Armed with a $1.3 million federal cooperative agreement, Providence Hospital, a teaching facility in Washington, D.C., has identified emerging nurse leaders who model and share tools with colleagues to promote interprofessional collaborative practice.
In July 2014, Providence received the three-year grant from the Health Resources and Services Administration’s Nurse Education, Practice, Quality and Retention Program. With the funds, Providence hired two IPCP nurse coordinators and has piloted the program in the ED and an orthopedic unit.
Since then, Providence nursing leadership has identified emergent nurse leaders. Novice nurses felt nervous at first, but they have since become excited and come together as a team, said Karole Thomas, MSN, RN, project director and senior director of acute care nursing.
“They are growing and learning a lot,” said Shenita Penn, MSN, RN, an IPCP nurse coordinator at Providence. “They are gaining knowledge about being a bedside nurse and being a change agent on the unit.”
The hospital provides emergent nurse leaders with 46 hours of training to lead in an interprofessional way. It began with a two-day didactic, followed by monthly educational sessions. The emergent nurse leaders take what they have learned and teach other nurses and allied personnel on their units.
“We have noticed an increase in confidence and leadership skills,” said Krystina Sims, MSN, RN, IPCP nurse coordinator. “They are able to apply the knowledge we are teaching them into their practice.”
Training focuses on TeamSTEPPS, an evidence-based system developed by the Department of Defense and the Agency for Healthcare Research and Quality. The nurses also will receive 428 hours of team-building, collaborative problem solving and care coordination experience.
“Teamwork is a No. 1 factor in which patients get well or do not get well,” said Mourine Evans, MS, RN, CNO at Providence. “The belief is if you have a strong intercollaborative team, the linkage to patient safety, employee satisfaction and patient satisfaction will show improvement.”
Providence anticipates the program will improve the experience of care and the health of its patient populations while reducing the cost of care. The program also will focus on improving care transitions to enhance health outcomes. As the hospital introduces training to other disciplines, it is using online education, followed by role playing.
TeamSTEPPS training prepares participants with leadership, communication, support and situation monitoring skills. It promotes communication for efficiently reporting important information to team members, such as when calling a physician with a patient change of status report.
The emergent nurse leaders also complete a strengths, weaknesses, opportunities and threats analysis, discuss evidence-based literature related to the initiative, and review hospital and unit data and metrics. Activities are designed to prepare the nurses to take on “critical roles at the forefront of change,” according to a TeamSTEPPS overview document from Providence.
Providence also has established TeamSTEPPS multidisciplinary huddles and rounding. It has scripted verbiage for dealing with conflict management, and provides tools to assist when someone feels uncomfortable about a safety issue.
“One of the biggest things is to get everyone on the team to communicate,” Evans said. “The biggest benefit to the patient will be a continuum of a seamless experience.”
The hospital tracks HCAHPS scores for communication among disciplines, quality of care, safety and teamwork, and will evalute whether metrics improve after the program, Sims said. Additionally, the hospital is using a tool to estimate front-line employees’ perspectives about interdisciplinary collaboration on their units.
Thomas related the experience of a patient admitted for a knee replacement, who commented on how differently the unit functioned on his most recent admission as compared with a prior admission. The patient commented that smoother collaboration made his care better.
In the program’s second year, Providence emergent nurse leaders will work with 24 to 30 final-semester students in associate and baccalaureate degree nursing programs to show them how to lead in an interdisciplinary manner. They also will work with the nursing students for an entire semester and teach them TeamSTEPPS skills during their practicum. Each student-leader team will work with a medical, physical therapy and social work student on TeamSTEPPS training and on a group project. The emergent nurse leaders also will serve as mentors and role models.
In the third year, emergent leaders in allied professions will work with participating schools of nursing in their respective disciplines to educate the students about TeamSTEPPS and IPCP.