retuRN to Care R2C & TCAB

1. retuRN to CareR2C & TCAB ARMC Nursing Retreat Annelle Beall & James Shrum August 28, 2008

2. retuRN to CareTMaka R2C Overview Annelle Beall August 28, 2008

3. What is retuRN to Care™? • Focused work speeds implementation of leading practices that: • improve medical-surgical patient care • improve nursing and patient satisfaction • increase the time that nurses have for direct patient care resulting in better patient outcomes

4. Our Goal with retuRN to Care: Make medical – surgical inpatient care safer, more reliable, and more focused on the patient.

5. VHA identifies the best way to deliver care and replicates it five thousand times.

6. A VHA Rapid Adoption Network… 8 Steps Make a Difference

7. Participation in a VHA RAN • It must be supported by the CEO to assure senior leadership support • All CEOs in VHA Ga. have signed off on R2C • Mr. Drew in full support • RetuRN to Care must have CNO support • -- VHA Ga. CNO Council supported at January 2008 meeting • -- Here today! • A Blueprint is available on the Leading Practice Portal (LPP). -- ARMC selects a model. • A Gap Analysis exists on the LPP to determine improvement priorities. ARMC will have to do the gap analysis. • In addition to Blueprint info, hospital specific CORE Measure or National Patient Safety Goal addressed. These are available now.

9. Return to Care™ VHA TV Series& Conference Calls The Business Case for Nursing Wednesday, March 26 12:30 – 1:30 p.m. ET Return to Care™: Leadership and Culture Better Practices Tuesday, April 15 12:30 – 1:30 p.m. ET Return to Care™: Med-Surg Better Practices Wednesday, May 28 12:30 – 1:30 p.m. ET Return to Care™ Straight Talk call #1 Wednesday, June 11 12:30 – 1:30 p.m. ET Return to Care™: Patient Satisfaction Wednesday, August 20 12:30 – 1:30 p.m. ET Facilitating Change at the Bedside: Making it Happen Wednesday, September 24 12:30 – 1:30 p.m. ET Return to Care™ Straight Talk call #3 Wednesday, October 1 12:30 – 1:30 p.m. ET

10. Leading practices with proven results for enhancing medical-surgical nursing care: The Blueprints

13. Relationship-Based Care • Relationship-Based Care is a delivery system in which the patient and family are the central focus. • The nurse and other members of the health care team strive to understand what is most important to the individual patient, and actively engage them in all aspects of care • It is a culture that supports caring & healing • Based on PRIMARY Nursing (not simply “total patient care”)

15. R2C Top Enablers Front Line Staff Drive Change ●●●●●●●●●●● Overarching Quality Strategic Plan ●●●●●● Hourly Nursing Rounds ●●●● MD/RN Unit Team Collaboration ●●● Streamlined Documentation ●●● Quality Process is Multi-Disciplinary e.g. IT, HR, Finance, Facilities, Nursing, Ancillary Areas ●● Nurses Realize More Time With the Patient Reduces Adverse Events ●● Cell Phones for Physician Callbacks ● Organization Pushes Envelope For Quality ● Relentless Attention to Patient Care ● Strong Medical Leadership & Code of Conduct Enforced ● Shared Governance ● Ownership & Accountability at the Front Line Level ●

16. Implementation • Selection of model • Pilot the model on Nephrology unit • VHA Georgia planning meeting in November • units throughout the state come together • PDAs used to collect data from nurses • Each nurse carries PDA that alarms at pre-determined intervals • Nurse selects what function is being done at that moment

17. Implementation (continued) • Data collected for one year • Sustainability demonstrated • Rolls out to other med/surg units • No time line for implementation throughout the Med/Surg service line

18. Thank You LilleeGelinas RN, MSN, FAAN Vice President and Chief Nursing Officer, VHA Inc. Karen Dunn RN, MBA

19. Are you ready to make a difference in medical surgical care?