Nurse leadership cultivates an environment of quality and a culture of safety within the healthcare organization. With the succession of a new generation of leaders, a few questions will arise. Will they uphold the same values? Will they apply a new vision for the organization or will they retain the existing vision? Where are these new leaders and what will it mean for our organization? These are some of the valid concerns that leadership has and they should be addressed because these challenges are real. The Joint Commission is adding and removing measures, the United States has a new president that may affect change to healthcare policy and payment reformation is in constant flux. Healthcare is in dire need of stellar leadership. With that said, the qualities needed in a leader are changing as well. Pragmatic leaders are attractive to healthcare organizations to retain the longstanding vision of the organization, and looking forward change is desired, leaving new leadership in an interesting position. With a host of innovation in technology and methodology being introduced to healthcare, leaders are being forced outside the defined structure of historical antecedence. Fear begins to become instilled in leadership when put in this position because as leaders start drifting away from pragmatic decision making and start drifting closer to innovation and disruption, their risk of failure intensifies.
These factors are flooding the minds of decision makers when considering bringing in new leadership. What control factors are in place to make sure that the next generation of nurse leadership is ready for these challenges? One word: training.
Healthcare Leadership Accreditation is key to how these leaders are being trained. CAHME, a highly esteemed healthcare leadership accreditation organization based out of Rockville, MD, is looking toward innovation in the educational processes, as well as innovations in the healthcare space, to drive positive leadership succession.
Commission on Accreditation of Healthcare Management Education
In the paper published by the Commission on Accreditation of Healthcare Management Education (CAHME) entitled “To Be The Change: Preparing The Future Leaders Of Healthcare – Thought Leader Insights March, 2016″(1) the organization states that there is a call “for increased accountability in higher education” and this accountability “demand[s] that colleges and universities demonstrate outcomes and student achievement measures.” Why? Governmental policies have “focused on undergraduates, yet its effects reverberate in graduate education in the increasing demands for improved graduation (i.e. completion) rates among students, increased employment attainment in careers of choice, and full transparency in sharing educational outcomes with the public.” These initiatives have been in place for almost a decade in the USA, however the “[s]tates’ disinvestment in higher education has driven up tuition and increased student debt, while disruptive technologies challenge the foundational models of education.”
CAHME suggests that all accredited educational institutions make innovation a part of the curriculum. The paper goes on to make the following suggestions:
- Consider innovation as a needed competency in CAHME criteria
- Competency models should include innovation
- Recognize that innovation is important to critical thinking and to problem solving
- Interactive learning exercises support innovative thinking
Why is this so important? CAHME goes on to report that “[a]s healthcare delivery changes, successful graduate programs in health administration are pressed to “stay ahead of the curve” to prepare students for the demands of their future leadership and management roles. This emphasizes the importance of leadership competencies, deeply embedded value systems, analytical skills, team building, and talent that can define and solve problems with clear strategy and innovation.”
As much as we may have an aversion to change, the need for change is here. “Healthcare is a large and growing sector of the U.S. economy at 18% of Gross Domestic Product. Increased and rapid innovation in delivery and payment models is driving consolidation among major health systems and payors.” We can see clearly that the obligation to accelerate innovation to improve value is a driver of change in healthcare.
With new leaders focusing on innovation, it is something that they will be looking for within the healthcare organization that they choose to serve. It is important to have proven innovations that can add an element of control to the nurse leader. For example, at St. Luke’s Miners Campus in Pennsylvania, HCAHPS scores, a value/quality initiative with nurses and talent attraction, were keeping leadership awake at night. In the next section we will consider what attracted them to innovation.
The Next Generation of Leaders are looking for Innovation
Now we will examine three ways that innovation was an enabler for St. Luke’s Miners Campus’ leadership team, helping them to implement change and to give them more control over value-based outcomes.
Value-Based Outcomes – Performance Scores
Patient satisfaction, patient experience, HCAHPS and Press Ganey scores/survey responses and other performance metrics easily turn into buzzwords in leadership meetings, while the smallest of improvements are reacted upon even though they may just be statistical “noise” commonly experienced by all organizations. Improving the patient’s experience has been top-of-mind for most healthcare leadership for many years. The next generation of leaders, trained by accredited schools to look for innovation in organizations, will be fiercely focused on innovations that they can implement or exploit parts of innovations within the organization that aren’t being utilized to their fullest potential. One example at St. Luke’s Miners Campus shows us that their leadership team was able to make a profound difference by harnessing innovation in a way that they never have in the past.
With solid patient room dry-erase board strategy, they were able to, with forward thinking, identify that patient room communication automation is what will be the ‘tipping point’ for their organization. To improve that dry-erase board strategy, they implemented MEDI+SIGN® digital patient room whiteboards.
Since MEDI+SIGN is a connected platform, the digital whiteboards will fill themselves out based on the hospital’s current patient record system. This allowed the hospital to strategically repurpose the nurses’ time so that the patients are put first, having a synergistic effect on all surrounding processes, methodologies and technologies.
What were the results? In just three months they experienced a sharp increase in their HCAHPS scores.
The electronic patient room whiteboards went live in April of 2016. In just three months after deployment, dramatic changes have been experienced. The nurse communication scores raised immediately by 11.8 points. Pain Control scores went up by 10.7 points. Two other noticeable improvements were experienced: Responsiveness of Hospital Staff, up 15.9 points, and Hospital Cleanliness & Quietness, up 10.9 points. When early assessments were analyzed by the hospital, they felt that a new nurse call system was what assisted with the staff responsiveness and a refresh/renovation was the reason for the increase in cleanliness scores.
Something that the micro-evidence tells us is that the physicians, over time, bought into the electronic whiteboards as a communications medium and started introducing the digital patient room whiteboards into their bedside processes. That is evident in the 9.2 point increase in Communication with Doctors over three months. We can also see in the micro-evidence that nurse communication improved immediately and those improvements cascaded throughout the rest of the scores in the following months. This is directly connected to nurse communication, including an 8 point increase in Discharge scores, and an 18.6 point improvement in Transition of Care scores. With nurse communication no longer being the ‘bottleneck’ that limits the organization, it opens up the healthcare organization to operate with the initiatives that they already had in place. This results in an Overall Rating of the Hospital improvement to 80 points, a 17.1 point increase in only three months! Were these results sustainable? Yes. We can see that the following 3 months the scores continued to improve or held steady.
By having a leadership team that was equipped to look for and implement innovative technology, St. Luke’s was able to move their organization to a place that they haven’t been able to do with strategies that were implemented in the past. Although, improvement on HCAHPS was only one of the benefits. Next we will examine talent attraction.
Attracting New Talent with Innovation
During a staff survey, it was noted that one of the nurses that was recently onboarded made the decision to take the job at St. Luke’s Miners Campus instead of another offer for a larger hospital that was in her same neighborhood, simply because the St. Luke’s Miners Campus is “high-tech.” She said that it made her feel good walking into the patient rooms and seeing her picture on the MEDI+SIGN displays. The hospital also just procured a brand new state-of-the-art nurse call system and performed a renovation to their patient rooms. This nurse wasn’t the only one. Since the feeling is so overwhelming, they have used the technology in the patient rooms and elsewhere as a part of their tour for physicians, surgeons and other high-caliber talent needed for the organization and they have been experiencing great results. Now other hospitals within the St. Luke’s University network use the Miners Campus as a tour site so that they can demonstrate how the network is forward thinking. This has proven a useful tool when searching for nurse leaders and other executives.
Efficiency and the Bottom Line
When leaders saw that they would gain some more control over wasted time, it was of great value to them. In a survey performed at five hospitals in Maryland and Pennsylvania, it was found that nurses were told by leadership that the dry-erase boards in each patient room needed to be filled out, however, they only had enough time to fill them out partially at best. Most leaders would agree that partially filled out patient room boards offer diminishing returns. What little benefit they were receiving was still requiring the nurse to spend the time on the boards. On average, the survey revealed that the compounded costs were $5,935 per bed per year in nurses time. This was derived from combining the estimated time spent on the commonly filled out sections of the whiteboard with the average hourly wage for nurses. That equals $118,701 on average per year just for the 25 bed MedSurge unit in the surveys. Further findings show that the time used is a 1.63 Full-Time-Equivalent (FTE) or 3,391 hours per year. With costs compounded over five years, we land at an outstanding $593,505 worth of time spent on whiteboards.
With leaders focused on the values of innovation, the hospital was able to invest in putting nurses’ time to better use, and with a full rollout in the hospital, they are saving millions of dollars over five years in time costs.
MEDI+SIGN was used in this paper as an example and is a result of something bigger at St. Luke’s Miners Campus. They built a culture of innovation and forward thinking and did so with leadership that shared those values and interests. By searching these new leaders out at accredited schools and by building a foundation that supports the new era of value-based outcomes with new technologies, processes and methodologies, paving the way for the new leaders coming in, past legacies will continue to flourish in the centuries of service to future patients.
To learn more about the MEDI+SIGN connected platform for healthcare, visit us at http://www.medisigndisplays.com and be sure to watch the video on the main page for more information on the impact that MEDI+SIGN can have on your organization.