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Disruptive Nurses Lead to Better Outcomes

Alexandra Wilson Pecci, for HealthLeaders Media, October 15, 2013

With healthcare reform well under way, now is a good time to come up with alternatives to traditional individual care, one innovative nurse midwife believes.

Lately I've been writing a lot about nurses who think and act creatively to improve patient care and health outcomes. Some of these "positively deviant" nurses break hospital rules when they think it's in a patient's best interest to do so.

Others create innovative programs that help care for caregivers. Still others are actually inventing or improving devices right in the trenches of their work, using only their wits and materials at hand, much like TV action hero MacGyver.

That's why I was intrigued when I came across the Centering Healthcare Institute's upcoming conference, which has as its tagline, "transforming care through disruptive design." The Centering Healthcare Institute's CEO and president, Sharon Schindler Rising, CNM, MSN, is not just thinking outside the box. She's ripping the box to shreds. And that's what disruptive design is all about.

Rising developed the Centering model of healthcare, which provides group healthcare, and first piloted the CenteringPregnancy model in 1993 when she was a nurse midwife.

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1 comments on "Disruptive Nurses Lead to Better Outcomes"


Chris (10/17/2013 at 1:36 AM)
I read the article and still apply my personal philosophy that conclusions are derived applying current knowledge and experience from an individual's perspective. A statement might be correct if applying current knowledge, but consider not only if such knowledge is verifiable with EBP, but does that knowledge encompass all aspects and variables? An RN might view changes as disruptive, concurrently, administration might see the whole picture with a positive outlook. I disagree with the article almost entirely, being disruptive may be subjective based on those perceiving the disruption, but from my limited experience disruption does not promote harmonious productivity toward any goal. Forget ripping the box to shreds, that is destructive....instead comply with ANA/State Board rules, and view the box as a dynamic cube. I would also question those that built the initial box if it had to be ripped. Perhaps those that are disruptive do not posses the spatial or critical thinking abilities to properly utilize available resources, not realize the availability of them or the long-term consequences. I do agree with the intended result positive deviants have, as I challenge everything everywhere in every aspect within my Scope of Practice. Achieving a goal more efficiently or effectively can be tested with theoretical simulations and algorithms or apply multiple PDSA cycles to eliminate all variables to achieve end result. Change may be disruptive or viewed as such if the implementation of it and relevant variables are not considered. I am very motivated and passionate to promote excellent and efficient health in every aspect, yet rationally inquisitive to seek opportunities for safe effective changes. By disagreeing with the article might I be perceived as disruptive or courageous?