Nursing and Patient Care Services Report (ppt)

Nursing and Patient Care ServicesFY 2009 Report

UWHC Authority Board

Maureen P. McCausland, DNSc, RN, FAANNovember 4, 2009

2

Agenda

Nursing and Patient Care Services Accomplishments– Respiratory Care– Clinical Nutrition

Initial Nursing Goals – March, 2004 Strategic Goals 2006-2008 Professional Practice Model Recruitment and Retention Nursing Sensitive Outcome Measures Financial Measures Conclusions Future Challenges

3

Respiratory Care Services

The Respiratory Care Practice Council has continued to focus on practice enhancements.

The department provided 260,000 treatments and diagnostic tests.

The shortened ventilator days LOS related to increased use of protocols has been maintained.

The FY 2009 turnover rate was 2.0%. The FY 2009 year-end vacancy rate was 0%. No travelers were used in FY 2009.

4

Respiratory Care

Involved in all health-link application go-lives Members of the department continue to be leaders in

professional organizations Matt O’Brien received the Presidential Scholarship for

Master’s in Biotechnology Anne Flaten elected President-elect of the WSRC Pulmonary Function Lab added exhaled Nitric Oxide

testing capability (used as a clinical guide for asthma management)

Expanded the use of mini-bal procedure (improves accuracy of diagnosing ventilator associated pneumonia and reduces the use of unnecessary antibiotics)

Implemented the Rapid Response Team

5

Infection Control

A significant leadership transition occurred with the retirement of Dennis Maki, MD

Nasia Safdar, MD, has ably assumed leadership

The department has led the organizational response to H1N1

6

Clinical Nutrition Services

Successfully matched applicants for our internship program. For 6 openings, we went down to number 13 for our first choices.

Facilitated role of clinical nutrition in inpatient model of care redesign. Expanded role of clinical nutritionist in adult nutrition support team and

developed staff capable of supporting a pediatric nutrition support team.

Continued to successfully train future professionals in the UWHC Dietetic Internship Program.

Collaborated with Princeton Club West & East to provide nutrition education and individual counseling to membership.

Consulted on healthy cafeteria initiatives. Effectively worked with Food Service management staff to modify recipes, menus, portions, and service. Analyzed nutrient content of recipes and foods offered. Worked with Public Affairs to market and disseminate information. Provided café patron education during heart and nutrition month.

7

Strategic Goals 2006-2008

UWHC Nursing Strategic Goals Deliver excellent patient care across the continuum which is evidence based

and fiscally responsible. Create a professional practice environment which supports clinical nurses

characterized by collaborative governance, participative decision-making and a commitment to professional development.

Provide superior customer service to patients and their families. Identify and act upon opportunities to advance collaboration with the

University of Wisconsin School of Nursing. Enhance operational efficiency by minimizing barriers to patient access and

streamlining patient throughput. Apply the power and potential of technology and informatics to support

delivery of superior care and enhance the effectiveness of professional nursing.

Recruit, retain and develop nursing leaders in clinical practice and clinical management.

Create and nurture a spirit of inquiry in all nurses from the systematic evaluation of one’s own practice, to the translation of research findings into practice and contribution to established programs of research at the University of Wisconsin-Madison School of Nursing.

8

UWHC Professional Practice Model

9

Practice Model Update: Nursing Care Delivery System

The primary nursing model at UWHC continues to be mature, but still has the potential to be more substantive.

Primary nursing is an essential component of the interdisciplinary model of care.

10

Professional Practice Model: Interdisciplinary Collaboration

Clinical nurses continue to report high satisfaction with “physicians appreciate what I do” in the NDNQI survey.

We continue to address concerns related to improving communication and relationships between nurses and physicians as necessary.

11

Professional Practice Model: Evidence Based Practice

The Nursing Practice Council completed three EBP guidelines for:– Catheter associated UTI– Care of patients in isolation– Care of patients in restraints and use of patient safety attendants

12

Professional Practice Model: Clinical Advancement & Recognition

The recognition activities for National Nurses’ Week were successful.

Leah Curtin, RN, FAAN was the keynote speaker.

Genevieve Nicol-Sey, BSN, CCRN, CNRN, RN received the Primary Nursing Award.

The clinical advancement program design was completed.

13

Professional Practice Model: Clinical Advancement & Recognition

Peggy Wiederholt, RN, Head and Neck Oncology nurse coordinator received the inaugural American Society for Therapeutic and Radiation Oncology (ASTRO) Nurse Excellence Award.

UWHC nurses outscored peers at 27 academic medical centers in their knowledge and treatment of pressure ulcers, sleep, incontinence and use of restraints in the Geriatric Institutional Assessment Profile funded by the Hartford Institute at NYU Division of Nursing

Dianne Danis, MS, RN, NEA-BC, FAAN, Director of Nursing Practice Innovation, was inducted into the American Academy of Nursing.

Dr. Paul Harari, Jack Fowler Professor and Chairman of the Department of Human Oncology at the UWHC and UW Carbone Comprehensive Cancer Center and PeggyWiederholt, RN

Dianne Danis, MS, RN, NEA-BC, FAAN, Director of Nursing Practice Innovation

14

Professional Practice Model: Clinical Supports

The HealthLink design and implementation benefited tremendously from the leadership of the clinical nurse specialists, nursing education specialists and the nursing informatic specialists. Two major applications were installed:– Clinical Documentation– CPOE

The AFCH Pain Clinical Nurse Specialist has continued to develop clinical nurses as pain resource nurses and has standardized care of children having painful procedures.

15

Professional Practice Model: Organizational and Managerial Structure

The collaborative governance structure received outstanding reviews from the Magnet appraisers.

The Advanced Practice Nursing Council was launched.

16

Collaborative Governance Structure

17

Non Clinical Supports

Support from non clinical areas continue to be a strength for our organization, particularly environmental services and facilities planning.

18

Recruitment and Retention of Professional Nurses

Steady progress has been made in both the recruitment and retention of professional nurses.

The RN vacancy rate continues to decrease and this has a positive impact on UWHC operations and on nursing sensitive outcome variables.

The total RN vacancy rate as of June 2009 was -3.4%.

The use of traveler and agency nurses was 19.0 FTE YTD across the entire organization.

19


Fiscal Year End RN Vacancy Rates

8.9%

7.1%

4.7%

6.4%

3.3%

5.4%

3.2%

-3.4%

-6%

-4%

-2%

0%

2%

4%

6%

8%

10%

FY 02 FY 03 FY 04 FY 05 FY 06 FY 07 FY 08 FY 09

20

Recruitment & Retention of Professional Nurses

Turnover of professional nurses was at its lowest point since tracking began in FY 02 or 6.2% (104 individuals) in FY09.

Turnover of nurse residents in the first year of practice was 6.5% (N=11) which was a decrease from FY08 (11.5%, N=19).

21

Recruitment & Retention of Professional Nurses

BSN New Graduate Turnover Within First Year

33.3%

23.3%

9.7%

11.5%

6.5%

8.9%

6.8%

10.8%10.7%

20.3%20.6%

0%

5%

10%

15%

20%

25%

30%

35%

Jan '99 FY00 FY01 FY02 FY03 FY04 FY05 FY06 FY07 FY08 FY09

22


UWHC continues to be dependent on new to practice nurses but successfully recruited more experienced RNs in FY09.– FY 2008 hires-289 FY 2009 hires-259

101 experienced RNs (35%) 70 experienced RNs (27%)

166 new to practice nurses (57%) 163 new to practice nurses (63%)

22 per diems (8%) 26 per diems (10%)

23

Registered Nurse Workforce Planning

Nurses continue to practice part-time at UWHC but 59.87% now work .9 or greater FTE.

The mean age of registered nurses is 39.1 at UWHC with a range from 21.4 years to 68.4 years.

The bell shaped distribution of the age of RNs in direct care continues to be an advantage for UWHC.

We have a substantial mid-career brain trust. The aging of the RN workforce and the numbers of RNs projected to

reach retirement are significant issues for the organization especially in the ambulatory, surgical services and psychiatric nursing areas.

Ambulatory positions are predicted to fill easily with transfers from inpatient areas. New graduates will be the primary source of staff for inpatient and surgical services areas.

7 of 62 eligible RNs retired in FY09. The average age at retirement remains 60 years of age.

24

Percent of Nurses in Age Bracket - Includes Residents/ADNTP

16.0%

10.7%

17.8%18.8%

20.2%

11.5%

13.0%13.9%

4.7%

1.5% 0.3%

14.0%

7.9%

10.6%

16.1%

15.1%

12.1%

7.4%

15.6%15.1%

11.5%

13.1%

12.9%

1.5%

0.0%

11.6%

1.7%

0.1%

7.3%

14.1%

12.3%12.1%

14.3%

8.7%8.6% 7.6%

11.8%

13.2%

11.7%12.2%

13.5%

2.4%

0.3%

9.6%

0.2%

3.0%

11.8%12.0%

7.2%

12.8%

11.8% 11.6%10.5%

9.6%

3.4%

11.9%

7.7%

0.2%

12.2%

20.0%

0%

5%

10%

15%

20%

25%

20-24 25-29 30-34 35-39 40-44 45-49 50-54 54-59 60-64 > 65

Age Bracket

Per

cen

tag

es

June '02 June '05 June '06 June '07 June '08 June '09

Percent of Nurses in Age Bracket Includes Residents/ADNTP

25

Mean Age of Nurses by Division With and Without Residents/ADNTP Data as of 6/30/09

Mean Age of Nurses by Division - With and w/o Residents/ADNTPIncludes 55400 and 80350 under Inpatient Nursing. Data as of 6/30/09

36.0

40.9

44.647.1

39.1

45.7

39.441.2

36.4

47.1

Ambulatory Nursing Inpatient Nursing Surgical Services Home Health Total

Mea

n A

ge

Mean Age w/ Residents Mean Age w/o Residents

26

Minimum/Maximum Ages of RN StaffFY 2005 – FY 2009

Minimum/Maximum Ages of RN Staff

21.1 22.0 21.9 22.0 21.4

64.9 65.9 66.9 67.4 68.4

0

10

20

30

40

50

60

70

80

FY05 FY06 FY07 FY08 FY09

Minimum Age Maximum Age

27

Number of RN’s Who RetiredFY 2005 – FY 2009

Number of RNs That Retired FY 2005 - FY 2009

6

9

10

18

7

0

2

4

6

8

10

12

14

16

18

20

FY05 FY06 FY07 FY08 FY09

28

Forecast of RN Retirement

Date

Total RN's Reaching Age of

55

Percent of Total RN Workforce Eligible

to Retire

Total RN's Reaching Age of

60

Percent of Total RN Workforce

Eligible to Retire6/30/2009 132 7.71% 62 3.62%6/30/2010 47 2.75% 23 1.34%6/30/2015 191 11.16% 156 9.12%6/30/2020 185 10.81% 191 11.16%

Forecast of RN Retirement

29

Professional Job Satisfaction and Engagement

The national sample contains – 696 hospitals– 234,588 RNs– 14,738 nursing care units.

Nurses’ professional job satisfaction trends continue to demonstrate progress on variables that are meaningful to them.

We now have 6 years of NDNQI comparative data. The response rate for 2008 was 77% (N=1259).

26 UWHC units achieved a 100% response rate.

30


Participation decreased 6 points from last fiscal year.

Scores have remained high since 2003:Individual Satisfaction Scores– Satisfied with the status of nursing – 17% increase– Career Development – 16% increase– Participation in decision making – 8% increaseWork Group Satisfaction Scores– Autonomy – 10% increase– Professional status - 11% increase– Task - 11% increase

31


Individual nurses continue to report moderate to high satisfaction with no variables in the low category.

High satisfaction– teamwork between co-workers– physicians appreciate what I do for patients– satisfied with my job– nurse manager is a good leader

32


Moderate satisfaction– Time for patient care– Participate in decision making– Autonomy in daily practice– Satisfied with status of nursing– Salary is satisfactory– Satisfied with CNO– Career development opportunities

Low satisfaction– No variables

33


Intent to leave1 has increased from 2007– 89.8% of nurses reported that they plan to stay at UWHC (1.6 pt

(1.7%) decrease)• 82.6% plan to remain on their same unit• 7.2% plan to transfer to another unit at UWHC

– 10.2% reported intent to leave UWHC • 3.6% plan to seek a direct patient care role outside UWHC• 2.7% plan to leave direct care• 1.3% plan to seek a new career• 2.6% plan to retire

18% improvement from 2003 to 2008 regarding nurses’ intent to leave UWHC – particularly true for those that would seek a direct patient care role

outside of UWHC

1 Percentages do not equal 100% due to rounding

34


10.2% of UWHC Nurses Intend to Leave

5.4%

4.6%

1.1%

1.4%

7.5%

4.4%

1.2% 1.2%

4.6%

3.4%

1.1%

0.4%

3.8%

3.3%

0.4%

2.2%

3.0%3.3%

0.5%

1.8%

3.6%

2.7%

1.3%

2.6%

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%

8.0%

Plan to Seek a Direct Care Role Outside UWHC Plan to Leave Direct Care Plan to Seek a New Career Plan to Retire

FY 2004 FY 2005 FY 2006 FY 2007 FY 2008 FY 2009

35

Educational Preparation and Professional Certification

UWHC nurses are well educated – 74% hold a BSN or higher degree– 65% hold a BSN– 11% hold a Masters degree and 9% hold a Masters degree in

nursing– 0.2% hold an earned doctorate

The number of UWHC nurses achieving professional certification has increased again in FY09 from only 7% (N=81) in 2004 to 21% (N=376) in 2009.

36

Career Development

Experienced nurses have voiced their concerns about lack of learning opportunities and this was a concern of the Magnet appraisers as well.

Career development for all professional nurses continues to be a priority at UWHC.

Two visiting scholars have accepted an invitation to do an external review of our educational program.

The new cultural diversity theoretical framework is being implemented.

37

Leading and Managing in a Professional Practice Discipline

The grand rounds series, Leading and Managing in a Professional Practice Discipline, was continued in FY 2009.

The FY 2009 series was built on four major conceptual areas:– Evidence based leadership and management– Emerging knowledge in clinical practice– Language of reflective practice and clinical skill acquisition– Quality and safety

Nationally recognized leaders who joined us in the Leading and Managing in Clinical Practice Discipline were:– Susan Adams, DScN, University of Iowa, Director of the National Nursing

Practice Network– Leah Curtain, RN, FAAN– Katharyn May, DNSc, RN, FAAN

38

Nursing Sensitive Outcome Measures

The American Nurses Association named UWHC the #1 Academic Medical Center for Nursing Quality.

There is a very concerning trend in satisfaction with nursing care with all practice areas ending FY 2009 below the 90th percentile.

A variety of analyses and interventions are underway. Themes related to the impact of HealthLink and the

financial environment in FY 2009 have emerged. The following slides show the current status of nosocomial

pressure ulcers, falls and patient satisfaction with nursing.

39

Nursing Sensitive Outcome Measures: Falls

Total Patient Falls Per 1000 Patient Days

2.23

1.511.73

1.94

2.39 2.33 2.292.07

1.962.06

2.32

2.682.57 2.49

2.89

2.55

2.272.38

2.24

3.11

2.39

2.13

1.521.64

0.00

0.50

1.00

1.50

2.00

2.50

3.00

3.50

Jul-0

7

Aug

-07

Sep

-07

Oct

-07

Nov

-07

Dec

-07

Jan-

08

Feb-

08

Mar

-08

Apr

-08

May

-08

Jun-

08

Jul-0

8

Aug

-08

Sep

-08

Oct

-08

Nov

-08

Dec

-08

Jan-

09

Feb-

09

Mar

-09

Apr

-09

May

-09

Jun-

09

Fall Rate UCL LCL Trendline Fall Rate

Upper Control Limit (UCL) +2 Standard deviations from meanLower Control Limit (LCL) -2 Standard deviations from meanMean based upon 24 data points

40

Nursing Sensitive Outcome Measures: Falls

Total Patient Injury Falls Per 1000 Blended Patient Days

0.60

0.250.17

0.340.27

0.33

0.46

0.60

0.360.25

0.50

0.17

1.06

0.77

0.520.44 0.45

0.57

0.33

0.50

0.84

0.28

0.620.71

-0.20

0.00

0.20

0.40

0.60

0.80

1.00

1.20

1.40

1.60

1.80

Jul-0

7

Aug

-07

Sep

-07

Oct

-07

Nov

-07

Dec

-07

Jan-

08

Feb-

08

Mar

-08

Apr

-08

May

-08

Jun-

08

Jul-0

8

Aug

-08

Sep

-08

Oct

-08

Nov

-08

Dec

-08

Jan-

09

Feb-

09

Mar

-09

Apr

-09

May

-09

Jun-

09

Injury Fall Rate UCL LCL Trendline Injury Fall Rate

Mean based upon data 24 data pointsUpper Control Limit (UCL) +2 Standard deviations from meanLower Control Limit (LCL) -2 Standard deviations from mean

41

Nursing Sensitive Outcome Measures: Nosocomial Pressure Ulcers

Overall Pressure Ulcer Incidence (Hospital Acquired) Rate with Control Limits

4.90%4.92%5.26%

3.04%

3.75%

4.44%

5.31%

3.45%

4.89%5.13%

3.27%

2.54%

3.12%

4.64%4.88%

3.85%

4.61%4.90%

6.12%

3.81%

5.32%

2.81%

4.55%

2.49%

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

Jul-0

7

Aug

-07

Sep

-07

Oct

-07

Nov

-07

Dec

-07

Jan-

08

Feb

-08

Mar

-08

Apr

-08

May

-08

Jun-

08

Jul-0

8

Aug

-08

Sep

-08

Oct

-08

Nov

-08

Dec

-08

Jan-

09

Feb

-09

Mar

-09

Apr

-09

May

-09

Jun-

09

Incidence Incidence UCL Incidence LCL Trendline Incidence

Upper Control Limit (UCL) +2 Standard deviations from meanLower Control Limit (LCL) -2 Standard deviations from meanMean based upon 24 data points

42

Patient Satisfaction with Nursing

Overall Nursing Section Score Inpatient Adult - Press Ganey Patient Satisfaction Survey

Academic Medical Centers Peer Group

80

82

84

86

88

90

92

FY

00Q

4

FY

01Q

1

FY

01Q

2

FY

01Q

3

FY

01Q

4

FY

02Q

1

FY

02Q

2

FY

02Q

3

FY

02Q

4

FY

03Q

1

FY

03Q

2

FY

03Q

3

FY

03Q

4

FY

04Q

1

FY

04Q

2

FY

04Q

3

FY

04Q

4

FY

05Q

1

FY

05Q

2

FY

05Q

3

FY

05Q

4

FY

06Q

1

FY

06Q

2

FY

06Q

3

FY

06Q

4

FY

07Q

1

FY

07Q

2

FY

07Q

3

FY

07Q

4

FY

08Q

1

FY

08Q

2

FY

08Q

3

FY

08Q

4

FY

09Q

1

FY

09Q

2

FY

09Q

3

FY

09Q

4

Mea

n S

core

0

10

20

30

40

50

60

70

80

90

100

Pec

enti

le R

ank

UWHC Mean Score Acad Med Peer Grp Mean Score UWHC's Acad Med Peer Grp Percentile Rank

43


Overall Nursing Section Score UW Children's Hospital Inpatient Peds - Press Ganey Patient Satisfaction Survey

All Hospitals in Database Peer Group

80

82

84

86

88

90

92

94

FY

00Q

1,2

FY

00Q

3,4

FY

01Q

1,2

FY

01Q

3,4

FY

02Q

1,2

FY

02Q

3,4

FY

03Q

1,2

FY

03Q

3,4

FY

04Q

1,2

FY

04Q

3,4

FY

05Q

1,2

FY

05Q

3,4

FY

06Q

1,2

FY

06Q

3,4

FY

O7Q

1,2

FY

07Q

3,4

FY

08Q

1,2

FY

08Q

3,4

FY

09Q

1,2

FY

09Q

3,4

Mea

n S

core

0

10

20

30

40

50

60

70

80

90

100

Pec

enti

le R

ank

UW Children's Hosp Mean Score All Hosp DB Peer Group Mean Score UWHC's All Hosp DB Peer Group Percentile Rank

44


Overall Nursing Section ScoreEmergency Department - Press Ganey Patient Satisfaction Survey

30K-40K ED Visits Peer Group

72

74

76

78

80

82

84

86

88

90

92

FY

02Q

2

FY

02Q

3

FY

02Q

4

FY

03Q

1

FY

03Q

2

FY

03Q

3

FY

03Q

4

FY

04Q

1

FY

04Q

2

FY

04Q

3

FY

04Q

4

FY

05Q

1

FY

05Q

2

FY

05Q

3

FY

05Q

4

FY

06Q

1

FY

06Q

2

FY

06Q

3

FY

06Q

4

FY

07Q

1

FY

07Q

2

FY

07Q

3

FY

07Q

4

FY

08Q

1

FY

08Q

2

FY

08Q

3

FY

08Q

4

FY

09Q

1

FY

09Q

2

FY

09Q

3

FY

09Q

4

Mea

n S

core

0

10

20

30

40

50

60

70

80

90

100

Per

cen

tile

Ran

k

UWHC ED Mean Score ED Peer Group Mean Score UWHC's ED Peer Group Percentile Rank

45


Overall Nursing Section ScoreAmbulatory Care - Press Ganey Patient Satisfaction Survey

University HealthSystem Consortium (UHC) Facilities Database Peer Group

87

87.5

88

88.5

89

89.5

90

90.5

91

FY

05Q

1,2

FY

05Q

3,4

FY

06Q

1,2

FY

06Q

3,4

FY

07Q

1,2

FY

07Q

3,4

FY

08Q

1,2

FY

08Q

3,4

FY

09Q

1,2

FY

09Q

3,4

Mea

n S

core

0102030405060708090100

Per

cen

tile

Ran

k

UWHC Mean Score Peer Group Mean Score UWHC's Peer Group Percentile Rank

NOTE - UWHC's Ambulatory Care Press Ganey benchmark FY05 Q1,2 through FY07 Q1,2 contains "Teaching/Residency Facilities Database Peer Group" percentile rank; benchmark FY07 Q3,4 through FY09 Q 3,4 contains "UHC Consortium Facilities Database Peer Group" percentile rank.

46

Staffing Effectiveness

We continue to evaluate our staffing effectiveness and submit our data to national benchmarking programs.

We have continued a number of strategies to meet these requirements:– UWHC-wide staffing plans are developed at the

cost center level– Staffing variables are reviewed in all RCAs

47

Staffing Effectiveness

Strategies continued:– Each inpatient unit reviews monthly data on

three clinical indicators (falls, pressure ulcers and patient satisfaction with pain) and two human resource indicators (direct care vacancy rate and direct nursing hours per patient day).

– Staffing level related performance metrics include the RN vacancy rate, NHPPD, RN skill mix and nursing sensitive outcome variables.

48

Total Holdovers

Total Holdover Hours as a Percent of Total RN Worked Hours

0.87%0.85%

1.11%

1.02%

0.90%0.94%

1.03%

1.13%

0.93%

0.75%

0.87%0.93%

1.17%

1.41%

1.06%

1.20%1.14%

0.55%

0.38%

0.53%0.53%0.46%

0.40%

0.50%

0.0%

0.2%

0.4%

0.6%

0.8%

1.0%

1.2%

1.4%

1.6%

Jul-0

7

Aug

-07

Sep

-07

Oct

-07

Nov

-07

Dec

-07

Jan-

08

Feb

-08

Mar

-08

Apr

-08

May

-08

Jun-

08

Jul-0

8

Aug

-08

Sep

-08

Oct

-08

Nov

-08

Dec

-08

Jan-

09

Feb

-09

Mar

-09

Apr

-09

May

-09

Jun-

09

Total HO Hours as a Percent of Total RN Worked HoursUCL (+2 st dev)LCL (-2 st dev)Trendline Holdover Rate

Total RN worked hours - includes direct worked RN and CTL hours.Upper Control Limit (UCL) +2 Standard deviations from meanLower Control Limit (LCL) -2 Standard deviations from meanMean based upon 24 data points

49

Operational Efficiency and Patient Access

3738433125

43

1321

36343436

57

1425

17146 5 8 4 3

30

47

86

4033

20

4155

42

182731

122223

5

2214

3 8191822

10 8 620

3119

1212111119

310

249

22

42

26

1019

113

201511 6

2223

46

27131923

123 2 1 2 8 4 9

110

2 1 1 1 2 07

3034291517

80 0 1 5 1 7 12

0 1 0 0 1 3 3 3 2 07 1 4 0 0 2 0 0 1 0 0 0 2 0 0 2 0 0 0 0 2 0 1 0 0 4 1 7 4 4 6 0

7 3 70 1 5 3 2 0 1 3 2 4 2 0 0 1 1 1 0 2 0 5 2 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0

147 12 6 0 4 3 2 7

0141511

0 1 1 0 1 0 0 1 0 08 11

3 5 2 5 7 3 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 2 0 0 2 0 0 0 1 0 1 1 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

145130

147

182

155

177176

223

190183183179184

231221

253

189

260255269

351

284266

280

315318

279286

315

276259

320

259

312316

358

330

356342

328318

345

316

357358359

340

380381

338

358

332

370

402

343

363362

402409

435

413

378

414427

384

406

360

390

426437

464

519

465

364

433437

415

463

400

427424

491

455

528

488

458

483

421413

439

490480

502513

0

50

100

150

200

250

300

350

400

450

500

550

Aug-

01

Nov-

01

Feb-

02

May

-02

Aug-

02

Nov-

02

Feb-

03

May

-03

Aug-

03

Nov-

03

Feb-

04

May

-04

Aug-

04

Nov-

04

Feb-

05

May

-05

Aug-

05

Nov-

05

Feb-

06

May

-06

Aug-

06

Nov-

06

Feb-

07

May

-07

Aug-

07

Nov-

07

Feb-

08

May

-08

Aug-

08

Nov-

08

Feb-

09

May

-09

Inp

atie

nt C

ases

Cancellations - Lack of Beds ED Diversions Medflight Diversions Completed Transfers

ICUDOC Adult Peds ED MedFlight Total

1 0 6 0 0 0 7

50

Conclusions

We have had an outstanding year– Magnet Recognition– ANA Quality Award

The UWHC nursing and patient care services team continues to make substantial, quantifiable progress.

– Significant increase in capacity, particularly ability to accept transfers– Improved financial performance– Improved patient satisfaction– Improved RN satisfaction

RN turnover is continuing to decrease and this is being driven by improvements in the practice environment and the economy.

UWHC has a very large number of RNs with less than three years of experience. Continuing development of them as well as experienced nurses.

51

Future Challenges

Addressing the recommendations of the Magnet Commission.

Positioning nursing and UWHC for success in the world of health care reform and innovative fiscally responsible practice.

Nursing and Patient Care Services Report (ppt)

Documents

Transcript of Nursing and Patient Care Services Report (ppt)