Developing a Compact

1. Developing a Compact Rhonda Wyskiel, RN, BSN Armstrong Institute for Patient Safety and Quality Feb 27, 2014

2. Before I had time • Interested in patient safety • Worked on a few QI and research projects • Saw difference nurse input could make on key decision making • Kept doing little things • Became a safety wizard on the unit

3. Calling it “non-productive” time is a symptom of the problem I asked for more time My nurse manager could not give it to me

4. Interested but didn’t have mechanism Not sure how to approach Had to do work above clinical work Tried to engage those who felt the same way Tipping point: Found patient safety fellowship and was asked to apply

5. It may not feel like it but we are supported • IOM’s 2010 report: The Future of Nursing: Leading Change, Advancing Health • Addresses patient safety • RWJF Initiative on the Future of Nursing • Recommendations to transform the nursing profession to better meet the nation’s healthcare needs, including: • Nurses to assume more leadership responsibility in the redesign of our healthcare system • Need leadership support too

6. How did I take this leap of faith? Draft proposal Share with nurse manager – her thoughts Take to department leadership – buy in

7. What the role became and encompassed • The kind of work I did • Implemented CUSP • Sustainability plan for new hires • Regular cycle for identifying and learning from defects • Engaged staff beyond nursing • Worked closely with CNS and HEIC to understand and affect infection rates through unit-based interventions • Encouraged staff members to submit posters and learn to write manuscripts to share their work

8. Who I connected with • Attended meetings at the department and hospital level • SME, COC, HEAT, Risk PSC • Gained insight to who was tasked to address which issues • Connected with media and internal communications to share successful innovations and lessons learned

9. In the midst of budget cuts • My role was protected because value was seen • Building a legacy plan • When I leave this position, who will continue • Challenges in spreading this to other units • Leadership support and buy in

10. Roles that look like this • Patient Safety Officer • Clinical Communities Charter • Physician Compact • Unit-based quality nurse • Successful implementation of a unit-based quality nurse to reduce central line-associated bloodstream infections Kerri A. Thom, Shanshan Li, Melissa Custer, Michael Anne Preas, Cindy D. Rew, Christina Cafeo, SurbhiLeekha, Brian S. Caffo, Thomas M. Scalea, Matthew E. Lissauer American Journal of Infection Control (2013)

11. No silver bullet No one way to do this

12. What can you do? • Do you have an opportunity to do a patient safety fellowship or internship in your organization? • If not suggest they try it with you. • Creative ways for funding: women’s board, private donor money, department budget • Robert Wood Johnson Foundation supports nursing programs that fund scholars in patient safety • http://www.rwjf.org/en/about-rwjf/newsroom/newsroom-content/2011/04/nurses-are-key-to-improving-patient-safety.html

13. Discussion