2.50
Hdl Handle:
http://hdl.handle.net/10755/162496
Type:
Presentation
Title:
Give up Control and Get in Control
Abstract:
Give up Control and Get in Control
Conference Sponsor:Emergency Nurses Association
Conference Year:2009
Author:Dougherty, William, RN, BSN
P.I. Institution Name:West Virginia University Hospitals - Ruby Memorial
Title:Nurse Manager, ED
Contact Address:1 Stadium Drive, Morgantown, WV, 26506
Contact Telephone:304-598-4173
Co-Authors:Kimberly Mecom, RN, BSN
[Leadership Conference Poster Presentation] Purpose: One academic Emergency Department Director's experience with handing the control of the unit over to the employees. A lesson in when and how to let go to gain ultimate outcomes. At the start of the experiment in leadership, employee satisfaction was less than 70%, cost for supplies and labor were grossly out of line. Documentation effectiveness and completion were not being measured, and the one area that was, pain management, was less than 70%. Internal billing audits revealed multiple errors and potential for increased revenue. There was a greater than 5% call-off rate and 10% turnover, with a 15% vacancy rate.

Design: Staff and management development project.

Setting: Academic Emergency Department with Level I Trauma Designation.

Participants: Nursing staff and management in Emergency Department.

Methods: After a comprehensive one on one evaluation and interview with all employees, the results of the 60 meetings were tabulated and shared with the staff. Three areas were defined as requiring attention as described by the individuals interviewed. There areas were documentation, scheduling, and staffing. Other areas were defined by organizational goals, patient satisfaction, reimbursements, and JCAHO issues, in particular policies and procedures, medication safety, and environment of care.
Committees were developed and fun 100% by the staff and charge nurses, Responsibility for the committees' recommendations were reviewed and sent back to the committee and the staff for intervention. Committees were required to report at all staff meetings, committee notes and recommendations were posted for all staff to review and comment.
Emergency Department Dashboard was developed and shared with all staff to plot current state and to track improvements. Monthly staff e-newsletters were written and distributed to promote updates and involvement. ED manager and Directors committed 2 days per week in clinical staffing to get to know the staff and the issues.

Results:
1. Scheduling guidelines developed and implemented within 3 months
2. Nursing documentation guidelines implemented within 2 months
3. Pain documentation improved from below 70% to 87%
4. Supply committee developed and implemented PAT levels within 1 month
5. Cost per case in supply cost decreased 25% within the first 2 months
6. Medication room re-designed and medication delivery and billing improved within 4 months
7. Charges per Visit increased over 6 months
8. Retention of Staff improved to less than 5% turnover
9. Truancy decreased from 5.5% of all shifts to 3%

Recommendations: With line staff buy-in and accountability to the outcomes, significant improvement can be made in patient care, staff satisfaction and financial management.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleGive up Control and Get in Controlen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162496-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Give up Control and Get in Control</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Dougherty, William, RN, BSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">West Virginia University Hospitals - Ruby Memorial</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Nurse Manager, ED</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1 Stadium Drive, Morgantown, WV, 26506</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">304-598-4173</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">DoughertyW@wvuh.com</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Kimberly Mecom, RN, BSN</td></tr><tr><td colspan="2" class="item-abstract">[Leadership Conference Poster Presentation] Purpose: One academic Emergency Department Director's experience with handing the control of the unit over to the employees. A lesson in when and how to let go to gain ultimate outcomes. At the start of the experiment in leadership, employee satisfaction was less than 70%, cost for supplies and labor were grossly out of line. Documentation effectiveness and completion were not being measured, and the one area that was, pain management, was less than 70%. Internal billing audits revealed multiple errors and potential for increased revenue. There was a greater than 5% call-off rate and 10% turnover, with a 15% vacancy rate.<br/><br/>Design: Staff and management development project.<br/><br/>Setting: Academic Emergency Department with Level I Trauma Designation.<br/><br/>Participants: Nursing staff and management in Emergency Department.<br/><br/>Methods: After a comprehensive one on one evaluation and interview with all employees, the results of the 60 meetings were tabulated and shared with the staff. Three areas were defined as requiring attention as described by the individuals interviewed. There areas were documentation, scheduling, and staffing. Other areas were defined by organizational goals, patient satisfaction, reimbursements, and JCAHO issues, in particular policies and procedures, medication safety, and environment of care. <br/> Committees were developed and fun 100% by the staff and charge nurses, Responsibility for the committees' recommendations were reviewed and sent back to the committee and the staff for intervention. Committees were required to report at all staff meetings, committee notes and recommendations were posted for all staff to review and comment.<br/> Emergency Department Dashboard was developed and shared with all staff to plot current state and to track improvements. Monthly staff e-newsletters were written and distributed to promote updates and involvement. ED manager and Directors committed 2 days per week in clinical staffing to get to know the staff and the issues.<br/><br/>Results:<br/>1. Scheduling guidelines developed and implemented within 3 months<br/>2. Nursing documentation guidelines implemented within 2 months<br/>3. Pain documentation improved from below 70% to 87%<br/>4. Supply committee developed and implemented PAT levels within 1 month<br/>5. Cost per case in supply cost decreased 25% within the first 2 months<br/>6. Medication room re-designed and medication delivery and billing improved within 4 months<br/>7. Charges per Visit increased over 6 months<br/>8. Retention of Staff improved to less than 5% turnover<br/>9. Truancy decreased from 5.5% of all shifts to 3%<br/><br/>Recommendations: With line staff buy-in and accountability to the outcomes, significant improvement can be made in patient care, staff satisfaction and financial management.</td></tr></table>en_GB
dc.date.available2011-10-27T10:29:11Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:29:11Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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