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Disruptive Nurses Lead to Better Outcomes

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

"There was appropriate space I could use, the obstetrician in charge thought this was a good idea, and the nurses were on board," Rising told me via email. "In addition, we had education materials that were used for prenatal classes!"

But not every health system would be onboard with upending the traditional models and adopting such a radically different way of providing care.

"I just sort of thought that 'you can go and do this,'" Rising later told me in a phone interview. "I realized that not everybody had a system that was as responsive as the one that I was in."

Providing prenatal care in groups rather than in a one-on-one setting completely "disrupts" the normal model of healthcare delivery in which the clinician is in charge of the encounter in many ways.

First of all, it puts the patient in charge in a big way. And there needs to be different kinds of scheduling, bigger rooms for the meetings, and two-hour chunks of time for clinicians to facilitate the discussions, among other things.

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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?