Leadership Collaboration to Enhance Dissemination of Evidence-Based Nursing and Research Across Community Organization Boundaries

Monday, 17 September 2018

Bryan W. Sisk, MPH, BSN, RN
Office of the Director, Central Texas Veterans Health Care System, Temple, TX, USA
Sharon S. Souter, PhD, RN, CNE
College of Nursing, University of Mary Hardin Baylor College of Nursing, Belton, TX, USA
Janice L. Walker, MBA-HCM, BSN, RN, NEA-BC
Central Texas Division, Baylor Scott & White Health Care System, Temple, TX, USA
Linda F. Wolf, DNP, RN, NEA-BC
Baylor Scott & White Health, Temple, TX, USA
Marjory D. Williams, PhD, RN, NEA-BC
Research Service, Central Texas Veterans Health Care System, Temple, TX, USA

Background: The setting for this initiative is a small urban community in a largely rural catchment area in Central Texas. Two distinct integrated health care systems serve the population of this community and surrounding area. The area includes proximity to a major military installation and significant veteran population. The two health care systems operate in the context of a common nursing workforce, patient/family population, and community environment. The nursing recruitment pool is also shared by the two systems and fed by a single BSN/post BSN academic affiliate. Both healthcare systems have similar organizational goals of formal recognition for nursing excellence through either Magnet or Pathway to Excellence designation. The two systems have specific nursing EBP and research efforts with minimum dissemination beyond organizational boundaries within the community. The Chief Nursing Officers for these two healthcare systems and the Dean of the local academic affiliate college of nursing identified opportunity to support potentially competing organization-specific objectives through a joint effort to share nursing best practices and innovations. Leadership vision for this transformational collaboration was to increase support for the mutual goal of improving community health by bringing diverse nursing stakeholders together around a focus on knowledge-driven practice at the point of care.1,2

Framework: Clinical and Academic Nursing Leadership receptivity to collaboration reflects elements of social accountability3 approaches to health care delivery. Through this transformational collaboration, clinicians, students and researchers view their work contextualized within the local community beyond an organization-specific perspective.4 The nursing workforce is better equipped to effect health system change as health partners in anticipation of community need. Diffusion of Innovation Theory5 provides a framework for addressing commonly cited barriers to adoption of evidence based nursing practices.4 Exposure, as peers, to community relevant examples of evidence based nursing practice and scholarly generation of accessible and meaningful nursing knowledge is a practical strategy for engaging end-users in adoption of evidence in practice.6,7,8

Description: A joint planning committee, comprised of members from both clinical systems and the academic affiliate, developed a strategic plan for a local event to share nursing practice and research activities with the stated purpose of advancing nursing excellence at the point of care. A call for abstracts was distributed to encourage front line nurses, undergraduate and graduate nursing students, and nurse researchers to submit work for either poster or podium presentations. Abstract guidelines and review rubric were collaboratively developed to accommodate possible differences in nursing scholarship models between the organizations. Each organization provided internal support for abstract preparation. Qualified volunteers for joint abstract review were solicited to insure organizational representation.

Evaluation: Initial response to the call for abstracts has been robust with representation of practice and research activities across organizations. Formative evaluation measures for the inaugural collaborative event will include final number of abstracts submitted, abstract rubric scoring patterns, attendance at the event, engagement of local nursing workforce in event activities, and attendee feedback and evaluation of the event. Follow up evaluation measures will include cross organization adoption of practice innovations, cross organization nursing evidence-based project collaborations, level of interest in continuation of community sharing and dissemination activities, and level of interest among nurse researchers in dissemination and implementation research collaborations.

Implications: Collaboration across organizational boundaries to engage point of care nurses in sharing best practice innovation and knowledge generation has the potential to (1) strengthen the culture of inquiry and nursing excellence in each organization, (2) strengthen connections within the nursing community across academic and clinical settings, (3) facilitate best practice approaches to common patient health concerns across settings, (4) enhance and leverage expertise in the nursing workforce, (5) create conditions for innovation and discovery driven by practice based evidence, and (6) provide a model for evaluating community level impact of transformational leadership collaborations.

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