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Nursing Department Improves Quality and Patient Satisfaction With Culture Change

Rebecca Hendren, for HealthLeaders Media, November 17, 2009

In 1998, The University of Kansas Hospital in Kansas City, KS, was faced with a patient satisfaction rate in the fifth percentile, turnover rates that were through the roof, and the reality of an organization that was losing market share.

As part of the organization's strategy to turn the hospital around, nursing set out to change the culture of the department. A renewed commitment to quality improvement, nursing excellence, and staff engagement—along with a six-part strategic plan—effected culture change that transformed the organization. Since 1998, the hospital has seen a 60% decrease in turnover, a 65% increase in inpatient admissions, and more than 200% increase in revenue.

"We were losing volume, but even now in this economy, we've still seen an 8% increase in inpatient visits this fiscal year over last fiscal year," says Tammy Peterman, executive vice president, chief operating officer, and chief nursing officer. "We believe that one of our critical success factors in staff engagement is this strategic plan. You can get where you're going without a plan, but you don't always get where you want to be. We put very specific action items, linked to the strategies, into the plan."

The nursing department's plan focused on six key strategies:

  • Excellence

  • Caring

  • Professionalism

  • Communication

  • Stewardship

  • Quality

Peterman says the department wanted to raise the overall level of professionalism of nursing in the facility, so they examined tactical ways to raise the bar and increase quality. They did this by methods such as encouraging nurses to pursue specialty certification and initiating professional portfolios.

To incentivize nurses to obtain specialty certification, the organization compensates nurses for certifications and provides a bonus each year they maintain their certification.

Nursing portfolios are an innovative way to focus on nurse professionalism. All nurses at the hospital create their own portfolio, which is a mechanism for them to monitor and track their professional activities throughout the year, including continuing education participation, committee involvement, research activities, or presentations they have conducted. The portfolios are a part of the annual review process and are also used by nurses when they interview for other positions within the hospital.

"We all have them," says Peterman. "And it's good to do that because you find if you look back on a five-year time period you can't remember all the things you have done to help promote the profession of nursing. But this way you can."

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