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The Ishikawa Diagram From the Perspective of the Fish. Celeste Chamberlain, BSN, MS Director, Clinical Quality Improvement St. Christopher’s Hospital for Children February 23, 2011. This Evening’s Journey. Review shared professional experiences
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The Ishikawa Diagram From the Perspective of the Fish Celeste Chamberlain, BSN, MS Director, Clinical Quality Improvement St. Christopher’s Hospital for Children February 23, 2011
This Evening’s Journey • Review shared professional experiences • Apply a quality methodology to my professional growth and development • Offer insights for application to help you develop a personal strategy for accessorizing your fish
Cynthia Wollman ParenteBeard LLC Sharyn Mlinar The Boeing Company Celia Berry Milton Roy Company American Society of Quality February 23, 2011 Celeste Chamberlain St. Christopher’s Hospital for Children
ASQ ASQ ASQ ASQ
American Society of Quality February 23, 2011 Professional Experience Education Teaching Leadership Certifications Quality Training Attitude/Philosophy
What if the Ishikawa fish could speak? What would she say about you…. about your company?
www.hospitalcompare.gov IBC Pay for Performance
Celeste Chamberlain, 1971 - 2011 Fill in your name, ???? – 2011 and beyond Back to the Future
Little Known Quality Formula SC3 Self-Confidence ContentCompetence Keep this in mind as you accessorize your fish…
0 B.A. A.D. B.S.N. M.S. 4 degrees below zero PhD (2012) 5 degrees below zero!!!
Education • B.A. Liberal Arts: Boston University 1971 • French teacher • No jobs (worked in ED as ward clerk) • A.D. Nursing: Lasell Jr. College 1975 • Aspiration: Emergency Department nursing • No jobs • Moved to Baltimore to work at Johns Hopkins Hospital (they had jobs!)
Education • B.S. Nursing: University of Maryland 1979 • This one was a “gotta” • M.S. Emergency Health Services: University of Maryland 1986 • Found this in the white pages • How’s that for a thoughtful decision?! • PhD. Candidate, Management: Walden University (online) 2008 - ??
Clinical Experience • Staff nurse: 1975 - 1986 • Emergency department • Level 1 trauma center • Critical care • Intensive care, coronary care • Cardiothoracic surgery intensive care • Post anesthesia care (recovery room) • Clinical Nurse Specialist (1986 – 1989) • Emergency and Critical Care nursing
Leadership Experience • Nurse manager, Emergency Department (1977 – 1979) • Director Emergency Department/Level 1 Trauma Center (1990 – 1998) • AHERF system bankruptcy, 1997 • 8 hospitals “on the auction block” • Tenet purchase/rescue of the Philadelphia health system • “Opportunity” in quality language 17
Leadership Experience • Director Quality Improvement (1999 – 2011) • Major change • Adrenalin driven ED to “desk job” • Quality experience: ED process data/analysis • Able to stay at MCP • Challenges • IS systems gone (with bankruptcy) • Needed to rebuild the program • New to the formal quality role (low on SC3) 18
Leadership Experience • More “opportunities” • Reorganizations and staff reductions • Assumed other organizational responsibilities • Director Medical Staff Office (2001 – 2007; 2009 - 2011) • Director Regulatory and Accreditation Compliance (2003 – 2011) 19
Leadership Experience • Still more “opportunities” • Hospital closure announcement 2003 • Hospital changed hands, 2004, then closed for good, March, 2005 • Director Risk Management (2004 – 2007) • Enough “opportunity” already • Reorganizations and staff reductions • Hospital sold 20
Teaching 1986 - 2011 • CPR, ACLS, PALS, NALS • Provider and Instructor courses • Affiliate faculty, American Heart Association • Critical Care Course (developed and taught) • Adjunct Faculty • Thomas Jefferson University • Hahnemann University
Teaching 1984 - 2011 • Guest Speaker • Holy Family University • Acadia University • National and Local Lectures • American Healthcare Institute • American Association of Critical Care Nurses • American Association of Post Anesthesia Care Nurses 23
Related Experience • Medical/legal expert witness (1995 – 2011) • Textbook reviewer: Emergency Nursing • Article publication: case study Tetanus • All measures of SC3 24
Certifications • Emergency Nursing (1980…) • Critical Care Nursing (1990….) • Six Sigma (2007) • Certified Professional in Healthcare Quality (2008)
Awards/Recognition • Nurse Manager of the Year, 1996 • Emergency Nurses Association • Instructor Excellence, Advanced Cardiac Life Support • National Institute of Emergency Care • Meritorious Service • Second Alarmers Association and Rescue Squad • Volunteer of the Year • Medical Education Care Associates • Honor Society of Nursing • Hahnemann University Hospital
Role Models/Mentors • When you are young – align yourself with older, smarter people • When you are old – associate yourself with young, smart, motivated people • Energy • New ways, perspectives • Be a mentor for others
Thomas Jefferson University School of General Studies Emerging Alumni Award, 2010
Mentor Colleague Sounding Board Gentle Critic Oh yeah……Husband!
Thanks to my Mentors for: • Mom and Dad: paying for a college degree I never used • Cheryl: Learn from the Hamster of Happiness • Susan: Always know the name of the person that cleans your office • John: SC3; The technique of tact • They are all “ceiling dwellers”
It’s About Decisions • Prospect theory of decision making • V=Σ(IIi vi) • V = The overall value • II = Decision weights • v = Consequence values • i = Outcomes
Shared Decision Challenges • Which graduate degree is right for me? • Strategic career decisions • Professional goals and personal philosophy • Promote quality • Drive social change • Expand your scope of influence
Decision Points • Initial aspiration: ED nurse – save lives! • Reasons for change/graduate school • Burnout • Shift work, weekends, holidays • Narrow focus versus expanding experience • Expanded clinical/organizational scope • Retirement “jobs”
Develop a Personal Methodology/Strategy • Create your personal Ishikawa diagram • Accessorize your fish with experiences that will help you achieve your goals • Develop your own SC3 factor • Conduct a personal SWOT, PEST • Plan for contingencies • What ifs, now what?
Recognize Signs of “Opportunity” • Those within your control • Current trajectory • Ceiling of growth • Possible stagnation • Possible burnout • Those beyond your control • Layoffs, closures, restructuring, etc. • Better to be the one left behind?
Final Thoughts • Accessorize your fish • Influence your own future even if your cannot always control it • Be ready for unsolicited “opportunities” • Take advantage of great resources like ASQ • Professional support network • Expand your horizons and……