In addition to his ED leadership, Donaldson was elected medical staff president and is demonstrating how successful organizations can be when caregivers collaborate and respect is high. The small hospital in the Catskill Mountains is proving to be a model other organizations want to look at more closely.
The care coordinator
Jeanne Yeatman, MBA, BSN, CEN, EMT, developed a program to improve care coordination among flight crews, paramedics, and emergency department staff in the Vanderbilt LifeFlight system in Nashville, TN. She launched the iFly program to help paramedics, ED physicians, and ED nurses learn more about care delivery during the "golden hour in trauma." The program brings caregivers along to shadow and learn the process, which ultimately improves patient care.
Yeatman also spends a lot of time talking about compassion fatigue, which plagues healthcare workers and is a major cause of burnout and leaving the healthcare profession. She recognizes the emotional strain on the more than 150 professionals who average more than 3,000 trips annually and to help them cope with the daily rigors of the job, she builds self awareness about the acuity of patients that LifeFlight transports.
The quality improvement specialist
Diane Whitworth, RN, CWOCN, is a wound ostomy and continence nurse—and a nurse safety scholar-in-residence—at St. Mary's Hospital in Richmond, VA. She has become a champion in the nationwide effort to prevent hospital-acquired pressure ulcers and has overseen her hospital's dramatic quality improvement efforts.
Pressure ulcers are the second most common patient safety incident, with a development rate of 36.05 incidents out of every 1,000 hospitalizations. In addition, healthcare-acquired pressure ulcer (HAPU) cost the healthcare system roughly $2.6 billion to treat annually, according to HealthGrades Seventh Annual Patient Safety in American Hospitals Study, which was released in March 2010.
Whitworth says over the years she started seeing more and more pressure ulcers in patients, which drove her to work toward reducing the rates. In the back of her mind, she often thought of her grandfather, who in his 80s, fell and fractured his hip and developed a pressure ulcer on his foot. He ended up having to have his foot amputated. "At the time it was an acceptable practice," she says. "Even being in healthcare, I thought, 'Well, that is one of the hazards of falling and breaking a hip.'"
In 2006, some areas of St. Mary's were showing healthcare-acquired pressure ulcer (HAPU) rates of 20%, at a time when the national average was only 5-6%. Whitworth and the hospital realized it had a tremendous opportunity to improve patient care. Now, after a culture changes regarding pressure ulcers, the hospital's rate is around 0.5%.
Read more about the incredible nurses making a different in the full HealthLeaders 20—2011 list.