Sunday, June 24, 2012

Title: Igniting Change in the Women's Service Line Through the Healthy Workplace Intervention

Woodrow Wilson (Gaylord National Harbor)
Patricia A. Cornett, EdD, MS, RN , Solúcion Associates, Canyon Lake, TX
Mickey Parsons, PhD, MHA, RN, FAAN , Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX
Angela A. Casias, MSN, BSN, RN , Women's and Preventive Health Services, University Health System, San Antonio, TX
Teri Grubbs, RN, BSN , Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX

Discipline: Professional Issues (PI)

Learning Objectives:
  1. To depict the innovative change method that empowers and reignites passion and commitment for excellence in patient care.
  2. To describe planning and implementation through the Healthy Workplace Intervention for inpatient and outpatient women’s’ and newborn care at University Health System.
  3. To delineate the future vision, strategies, process changes, and outcomes of an empowered interdisciplinary service line team.
Submission Description:
Purpose for the program:

To describe University Health System, Women’s Service Line, interdisciplinary planning process and outcomes to improve the inpatient and outpatient care of women. The Healthy Workplace Intervention (HWI) served as the planning method to empower clinicians, executives/managers, quality and business professionals to design a future vision--Health for Women. The innovative method reignites passion and commitment for excellence in patient care.

Proposed change:

The Healthy Workplace Intervention is a capacity-building process that promotes shared leadership, participatory change and empowerment. Through Future Search Conferencing, participants’ bridge differences in status, position power, work experience, gender and hierarchy by working as peers to achieve shared goals and fast action. This generative process incorporates the tenets of Appreciative Inquiry by amplifying positive anticipatory images of the future and the team defines the actions to actualize their future, measure the outcomes and ensure sustainability.

Implementation, outcomes and evaluation:

The participants identified a shared history of patient care and the current operational status of inpatient women’s and newborn care and the 12 Greater San Antonio clinic outpatient sites. Goals were to design seamless, coordinated care for women and to promote healthy families. Interdisciplinary communication, care coordination, and partnering with physicians were key strategies.

Outcomes include: 1) 10.5% increase in births through changing the process to identify women with positive pregnancy tests earlier and scheduling a clinic visit; 2) 100% of patients are now facilitated throughout  pregnancy and postpartum care by a redesigned Patient Navigator role to provide coaching and follow-up for appointments and education; 3) 56% decrease in newborn post-discharge visits to the nursery by collaborating with MDs and scheduling appropriate clinic visits; 4) Reduced patient clinic waiting times through the implementation of a pre-registration process prior to the clinic visit;  5) Enhanced team communication through the initiation of monthly service line meetings; and, 6)  Standardization of breastfeeding education; and, 7) Implementation of Mother/Baby Couplet care is in process.

Implications for nursing practice:

The implications are that the HWI builds relationships across the complex landscape of healthcare and empowers staff to lead and sustain positive change.

Keywords:

healthy workplace intervention, interdisciplinary service line team empowerment, organizational capacity-building