Nursing Leadership and Quality Safety

1. Nursing Leadership and Quality Safety Creative Implementation of Leadership Project Tracy Smith Frostburg State University Fall 2013

2. Module 1 - My Personality

3. According to the KierseyTemperment Sorter the INJF (my personality type) is grouped in the idealist temperament, specifically in the category of a counselor with the role of guiding.

4. “Counselors have an exceptional strong desire to contribute to the welfare of others, and find great personal fulfillment interacting with people, nurturing their personal development, guiding them to realize their human potential” (Idealist, 2013). It is thought that one’s personality is partially innate and partially developed based on environmental situations. Being a clinical nurse has helped in the development of my personality type and leadership style in the hospital setting. I believe the positive leadership/counseling character traits that I usually exhibit includes: -patience -good listener -compassion -empathy -encouragement -positive outlook -kind -nonjudgmental -authentic -concerned

5. Module 2- My Facility • ADULT SPECIALTIES: • Cancer • Diabetes & Endocrinology • Gastroenterology & GI Surgery • Geriatrics • Gynecology • Nephrology • Neurology & Neurosurgery • Orthopedics • Psychiatry • Pulmonology • Urology Meritus Medical Center is a general medical and surgical hospital in Hagerstown, MD, with 278 beds. It is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF). Data shows that last year 72,575 patients visited the hospital's emergency roomand it had a total of 16,206 admissions (Health, 2013). It is a level III trauma center.

6. Meritus Medical Center has a complicated organization of flow that begins with the chief executive officer and trickles downward to each individual employee. “Teams” are created, each with specific goals and responsibilities, but all with the same purpose: to improve the health status of the region by providing comprehensive health services to patients and families while relentlessly pursuing excellence in quality, service, and performance (Meritus Health, 2013). My unit’s collaborative team: Patient

7. My unit then collaborates with other units throughout the hospital. As a Resource Nurse I frequently communicate with the Staffing Office to plan for staffing the unit appropriately for the current and upcoming shifts. I also communicate regularly with my manager and the nursing supervisor of the hospital to discuss issues, both positive and negative. As part of this team it is vital that I: -Use professional conduct -Maintain a positive attitude -Use patience -Think before I speak -Actively listen -Advocate for staff and patients As a leader/coach on my unit it is vital that I: -Check in with each staff member to develop open communication -Ask questions and listen attentively -Advocate for my staff -Encourage staff to maintain a positive attitude -Assist staff when seeking assistance or information

8. Ethical and Legal Responsibilities as a Resource Nurse -Ensure standards of care per policies and procedures are followed -Stay within my scope of practice and ensure those I delegate to are as well -Seek the help of the patient advocate or ethics committee when needed -Maintain competency in my skills and assist others in maintaining theirs -Document appropriately and timely -Make nursing assignment based on the matrix and acuity level of patients to ensure appropriate nurse to patient ration for safety of the nurse and the patient Cultural Development within the Hospital -Availability of interpreters -Ongoing annual competencies -Literature reviews -Hiring employees of all cultures

9. Modules 3 and 4- Leadership Responsibilities/ Accountabilities Success in the work setting begins with the leadership. Shared and Transformational Leadership Meritus Medical Center management endeavors to: -support and encourage continuing education of staff -commit to excellence in patient care -inspire all those employed to achieve quality -motivate each individual to do best quality of service -maintain and promote a positive attitude and outlook -develop strong interpersonal relationships in shared leadership -continually seek advancement and improvement in technology and care -strive to create collaborative teamwork in sharing responsibilities -promote a sense of vision to provide excellent quality care -foster, develop, and empower each employee -maintain a good relationship with the community

10. Transformational Leadership As a nursing leader I endeavor to: -commit to excellence -inspire -motivate -maintain a positive attitude and outlook -develop strong interpersonal relationships -support changes in improvement -strive to create collaborative teamwork -promote a sense of vision -foster, develop, and empower followers -go above and beyond when possible

11. Regulatory and Accrediting Agencies over Meritus Goal: to improve safety and quality of care to patients -Medication Safety -Identify Safety Risks -Prevent Surgery Mistakes Joint Commission Meritus Medical Center • - Continually Improve Services • Encourage Feedback • Optimal Outcomes • Serving the Community

12. As a nurse leader on a rehabilitation unit I am part of a collaborative team that strives to maintain a certification awarded by the Commission on Accreditation of Rehabilitation Facilities (CARF). We provide consistent quality patient care that CARF supports and mandates for certification renewal. • The Mission • “The mission of CARF is to promote the quality, value, and optimal outcomes of services through a consultative accreditation process and continuous improvement services that center on enhancing the lives of persons served.” • The Vision • “Through responsiveness to a dynamic and diverse environment, CARF serves as a catalyst for improving the quality of life of the persons served.” • The Core Values • “-All people have the right to be treated with dignity and respect.” • “-All people should have access to needed services that achieve optimum outcomes.” • “-All people should be empowered to exercise informed choice.”

13. Meritus’s Forecasting: As the only hospital in Washington County, Maryland, Meritusaims to provide safe and quality care to members of the community that are in need of medical care. Meritus forecasts these community needs will continue to be met while the hospital also seeks to continue to improve and advance in multiple areas. Meritus Medical Center is actively pursuing: -Magnet status in nursing -All nurses holding a Bachelor’s degree in nursing -Total electronic charting -State of the art diagnostic imaging -Electronic scanning for safety in medication scanning -Bedside end of the shift reporting for nurses -Maintain Trauma Center rating -Achieve Stoke Center certification -Decrease the turnover rate of employees -Maintain financial stability

14. Module 5- Return on Investments Meritus’s Strategies in Marketing and Recruitment In following the “4 P’s of marketing”:

15. Retaining and Motivating Employees Employees are the biggest asset to the hospital “Attract good people, retain the better ones, and advance the best!” Support and encourage: Independence Authority Flexibility Learning Having Fun Invest in them: Actively listen to them Respect them Show appreciation for them Give perks Give due pay raises Provide educational opportunities Support requested time off

16. Human Resources at Meritus “The field of health human resources deals with issues such as planning, development, performance management, retention, information, and research on human resources for the health care sector. In recent years, raising awareness of the critical role of HRH in strengthening health system performance and improving population health outcomes has placed the health workforce high on the global health agenda” (Health, 2013). Function of Human Resources (HR) • Oversees each department’s functions utilizing strong communication skills and decision making capabilities in: • -compensation • -benefits • -training and development • -employee relations • -recruitment and selection in hiring

17. Flow Chart in Communication in Nursing Reasons to report: -Staffing updates -Issues in patient safety staff safety incidents an event an occurrence computer system patient care ethics -Patient admissions -Patient discharges -Patient dissatisfaction -Errors -Utilizing resources

18. Module 6- Disaster Preparedness/Critical Issues Natural and Man-Made Emergency/ Disasters that Meritus must be prepared for potential: -floods -tornados -fires -epidemics or pandemics -building or bridge collapse -toxic spills -explosives -mass casualty motor vehicle accidents or shootings Meritus has policies and procedures located on the hard drive of each computer available for each staff member to access and if the computer network is down, each manager has a hardcopy of the policies. The emergency operations plans (EOP) were influenced and developed around the Joint Commission guidelines in activation response, communication plan, patient care coordination plan, security plan, traffic flow plan, data management strategy, and in making sure resources are available. A telephone tree is in place for unit clerks to initiate calls if needed.

19. Nurses being prepared For disasters The National Emergency Preparedness Education Coalition has established core competencies for nurses so they may be prepared. These include: -critical thinking where the nurse must be able to prioritize and demonstrate good clinical judgment. -self and situational assessments of physical and emotional injury -technical and therapeutic skills and treatments -effective communication with patients and staff STAY COOL AND CALM!

20. Networking for Nurses at Meritus Nursing Supervisor Resource Nurses CNO Tech support Doctors Administration Social Workers Ethics Committee Chaplains PATIENT Security Staffing Office Unit Managers Patient Advocate Laboratory Surgery Center Blood Bank Operating Room HR Radiology Respiratory Therapy

21. Keeping Current on issues

22. Plan for Succession My hospital recognizes the need for training in order for one to be adequately prepared for a position. I currently precept and mentor nurses to share my position to be able to take turns to prevent burnout. I make myself available to be a “go to person” if needed. Plan for Retirement I believe I am still in the middle of the “Momentum” phase of my career where I am continuing to learn and grow while developing experience and building leadership abilities. I am content in my current position as it fits in with my family life, though I have considered becoming a nurse educator, whether in a hospital or at a university. And that would mean I would need to put pursuing a Masters in Nursing Education next on my list. “The best way to predict the future is to create it”

23. References Amer, K. S. (2013). Quality and Safety for Transformational Nursing Core Competencies. Upper Saddle River: Pearson Education Cooperation. CARF's mission, vision, core values, and purpose. (2013, December 12). Retrieved from CARF International: http://www.carf.org/About/Mission/ Health Human Resources. (2013, December 15). Retrieved from Wikipedia: http://en.wikipedia.org/ Idealist Portrait of the Counselor (INFJ). (2013, September 8). Retrieved from Keirsey.com: www.keirsey.com/4temps/counselor.asp Jung Typology Test. (2013, September 8). Retrieved from Humanmentrics: http://www.humanmetrics.com/cgi-win/JTypes2.asp Management. (2010, September). Retrieved from Express Healthcare: http://healthcare.financialexpress.com/ Meritus Health. (2013, October 12). Retrieved from Meritus Health Our Mission and Vision: http://www.meritushealth.com/About-Meritus-Health/Mission-Vision.aspx Sullivan, E. J. (2013). Effective Leadership and Management in Nursing. Upper Saddle River: Pearson Education Inc.