1. Creating Partnerships in Practice In the Healthcare Setting Kathie Poplar RN-BC, MSNFebruary 2015

2. Partnership Outline  Immediate Resources  Information  Barriers to Practice  Opportunities for growth  The Bigger Picture

3. Who Are Your Resources ? Preceptor Charge Nurse Educator House Supervisor LNA

4. More Resources! Diabetes Therapy Nutrition Wound Team Respiratory Rapid Response Team Risk Manager Directors Transport Wound Team Academic Affiliation Physicians IS

5. Building Relationships  As important as building clinical skills  Fosters a positive work Environment  Safe patient care  Team partnerships for shared care & efficiency  Teamwork

6. Where to Find Information  Nursing Policies  Medication Resources (Lexicomp)  Reputable Online Resources  Patient Education Materials  Ancillary Departments  Bringing forth foundational information and following up with preceptor  Nursing Policies  Medication Resources (Lexicomp)  Reputable Online Resources  Patient Education Materials  Ancillary Departments  Bringing forth foundational information and following up with preceptor

7. Barriers Encountered  Time pressures with patient care needs  Resistance to change with culture  Lack of knowledge about new trends or current practice  Technical issues  Lack of knowledge for policies (Patient Safety Solutions, 2007)

8. 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 concerned when new nurses do not ask questions

9. Constructive Criticism  Listen to what your preceptor is telling you  Anticipate constructive feedback  Don’t be afraid to admit that you do not know something  Don’t argue with your preceptor  Listen  Follow up with Clinical Manager or Educator if you have a personality clash with your preceptor.

10. 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)

11. 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)

12. 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

13. 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)

14. 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)

15. Shared Governance Committees Unit Practice Council Diabetes Team Professional Recognition Program Magnet Ed & Prof Development Evidence Based Practice Skin-Wound Assessment Team EPAC

16. 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

17. 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

18. 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 …….

19. 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

20. Health Network Systems Community Based Programs – Urgent Care – Volunteer Organizations – Paramedics – Health Clinics – Patient Education

21. 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

22. Embarking on Your Nursing Journey

23. 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 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 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/ 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.