The Voice of Nursing Community of Practice Forum Pam Jensen, NPCS Senior Project Manager

1. Baldwin Park Medical Center Diane J. Thompson, Interim CNE Michelle R. Nowicki, COO Irene Kuwaki-Chuman, APL The Voice of NursingCommunity of Practice ForumPam Jensen, NPCSSenior Project Manager

2. Voice of Nursing Community of Practice Forum Monthly interactive forum for Kaiser Permanente teams, facilities and/or regions to share their on-going activities, best practices and challenges to: • Embed the Kaiser Permanente Nursing Vision, Values, and Professional Practice Model • Drive nursing professional practice goals • Improve patient outcomes Learn from others, get new innovative ideas, identify potential obstacles to speed and spread your own process Today’s forum will be recorded. The slides will be posted on the Nursing Pathways website. To minimize noise, please put yourself on mute during the presentations. Do not place the call on hold.

3. The Voice of NursingCommunity of Practice Forums (CoP) Forums Kaiser Permanente Baldwin Park Medical Center Date: February 18, 2016 Diane J. Thompson Interim CNE, Michelle R. Nowicki, COO, Irene Kuwaki-Chuman, APL “FROM BETTER to BEST”

4. SCAL-KP Baldwin Park Presenters Diane Thompson, PhD, CNE - Introduction Irene Kuwachi-Chuman, Ambulatory Practice Leader Lisa Marcos, Research Liaison Denise Goodwin, Clinical Director Med/Surg/Tel - Research Don Estudillo, Clinical Director ED- Quality and Safety- ED Vuena Loyola, Charge Nurse M/S/T- Quality and Safety- NITC Sue Bailey, Clinical Director Periop Services- Quality and Safety: RN - Pharmacy and PACU Diane Thompson, PhD - Nursing Leadership Dahly Martin-Lovelace, Clinical Director Education - Professional Practice Council Judith Okoth, Department Manager M/S/T- NICHE Shirley Gardner, Clinical Director Maternal Child Health Reward and Recognition Diane Thompson, PhD - Conclusion

5. KP Baldwin Park VON- “From Better to BEST” Using the framework of the continuum of care we have been inclusive of all settings of nursing, including ambulatory, inpatient, population care management, and home health. This work is being synchronized across the Medical Center to bring about new vision for the professional practice of nursing through transformational leadership. Professional nursing practice contributes to the safe, effective care of patients through evidence based competent, collaborative expert care.

6. Shared Governance: Model, By Laws, & Charter Advisory Council Members Michelle Nowicki-COO Diane Thompson- Interim CNE, Irene Kuwaki-Chuman-APL, Elizabeth Hawkins-UNAC KPBP President, Denise Goodwin-Dir, Dahly Martin-Lovelace-Dir. Edu. Inpt, Charlette Ford-Charles-Dir. Edu. Amb Shirley Gardner-Dir., Felipe Garcia-Dir., Don Estudillo-Dir, Sue Bailey-Dir, Sharnette Ortiz-Dir. Amb, Cleo Barretto-Mgr, Fredelyn Williams-Mgr, Jonathan Bestwick-ED Charge Nurse, Denise Reyrata-Mgr, Celso Silla-III-Mgr, Lisa Marcos-Stroke Coordinator, Jay Soriano- Clinical Informatics Specialist, Michelle Pierce-PMI Bylaws, Charter

7. Ambulatory Council – IRENE KUWAKI-CHUMAN, APL

8. Ambulatory Council – IRENE KUWAKI-CHUMAN • Concept of Ambulatory Council being developed • Charter – to be defined • Membership- RN’s, Advanced Practice Nurses, and collaborate with support staff in the Ambulatory Setting • Current Work- • Daisy Reward Program, • Leadership Council, • Education – current 20% • Challenges – Nursing centric metrics • Research studies

9. KP Baldwin Park Recognition The DAISY Award was created to say “thank you” to nurses like you…

10. Inspiration: KPB Nurse Recognition: Quarterly Daisy Recipients Daisy recipients: Nurse Dulce Gutierrez, Marina Sepulveda, Mishari Zulueta, Center: Melissa Barnes, Daisy Foundation Vice President, Regional Program Director and Sister-n-Law to Patrick Barnes Daisy recipients: Nurse Kitty Chan, and Christina Concepcion

11. Research Council – LISA MARCOS, Research Liaison

12. Research Council Charter- defined • Membership: 6 managers, 1 staff RN, and 1 Regional Nurse Researcher Scientist • Established for approximately two years • Opportunity- addition of staff nurses • Current Work …

13. Research Team: Minimum Three Yearly Studies 2016 Studies include: Swallow Screen - Lisa Marcos: co-investigator. To establish inter-rater reliability among the medical centers and validity for the current nursing Swallow Screen tool in KPHC. Compassion Fatigue Study – Susan Bailey: co-investigator- Approved by the IRB and ready to start the survey in March 2016 Survey: Self-Reported Degree of Evidence-Based Practice for Registered Nurses in Southern California: Organizational, Unit, and Personal Factors Study-Dahly Martin-Lovelace: co-investigator. JAN Journal OF ADVANCED NURSING

14. Research Team: Minimum Three Yearly Studies 4. Mobility Ambulation tool validation: Felipe Garcia: co-investigator 5. GetWell Network- Denise Goodwin: co-investigator- Brochure submitted to Regional Research Council: The research questions for this study are: • 1. Were the psychometric properties of the Person Engagement Index instrument valid and reliable to measure the construct of a person’s capacity to engage in their healthcare? • 2. Which factors impact a person’s engagement index score? JAN Journal OF ADVANCED NURSING

15. Quality and Safety Council DON ESTUDILLO, Director Emergency Department

16. Quality and Safety Council Concept of Quality and Safety Council forming Subcommittees of this council include • ED Department • Membership includes ED • Current activities • Safety and Injury Reduction Program Related to Behavioral Health Patients • WPS – Lateral transfer task standardization • NITC- Nurse Initiatives and Technology Committee • Membership includes 8 staff nurses and 1 manager • Current activities GWN HC interface • RN pharmacy Committee • Membership includes 5 staff nurses 1 manager and 1 pharmacist • Current activities addressing workflow in narcotic waste documentation based on a risk identified • PACU Department

17. Quality and Safety Council- ED ED Subgroup Safety and Injury Reduction Program Related to Behavioral Health Patients • Staff training • Visual identification of risk • Green paper scrubs • Red hazard signs outside the door • Room checks • ED/Security collaboration • Annual training on de-escalation and safety

18. Quality and Safety- ED

19. Quality and Safety Council Subgroup: NITC- VUENA LOYOLA, Charge RN

20. Quality and Safety NITC Nurse Initiatives and Technology Committee Getwell Network is an Interactive Patient Care System (IPS) KEY: From the beginning of its inception staff has been involved with GWN decision making regarding workflow, educational videos clips, and input on how and when teachings are implemented. Tool for the patients, nurses, health care providers, to collaborate with the patients’ plan of care. Patient Education Videos and Medication- instruction. Patient immediate feedback. Documents in HC under Patient Education tab. Customized Patient Education Videos – eg. Bone and Joint surgeon instructional videos Patient food selection – Based on MD Diet order Patient Instructional pop ups, surveys, and staff paging alerts assist in improving patient care experience.

21. GWN: Medication Instructions as of Jan 2016

22. GWN: Medication Instructions as of Jan 2016

23. Quality and Safety Council: RN/ Pharmacy/ PACU Subgroups SUE BAILEY RN, Periop Director

24. Quality RN – Pharmacy Collaboration UBT RN representatives volunteer to collaborate with pharmacy to examine risks and workflow gaps. To establish and standardize nursing best practices and workflow processes. To act as conduit of information. To elevate the nursing practice. PACU – Improved patient safety. Redesigned workflow to include securing of multidose narcotic administration during post anesthesia care in the unit

25. Nursing Leadership Council Denise Goodwin, Director of Med/Surg/Tele

26. Nursing Leadership Council • Nurse Leadership Council developed • Charter – refocus and intergration • Membership- Managers- Inpatient • Opportunity for increased inclusiveness throughout the continuum of care. • Current Work • Share service scores • Professional Development for the Nursing Leadership • Professional Certification • KP Management curriculum • Policy and Procedure review • Resource review – financial and resource annual discussion and plan

27. Professional Practice Council DAHLY MARTIN-LOVELACE, Director of Education

28. Voice of Nursing Overview of Current Work VON: Introduction to our professional staff: 3 Workshops given by senior leadership well attended by charges, preceptors, educators, nursing leaders, formal and informal- To date 150 Registered Nurses have attended. • 2016- Classes held throughout year targeting 100% RNs both Ambulatory and Inpatient areas Interview tools in place for all new hires Visual branding used on communication tools. Enhancement of Nurse Recognition Program • Maternal Child Health Reward Recognition • Medical Center Wide Daisy Award Peer • Peer recognition Program based on 6 Values

29. Professional Practice Council • Professional Practice Council is in development stage • Charter – Charter and Bylaws developing • Membership- Nurse Managers, Staff RN’s, Advanced Practice Nurses, and Educators across the continuum of care • Current Work (subcommittee examples): • Education Plan • NICHE - Nurses. Improving. Care. for Healthsystem. Elderly. • Membership includes 5 staff nurses 1 manager and 1 pharmacist • MCH Patient Safety Program Committee • Membership- 5 staff RN’s, 1 Advanced Practice Certified Nurse Midwife, 1 Clinical Educator, 2OB Provider, 3 Managers • MCH Reward and Recognition • VON- Socialization and Peer Recognition

30. KP Baldwin Park VON Education Plan Ambulatory Clinic- Train all Ambulatory RN both at the Medical Center and the outlying MOB’s by end of 4th quarter 2016 ICU/MST/-Perinatal/Perioperative Services /ED Train all Inpatient RNs by end of 2016. Classes held throughout the months beginning end of March, 2016 Promotion of Specialty Certification by CNS, Advance Practice Nurses, and Clinical Educators

31. Professional Practice Council: Subgroup NICHE JUDITH OKOTH

32. : Nurses. Improving. Care. for Healthsystem. Elders. • Charter – Charter • Membership- Nurse Managers, Staff RN’s, Educators Pharmacy, Physician Champion, Palliative Care, RN Improvement Advisor • Current Work- • 6 weeks of intense training, • Acquisition of physician champion, pharmacy, Goal-Achieve systemic nursing change that will benefit hospitalized older adults Vision- Provide geriatric sensitive and exemplary care to all hospitalized adults 65 years and over Mission-Import principles and tools to stimulate change in the culture of healthcare facilities and achieve patient-centered care for older adults

33. Professional Practice Council: Subgroup SHIRLEY GARDNER, Director of Maternal Child Health

34. Maternal Child HealthPatient Safety Program Committee • Subcommittee of Professional Practice Council • Charter – refocused • Membership- 5 staff RN’s, 1 Advanced Practice Certified Nurse Midwife, 1 Clinical Educator, 2 OB Provider, 3 Managers, Current Work- • Drafting of Standardized Procedures for Labor and Delivery triage

35. Reward and Recognition SHIRLEY GARDNER , Director of Maternal Child Health

36. Maternal Child Health Recognition • Lollipop Moment • Present a lollipop to someone who said or did something significant and you never had the opportunity to go back and share with that person the impact it had on you that day. • Charge Nurse and Staff Recognition • Certificate presented based on input from leadership and peers • Round Table Recognition Focuses on Peer and Leadership recognition

37. Maternal Child Health Recognition Results as of February 2016 People Pulse Survey: Commitment : 97% Engagement : 96% Line of Sight : 90% For more information on High Performance Manager Webinar Series These 60-minute webinars introduce you to the high performance model and share specific actions that managers can take to promote high performance within their departments. https://epf.kp.org/wps/wcm/connect/be0bf25a-fc3a-4963-a588-1aff20047c80/PPulse_high_performing_webinar.pdf?MOD=AJPERES

38. Socialization and Peer Recognition- 1. Nursing Scope of Practice and Ethics Banners 2. 6 VALUES- Peer Recognition Cards P E P C I T 3. Nurse Leadership Rounding Cards Patient/Family-Centered Excellence Professionalism Compassion Integrity Teamwork

39. Conclusion- DIANE J. THOMPSON, CNE

40. Conclusion What we have learned… The VON is inspirational. Thank National for providing all of Kaiser with the vision, tools, and platform necessary to truly carry out ONE KP Nursing. Experiencing nurses who are practicing consistently with one vision is no small feet, but KP Nurses have stepped up to the challenge- greater than 50,000 strong. Here at Kaiser BP, nurses are eager and enthusiastic for new vision “From Better to BEST” during our Magnet journey. Using the framework of the continuum of care we have been inclusive of all settings of nursing, including ambulatory, inpatient, population care management, and home health. This important work is being synchronized across the Medical Center to bring about new vision for the entire professional practice of nursing through transformational leadership. Below is one of many stories of transformational leadership occurring at the bedside.

41. What We Have Learned…. VON is Inspirational Med/Surg Tele RN hired as new graduate in 2011. Within two years went back to school for her MSN/Ed. After 2015’s, VON inspiration, Monika recently accepted a position as adjunct faculty for Azusa Pacific University. She continues to practice as a bedside nurse here at KP Baldwin Park. When asked about her professional practice she pauses with thought… “I know where I am going, I like what I am doing, but I also love where I am. [Baldwin Park].”

42. Q & A

43. KP Nursing Pathways Website http://kpnursing.org/ Professional Nursing Practice: An Update ANA Code of Ethics Bookmarks KP Nurse Brand Statement Leadership Orientation Slide Deck

44. KP Nursing Pathways Website http://kpnursing.org/ Facilitator Guide Bookmarks Signature Block Thank You Cards Desktop Wallpaper

45. Voice of Nursing Accountability & SustainabilityPost 3 Day Strategy Planning Meeting Action Plan & Timeline (30 days post – Site to forward to NPCS) Check-In Call (3 months post – NPCS will contact site and schedule call) Gap Analysis Self-Assessment Tool (Tool located on Nursing Pathways website) Community of Practice Forums (Bi-monthly CoP Forums) Site Visit (Approximately 12 months post – NPCS will contact to schedule) Tools located: KP Nursing Pathways Website http://kpnursing.org/