Nursing Department Improves Quality and Patient Satisfaction With Culture Change

Rebecca Hendren, for HealthLeaders Media , November 17, 2009

One tactic used to engage nurses was having staff decide the department's vision statement. "We had a small team that went out and held brainstorming sessions about our vision," says Chris Ruder, vice president, patient care services. "These sessions were held during day, evening, and night shifts to really capture what the staff throughout the organization thought it should be."

The team collated all the statements, which encompassed hundreds of ideas and areas that nurses felt strongly about, and the results were voted on by the whole department. The result was a vision statement that Ruder says is truly about all of nursing at the hospital.

Once the departmentwide statement was decided upon, each unit crafted a personal vision statement that encapsulated the unit's ethos.

The sixth part of the department's strategic plan related to quality. The hospital was an early adopter of the rapid response team concept and it has tracked data for more than 3,000 rapid responses since its inception. The RRT is staffed by the medical intensive care unit, and it has played a significant role in the hospitalwide low mortality rate.

One of the most nurse-friendly initiatives the hospital undertook as part of the commitment to quality improvement was to create a nursing resource center. Now nurses have somewhere they can go when they need a quiet space to study for professional certification, a computer to research the latest evidence-based practices, or a conference table to bring people together. The nursing resource center is a room dedicated solely to nurses' use and equipped with comfortable chairs, audiovisual equipment, professional journals, and computer access.

"It is funded through an endowment that nurses and others donate to," says Peterman. "[We] have money taken out of our checks each month to support the nursing resource center. So it's really a nursing resource center supported by nurses."

This center is an example of the commitment to nursing excellence that turned the culture around. The plan helped the organization achieve patient satisfaction rates in the 91st percentile, an impressive turnover rate of around 10%, and a committed and engaged staff.

"On almost all the metrics that you would consider important, we as an organization are doing well and we righted the ship in terms of where we started and where we are today," says Peterman.

Rebecca Hendren is a senior managing editor at HCPro, Inc. in Danvers, MA. She edits and manages The Leaders' Lounge blog for nurse managers. Email her at

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