotics. Psychiatrists and residents recognize Sonza’s metabolic reminder as a safety tool that helps to identify antipsychotic medication side effects. Nurse-doctor collaboration in reeducating patients about therapeutic lifestyle changes has improved due to his work, which underscores the contributions Sonza has made and their impact on quality.
David Vasquez, BSN, RN, Nurse manager, Cardiac Cath and Vascular Lab, Interventional Radiology, Infusion Center, Hematology/Oncology, Medical Specialty Clinics, VA Northern California Health care system, Mather, Calif.
Vasquez is a nurse leader who has fully implemented shared governance throughout his units, and his staff enjoys a highly autonomous, collaborative daily work environment which translates to outstanding veteran-centric care, said his nominator. Known for his outstanding people skills, he worked closely with staff at Travis Air Force Base to help build two state-of-the-art cardiac cath labs, receiving high praise for his knowledge and leadership from the medical center commander, cardiologists and cardiac surgeons. He initiated radial artery access for heart caths, markedly improving safety and patient comfort, and is recognized in the community as the project manager in the building of a two-room cath lab. He implemented an infusion/PICC center, eliminating approximately $70,000 in contract PICC costs, decreasing length of stay for patients awaiting PICC placement, opening up beds for ED and OR admissions, and decreasing the number of patients sent into the community for lack of beds. He was nominated for the VA Secretary’s Award for Excellence in Nursing Practice, and reached the national phase of the award program. He is recognized for maintaining a professional demeanor regardless of how difficult a situation may be and has instilled a deep respect for veterans in all of his staff.