Advisory Board Recognizes BWH Nurses
The PACU’s Clinical Practice Committee is chaired by Kristin Alt-Styer, far right, and include, seated from left, Danielle Coutu, Karen Lane and Vicky Sherry; and standing, Kathy McGrath, Katrina Bickerstaff and Deidra Devaux
Health care leaders and nurses from across the country look to the Advisory Board’s Nursing Executive Center for best practices research and analysis focusing on business strategy, operations and general management issues. After visiting BWH in December, the Advisory Board now recognizes the orientation manual and in-service training sessions in the PACU and the leadership of BWH’s Center for Labor and Birth and how the unit responds to unusual events as national best practices.
BWH is prominently featured in “Unlocking Unit Excellence,” a reference book the Advisory Board’s Nursing Executive Center compiled. Also, the best practices of the PACU and Center for Labor and Birth were detailed during the organization’s national membership meeting and several chief nursing officer roundtables in a presentation entitled, “Safeguarding Frontline Care: Optimizing Current Resources, Elevating Future Practice.”
Joshua Gray, managing director of the Advisory Board’s Nursing Executive Center, led the research team that visited BWH in December. “After spending a day with the nurses and nurse leaders in the PACU and labor and delivery unit, we left incredibly impressed with their professionalism and commitment to patient safety,” Gray said. “We are presenting the results of our findings, which include highlights of our visit to Brigham and Women’s, in a series of meetings with hundreds of nurse executives and nurse managers around the country. Response to our research has been overwhelmingly positive to date.”
As part of its mission to deliver excellent patient care to patients and families in the safest environment, the BWH Department of Nursing looks for best practices within the hospital’s distributed campus as well as outside sources such as other hospitals and professional organizations like the Advisory Board.
“When outside agencies and hospitals look to BWH for best practices, the entire hospital should be proud,” Mairead Hickey, PhD, RN, chief nursing officer and senior vice president of Patient Care Services, said.
“This recognition of our practice of Nursing is significant, but not just because we are being recognized from an industry leader like the Advisory Board,” Hickey said. “The impressive and significant aspect of these practices is that they have improved care here at BWH and they will serve to advance the practice of Nursing at many other places.”
Specifically, the Advisory Board detailed the PACU’s in-service orientation manual and highlighted the successes of unit-specific learning. “The goal of our orientation manual is to make sure everyone feels part of the team,” PACU Nurse Manager Jeanne Lanchester, RN, said. Twenty nurses on the unit authored the 25 chapters in the massive manual, which was spearheaded by the PACU’s clinical practice committee chaired by Kristin Alt- Styer, RN.
The PACU’s staff-driven in-service training sessions gained praise from the Advisory Board, too. New surgical services are highlighted on the department’s bulletin board once a month, and staff nurses, physicians and nurse practitioners routinely gather for training sessions. “We must have had 40 people—including some nurses who weren’t even working that day—attend the in-service on pain management,” an unidentified PACU staff nurse said in the Advisory Board’s “Unlocking Unit Excellence” publication.
Both the orientation manual and the in-service training sessions demonstrate the commitment of the PACU staff to ensure the safest environments for patient care, Lanchester said. “Our staff have the ability to turn to the orientation manual to reinforce their knowledge of the ins and outs of our department, and our in-services foster teamwork and meaningful discussion centered around specific procedures. Our nurses look to both to ensure the safest environment for our patients,” she said.
The Advisory Board’s field team came away from its visit to BWH’s Center for Labor and Birth impressed with how well unit staff and leadership respond to unusual events. “Unexpected occurrences happen, and we have to make sure we go over what happened in a timely manner to find how it happened,” said Maggie Hickey, MS, RN, nurse manager for the Center for Labor and Birth. “There’s nothing punitive that comes from our debriefings, and that’s important.”
Too often, busy units miss the opportunity to debrief on adverse events and use such occurrences as valuable learning experiences, according to the Advisory Board. In highlighting the approach at the Center for Labor and Birth, the Advisory Board pointed to the unit’s commitment to communication and drive to ensure a safe environment.
In a slide presented to its membership meetings and chief nursing officer roundtables, the Advisory Board describes the ideal course of action when an incident occurs: the nurse in-charge notifies the nurse manager; the nurse manager meets with staff involved to review the event, diagnose system issues, reinforce confidence; then the nurse manager educates the entire unit.
That’s the way it’s done in the Center for Labor and Birth.
“Our staff really are committed to the process of evaluating and re-evaluating practices,” Maggie Hickey said. In addition to event debriefings, which occur on an as-needed basis, Center for Labor and Birth nurses, PCAs, physicians and other staff gather twice daily for Safon Rounds to review patient needs.
“Making the Center for Labor and Birth as safe as possible for our patients and their families is at the heart of what we do here every day,” Maggie Hickey said.
The Advisory Board boasts a membership of 2,500 of the country’s largest and most progressive health systems and medical centers. The Advisory Board provides best practices research and analysis to the health care industry, focusing on business strategy, operations and general management issues.
Gathering data across and beyond the membership, the Advisory Board publishes daily and weekly news services, 50 major studies and 3,000 customized research briefs each year on progressive management and clinical practices in health care. In general, the research focuses on the best (and worst) demonstrated practices, helping member institutions benefit from one another’s learning curves.
Maggie Hickey, at left, and the interdisciplinary team of clinicians in the center for Labor and Birth regularly meet to discuss patient care and debrief on unexpected occurrences.