The best ideas for improving patient care are not coming from the C-suite, says the chief nurse executive of North Shore-LIJ Health System. The best ideas, she says, are "coming from front-line staff."
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"CSI" seems to be everywhere, at least on TV. CSI: Crime Scene Investigation, the popular CBS program that has launched multiple spinoffs, will broadcast its 300th episode this season.
Nursing has its own CSI, but it's quite a bit different than the dramatized prime-time variety. It's the American Association of Critical-Care Nurses' Clinical Scene Investigator Academy, or AACN CSI Academy. Last week, the academy selected seven New York hospitals to serve in the sixth and final cohort for its preliminary national rollout of the program.
CSI Academy aims to "empower bedside nurses as clinician leaders and change agents" through programs that are developed and implemented by nursing teams, according to AACN.
The idea of teamwork and engaging bedside nurses is very important to Maureen White, RN, MBA, NEA-BC, FAAN, senior vice president and chief nurse executive of North Shore-LIJ Health System, one of hospitals recently selected to be part of the New York cohort. She says she is excited to be a part of a project that will empower bedside staff to participate in nurse-led programs that improve patient care.
"I believe when it comes to making changes in healthcare, you really must include the frontline caregivers," she told me, because they're the ones who see what works and what doesn't work.
"The best ideas are not coming from the C-suite when it comes to care delivery," she says. The best ideas, she says, are "coming from front-line staff."
She says this initiative "encourages and requires that kind of environment." During the course of the program, a team of nurses will work with CSI faculty, an internal mentor, and the hospital's CNO to identify issues related to patient care, according to AACN.
Then, they'll develop and implement unit-based projects that aim to improve patient outcomes and decrease hospital expenses. AACN says the CSI Academy will provide each participating hospital with a $10,000 implementation grant to support the teams' learning and project implementation.
According to White, the premise of the program is to provide the tools to the frontline staff in critical care areas to identify and improve the root cause of a certain quality metric.
Each critical care team is asked to identify an area where they would like to see improvements. White says North Shore-LIJ is still narrowing down which issue it would like to focus on improving for the program.
One goal is to get families more involved in treatment plans and in decision-making processes. Other possibilities could include reducing post-op infections or ambulation programs for critical care/ICS patients that would aim to reduce length of stay.
Whatever the hospital chooses, the AACN CSI Academy program, which launched in April 2012, has already shown promising results. The program began with a pilot in which nurse-led projects saved $2.6 million across the seven hospitals participating in the program, AACN says. The results were impressive at individual hospitals, too. For instance, one hospital saw an 80% reduction in heel ulcers, thanks to the program.
In addition to hospitals in New York this month, the CSI Academy has been rolled out in hospitals in six states: Indiana, North Carolina, Massachusetts, Texas, and Pennsylvania.
White says she was initially drawn to the program because it has the same kind of "feeling" as Robert Wood Johnson's Transforming Care at the Bedside initiative, which North Shore-LIJ was also involved in, and with good results. White—and staff nurses, she reports—are excited to participate in another program that empowers staff nurses to innovate at the bedside, especially one that counts as its tenets teamwork, collaboration, and sharing of metrics and core processes are the program's tenets.
"We have a culture of teamwork and collaboration," White says.
Alexandra Wilson Pecci is an editor for HealthLeaders.
