Creating Partnerships in Practice

In the Healthcare Setting

Kathie Poplar RN-BC, MSN February 2015

Partnership Outline

Immediate ResourcesInformationBarriers to PracticeOpportunities for growthThe Bigger Picture

Who Are Your Resources ?

PreceptorCharge Nurse

EducatorHouse

Supervisor

LNA

More Resources!

DiabetesTherapy

NutritionWound Team

RespiratoryRapid

Response Team

Risk Manager

Directors

Transport

Wound Team

Academic Affiliation

Physicians

IS

Building Relationships

As important as building clinical skills

Fosters a positive work Environment

Safe patient careTeam partnerships for

shared care & efficiency

Teamwork

Where to Find Information

Nursing PoliciesMedication Resources

(Lexicomp)Reputable Online ResourcesPatient Education MaterialsAncillary DepartmentsBringing forth foundational

information and following up with preceptor

Barriers Encountered

Time pressures with patient care needs

Resistance to change with culture

Lack of knowledge about new trends or current practice

Technical issuesLack of knowledge for policies(Patient Safety Solutions, 2007)

Value of Asking Questions

Find a resource at the beginning of the shift so they know to be there

for you

Not asking puts you &

your patient in danger

You are not expected to know it all

Preceptors are concernedwhen new nurses do not

ask questions

Constructive CriticismListen to what your preceptor is

telling youAnticipate constructive feedbackDon’t be afraid to admit that you

do not know somethingDon’t argue with your preceptorListen

Follow up with Clinical Manager or Educator if you have a personality clash with your preceptor.

Adopt Caring Behaviors

♥ See possibilities in solutions♥ Respect and value co-workers♥ Do what ever it takes to do the “Right

thing”♥ Follow through on commitments♥ Seek to understand the other person’s

point of view♥ Avoid making assumptions♥ Seek to understand other people’s roles• (Koloroutis, 2004)

Healthy Team Relationships

♣ Establish trusting relationships through competency & character

♣ Treat others with mutual respect regardless of their role

♣ Trading weekends and work shifts♣ How does your work ethic impact

the team♣ Consistent and visible support so

people know they can count on you♣ Open and honest communication(Koloroutis, 2004)

Partnerships with LNAs Treat LNAs with respect! Patient centered care – Walk away from

old notions of “my” role vs “their "role. How can “we” work better together to

take care of “our” patient How do you transition from old role of

LNA to new role of RN delegation Bringing value and respect to our

members of team Relationships built on trust bring staff

satisfaction & quality patient care Patient care such as “toileting” does not

belong only to LNA

Nurse-Physician Communication

► Joint Commission Patient Safety Goal #2 is to Improve the effectiveness of communication among caregivers

►TORB – Clarification of Orders(VORB taken only in emergencies)

►Teamwork and good communication is imperative for safe patient care

►Decreased mortality►Decrease cost of patient care► Increased job satisfaction and overall work

relationships(2012 National Patient Safety Goals)(Hughes & Fitzpatrick, 2010)

Magnet Journey◙ Getting involved in a committee helps to

network within the organization◙ Fosters understanding of how other

departments function◙ Building the bedside nurse as leaders◙ Grooms you as an expert resource within

your own department◙ Presents an opportunity to make a

difference◙ Unit Practice Councils provide a forum for

the nurse to raise their voice◙ Understanding organizational initiatives(Sanborn, 2006)

Shared Governance Committees

Unit Practice Council

Diabetes Team

Professional Recognition

Program

Magnet

Ed & Prof Development

Evidence Based Practice

Skin-Wound Assessment

Team

EPAC

Building Your Network• Linked In• NHNA/ANA or professional

organization • Work towards specialty certification• Attend conferences• Again…get involved in shared

governance• Volunteer activities• Legislative forums• Academic Affiliations• Social Network systems

Professional Growth & Development

• Nursing is a profession…..not just a job

• Full completion of orientation• Participation in Shared

Governance Committees• Precepting• Charge• Unit based Involvement

Governing Bodies

• CMS: Centers for Medicare & Medicaid

• The Joint Commission– Reimbursement– Setting standards of Practice– Open Reporting– Accreditation– Core Measures: heart failure,

CAUTI, VAP, Pressure Ulcer prevention, Stroke …….

Core Measures• Conditions impacting morbidity

and mortality• Represent National Health

priorities• Conditions that drive up

healthcare costs• Require involvement of the

healthcare team• Building of electronic health

records for communication

Health Network Systems

• Community Based Programs– Urgent Care– Volunteer Organizations– Paramedics– Health Clinics– Patient Education

Accountable Care Organizations (ACO) Doctors, hospitals, and home healthcare

providers that network for the provision of high quality care for Medicare patients

Share financial and medical responsibilities Coordinate care Goal targeted for chronic illness Avoiding duplication of resource Focus on prevention and meeting benchmarks Reduction of costs High performers can pocket more of the costs Projected savings Medicare $940 million/4years G5 example

Embarking on Your Nursing Journey

References• Centers for Medicare and Medicaid Serivces(2013).

Recommended Core Measures. Retrieved from: www.cms.gov/Regulations-and-Guidelines/Incentive Programs/ Recommended_Core_Set.html

• Centers for Medicare and Medicaid Services ((2015). Accountable Care Organizations. Retrieved from: www.cms.gov/Medicare/Medicaid-Fee-for-Service-Payment/ACO/index.html

• Kaiser Health News (2015). FAQ on ACOs: Accountable Care Organizations, Explained. Retrieved From: kaiserhealthnews. org/news/aco-accountable-care-organization-faq/

• Koloroutis, M. (2004). Relationship Based Care: A Model for Transforming Practice. Minneapolis, MN: Creative Health Management

• Hughes, B. & Fitzpatrick, J. J. (2010). Nurse-physician collaboration in an acute care community hospital. Journal of Interprofessional Care,November 2010; 24(6): 625–632

• The Joint Commission (2012). 2012 National Patient Safety Goals. From: http://www.jointcommission.org/2012_npsgs_slides/

• World Health Organization (2007). Communication during patient hand overs. Patient Safety Solutions, 1 (3).

• Sanborn, M. (2006). You don’t need a title to be a leader. New York: Crown Business.