Frontline managers play an important role in improving patient experience, safety, and quality of care. If you don't believe it, look at these numbers.
If a top-down push for quality improvement isn't working, try something that does.
At its annual conference in December, the Emergency Nurses Association recognized Brentwood, TN-based LifePoint Health's Emergency Department Nurse Director's Council with its Team Award for 2016.
The ENA gives the award to a group or committee that has made contributions to patient safety and excellence in emergency nursing through the development of sustainable projects or programs.
The idea behind creating the council was to "bring in the frontline leaders, to get input and feedback on any process changes, policy changes, supplies, equipment, and best practices," says Pam Booker, RN, MSN, western group chief nursing officer for LifePoint Health and executive sponsor for the emergency services team.
"It was an understanding that promoting change at the facility level always has to be patient-focused and employee-owned," says Sue Atkin, RN, MSN, regional director of emergency services for LifePoint Health.
"Having a corporate, top-down push on initiatives never seems to be successful. So we said, 'let's listen to our leaders at the local level and see what their input is on how best to leverage best practices throughout all of our facilities.' "
Listening to frontline leaders has paid off, says Booker.
Since its inception in 2012, the 12-member council of ED nurse directors from LifePoint's 72 hospitals helped drive improvements in patient experience, safety, and quality of care by:
- Reducing time-to-provider times by 43%—from to approximately 46 minutes to 26 minutes
- Reducing the time-of-arrival to receiving appropriate pain medication by 41% for long bone fracture patients—from 55 minutes to 32 minutes
- Reducing the number of patients leaving without treatment by 48%—from 2.4% to 1.3%
Finding Focus by Polling and Listening
The council determines where to focus improvement efforts by reviewing core measures for ED care, CMS regulations, and input from the front line.
In addition to connecting via conference calls, the ED nurse director council members have an onsite meeting once a year. Prior to the meeting, a survey is distributed to all of the organization's ED directors, chief nursing officers, and ED medical directors, Atkin says.
The survey asks questions such as these:
- How did we do last year?
- Did we accomplish your goals last year?
- What do you see on the forefront for emergency care in the upcoming year?
- Have physician practices changed for a specific patient group?
- What new patient problems could present in the ED during the year?
"Our ED council then gets together, reviews the results of those surveys, and then says, 'OK, this sounds like it's really important to all of our teams,' or, 'There's a new regulation coming down that we're going to have to focus on for the year,'" Atkin says.
"And the council says, "We have very specific items that we're going to work on that fit into our strategic priorities of quality and service high performing talent, operational excellence and growth.'"
Site-specific experiences are used to help drive the development of organizational best practices.
The council members share what works and where they need help in meeting their goals.
"We have hospitals that are doing better, and then we have hospitals that are still struggling [to meet the goals]," Atkin says. "They compare their practices amongst each other… and the 12 council members are liaisons to their facilities to say, 'This is what we talked about in our council meeting. Why don't you try this and see if it helps.' "
If healthcare leaders want to achieve similar results, it's important to recognize the integral role frontline managers and staff play in meeting those goals.
"With buy-in from the frontline, there's ownership and with ownership comes pride and successes," Booker says.
Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.