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In Nursing, Accountability Fosters Quality

Michelle Wilson Berger for HealthLeaders Media, July 31, 2012

When something doesn't sit right at Poudre Valley, the hospital has a protocol: "We always like to outperform the mean," Poduska says. "So if you don't, you have to develop an action plan [for] how you're going to improve. Then we monitor those action plans." The method works from the most granular level to the broadest, with improvement strategies employed for individuals and units, even hospitalwide when necessary. Poudre Valley follows up on the action plans quarterly because that's how frequently data arrive—except for nurse satisfaction data, that is. Those come annually.

Satisfaction of patients and nurses
Of course, Poudre Valley takes the temperature, so to speak, of its nurses more than just once a year, Poduska says. Nursing leadership performs what she calls spot checks periodically. Then the annual survey digs deeper, looking at nurse-to-nurse communication, nurse-to-physician communication, even job enjoyment.

Veneziano says empowering Robert Wood Johnson's nurses to effect organizationwide change, for example, or improve bedside care, goes a long way toward fostering contented caregivers. "They realize they have the capability within their own practice to affect patient outcomes so tremendously because of the accountability they have and take on," she says. And, she adds, there's a direct correlation between engaged, happy nurses and satisfied patients.

One tactic Veneziano says she believes upped the hospital's patient-satisfaction scores is a hospitalwide discharge callback system. In theory, the concept is simple. Within 24 hours of a patient's departure, a nurse calls to ask about pain, follow-up appointments, rounding during the stay, and medication, as well as whether the patient has questions or wants to recognize or reward a caregiver.

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