CSTS Staff Empowerment Christine A. Goeschel ScD MPA MPS RN.
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Transcript of CSTS Staff Empowerment Christine A. Goeschel ScD MPA MPS RN.
Slide 2
Learning ObjectivesLearning Objectives
• To understand the importance of empowering front line staff
• To consider the regulatory and accreditation expectations that support patient focused decision making by all members of the clinical team
• To explore techniques that help front line staff when challenged by hierarchical structures or power gradients
Slide 3
What We KnowWhat We Know
• Change involves technical challenges– Evidence– Measurement– Analysis
• Change involves adaptive challenges– How to Engage nurses, physicians, executives– Competing priorities– Organization hierarchies– How to hardwire practice changes
Slide 4
What Have We Learned So Far?What Have We Learned So Far?
• Work involves technical problems– Evidence– Measurement
• Adaptive problems– Engagement of nurses, physicians, others clinical
and administrative staff– CUSP– Daily goals– Competing priorities
Slide 5
Improve Patient Safety Improve Patient Safety Culture: Create TrustCulture: Create Trust
• Caring
– Keep Patients your North Star
– Commit that preventable harm is not tenable
– Tell your own Josie Story
• Competent
– Learn from mistakes
– Implement teamwork tools (CUSP)
Slide 6
Ensure Patients ReliablyEnsure Patients ReliablyReceive EvidenceReceive Evidence
Pronovost: Health Services Research 2006
Senior TeamStaff
leaders leaders
Engage How does this make the world a better place?
Educate What do we need to do?
ExecuteWhat keeps me from doing it?How can we do it with my resources and culture?
Evaluate How do we know we improved safety?
Slide 7
Placing Value on Staff Placing Value on Staff EmpowermentEmpowerment
Keep patient as north star ~ Harm is not tenable
• Support decision to speak up– Must feel competent – Must feel it is safe– Must feel it will work
• Transparency when harm occurs– At patient level– At provider level– At organization level
Slide 8
Strategies for Staff Empowerment
• Policy Level (only helpful if enforced)
• Examples:
• Code of conduct
• Require nurses to assist with central line placement
• Require adherence to checklist
• Policy to deal with disruptive behavior
• Require surgery briefing and debriefing
• Require written report when handoffs occur
Slide 9
Strategies for Nurse Empowerment
• Practice Level
– Licensure
– Nurse Practice Act
– Magnet Nursing
– Collaborative Practice Models
• Infection Preventionists
• Attending Physicians
Slide 10
Structures that Support Empowered Staff
• Performance Level
– Orientation /Skill Building
– Annual Competency Assessment
– Recognition/Reward
• clinical ladder (nurses)
• compensated time (physician staff)
• ???Perfusionists, techs, therapists, etc
Slide 11
• Use tools to practice empowerment in safe space– Participates in patient rounds– Daily Goals with non-physician read back– Learn from Defects– Participate in M&M
• Address disruptive behavior quickly
Strategies for Empowering Clinical Staff
Slide 12
• In conflict, keep focus on patient as north star
• Remind staff that teams make wise decisions with diverse and independent input– Do not play man down
Strategies for Strategies for Empowering Clinical StaffEmpowering Clinical Staff
Slide 13
Action PlanAction Plan
• Project leaders meet with CSTS teams
• Discuss what policies/procedures exist to support empowerment
• What procedures may be needed?
• Create strategy to involve frontline staff across the care continuum in this project : use the 4Es
• Discuss what tools you can use to enhance empowerment