| Learning Objective #1: Describe challenges in assessing and improving care and outcomes by examining micro-systems | |||
| Learning Objective #2: Discuss an innovative educational, practice, and leadership partnership to develop nursing leaders to improve patient care through technical, service, and cost excellence |
Objective: This project focused on providing clinical nurse specialists (CNSs) in an academic medical center state-of-the-art subject matter knowledge about and the ability to: •Accurately assess nursing practice within the context of micro-systems, •Understand the optimal relationship between nursing and other clinical staff, •Read the horizon and recognize threats and opportunities, and •Lead the improvement of patient care through technical, service, and cost excellence. Background: A clinical micro-system is defined as a small group of people who work together on a regular basis to provide care to discrete subpopulations of patients. It has clinical and business aims, linked processes, a shared information environment, and produces performances outcomes. Methods: The Senior Nurse Executive partnered and collaborated with the Center for Evaluative Clinical Sciences faculty at Dartmouth Medical School to lead a 12-month action learning cycle for all of the CNSs and key nursing leaders. The program mixed real world challenges in assessing and improving care and provided useful knowledge of fundamental principles and methods for leading patient care improvement. Each learner selected a meaningful project to improve patient care (technical/service/cost) and worked with a team, to plan and test the improvement focusing on the Plan-Do-Study-Act (PDSA) approach and received expert consultation and coaching by scientists and clinician-scholars. The goal focused on making multiple changes in the micro-system that would result in substantial gains in technical/service/cost excellence. Outcomes: Participants examined high-performing healthcare micro-systems across the care continuum. Multidisciplinary project teams facilitated by the individual CNSs included nurses and nurse practitioners, physicians, care managers, and other members of the healthcare team. Examples of projects include “Reducing Medication Errors in the ICN,” “A Medication Assistance Program in Ambulatory Care,” “Glycemic Control in Cardiothoracic Patients,” and “Providing a Response Team to Adult Victims of Cardiac Arrest at DHMC.”
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