Goals for the session: Have beginning understanding of next level of the Documentation Framework Support introduction of Safety & Education documentation changes as next building block of Documentation Framework Have begun a unit-specific implementation plan Know proposed rollout schedule, especially go live date for your unit. Knowledge of resources available to support this work Falls/Safety Documentation Changes: Implementation Planning
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Goals for the session: Have beginning understanding of next level of the Documentation Framework Support introduction of Safety & Education documentation.
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Goals for the session:
Have beginning understanding of next level of the Documentation Framework
Support introduction of Safety & Education documentation changes as next building block of Documentation Framework
Have begun a unit-specific implementation plan
Know proposed rollout schedule, especially go live date for your unit.
Knowledge of resources available to support this work
◦ We began to implement changes to our Nursing Documentation Framework in October, 2010 with the rollout of Priority Problems.
◦ Based on feedback from nurses and from recent Magnet and JCAHO Surveys, this change has been the catalyst for dramatic improvements in documentation. “My documentation reflects how I impact patient
outcomes” (typical Staff Nurse comment when speaking about Priority Problems).
Intro
◦ We are now ready to begin the next phase of the Nursing Documentation Framework change with implementation of the Falls/Safety Section and changes to Education Tab.
◦ As with Priority Problems, this is less of a technical change, more of a practice change.
◦ This is a huge ongoing culture change
Intro. (cont.)
◦ CAPS will sit with participant(s) from their unit(s) the extent possible but we want to work in teams, even if it’s not your unit team.
◦ We will begin to craft a unit-specific Implementation Plans
◦ We ask that you honor timeframes
◦ Jot down questions and “ah-ha’s” as you go so you don’t lose them. If there are any issues we are not able to address today, we will put on Parking Lot for follow up after the session.
Logistics
Falls expert brought in to address high Falls rate said our emphasis was on screening for rather than preventing falls. Our old screen had been modified to the point that it was NOT evidence-based.
Historical approach to a new regulation or problem – ADD a NEW Documentation section◦ Increases documentation burden on nurses◦ Nurses spend time documenting about instead of preventing
problems◦ Our goal to help with increasing staff satisfaction – standardize
and simplify documentation. The hospital is a dangerous place for patients. “First do no harm” (Hippocrates). Organizational Goal --
Culture of Safety
Kotter’s 1st Step:
Increasing the Sense of Urgency
At your table, identify 3-5 common safety risks for patients on your unit. 1. _____2. _____3. _____4. _____5. _____
Kotter’s 1st Step:
Increasing the Sense of Urgency
Finding our way together….
Kotter’s Step Two: Form a Powerful
Coalition
As the Nursing Leaders of VUMC, we must actively LEAD this transformation of practice & documentation
Requires strong leadership & visible support
We cannot “manage” change from the sidelines
“Managing change isn’t enough – you have to lead it.” (Kotter, 1996)
Managers create order & predictability, while leaders establish direction, vision, motivate & inspire people. (Weber & Joshi, 2000)
◦ Nursing Leaders & Nursing Educators
◦ Staff Nurses (novice to expert)
◦ SuperUser Champions
◦ SSS CAPS
◦ HED Builders
◦ Key Stakeholders: Medical Director, Physicians, Nurse practitioners
◦ Engage Opinion Leaders early & engage as Champions
Building a Change Coalition
Work as a TEAM
Build ongoing urgency & momentum for the need for change
Change Coalition will…
Vision Statement Safety Documentation, including
assessment, interventions, teaching, and notification, will result in a safer environment for our patients and will prevent or minimize injury.
This will improve patient care and clearly define nursing’s contributions to patient care and the team.
Kotter’s Step 3: Create a Vision
If documentation is a reflection of our care – does it show that nurses make a difference?