Diane DiFiore submitted this information about Oakwood’s nursing assistant program based on the RROHC program.  This has put new vitality into their teams! We are proud of what Diane and her organization has done!

OAKWOOD HEALTHCARE SYSTEM ROC AMBASSADOR PROGRAM Oakwood Healthcare System is the first healthcare system in southeast Michigan to implement Relationship Oriented Care (ROC) – “a philosophy and method of delivering care combining patient and family-centered communication with high-impact team practices to create positive health outcomes”  (Hansten) based on Hansten Healthcare’s RROHC program. As an extension to the Registered Nurse ROC Specialist certification, the ROC Ambassador Program was created for unit-based Nursing Assistants, ED Basics/Assistants and Mental Health Workers. Employees complete the application to participate and submit this to their unit manager for approval. The program’s purpose is to facilitate support of ROC, raise awareness and attention around ROC values, and educate these ambassadors about ROC fundamentals in order for them to become an example for their unit and beyond. This is a voluntary option for Nursing Assistants, ED Basics/Assistants and Mental Health Workers and includes two paid hours of ROC class, along with 4-6 hours of unpaid self-study, and 90 minutes paid time for participating in one of the ROC Site Advisory Meetings. Upon completion, the Nursing Assistant, ED Basic/Assistant or Mental Health Worker receives a ROC certificate and a badge identifier as a ROC Ambassador. The ROC Ambassador Program was developed through feedback received from an online ROC survey. A Nursing Assistant requested to be more involved in the ROC program through ROC certification. Since the ROC certification is limited to nurses, this idea sparked Oakwood’s pursuit of creating the ROC Ambassador Program for support staff. Approval from two unions was needed before moving forward. Each union received this request very positively and supported Oakwood’s initiative. A team of three ROC Specialists created the contents of the program addressing teamwork, communication, and delegation. The program is presented in two segments. The Overview Session gives the employee an understanding of ROC and the contents of the portfolio. Celebration is the second session discussing their learning’s as well as celebrating their accomplishments. A festive theme with balloons, cake, and a photographer make each celebration event special! Additionally, the support staff attend one ROC Site Advisory Meeting which now has both nurses and support staff at the table discussing ROC themes. A much richer conversation is occurring while recognizing the importance of all healthcare employees and their contribution to ROC implementation. Oakwood is offering three sessions annually (winter, spring and fall). In the first two sessions offered in 2010, Oakwood has graduated 35 support staff! One Nursing Assistant who is a recent ROC Ambassador graduate stated that this program changed her life. She feels much more valued and respected as a team member of her unit. Kudos to ROC!

Please join me in congratulating Margaret Orn, MS, RN, CCRN, PCCN, Education Coordinator at Harrison Medical Center, Bremerton, Washington!  Margaret authored an article, “Impact of Incorporating a Patient-Centered Care Model,” which appears in the current issue of  Journal for Nurses in Staff Development, Volume 26, Number 4, 164-169.

In the article, Margaret describes a program that educates nurses to use the RROHC concepts to increase patient and staff satisfaction and decrease nurse turnover.

If you’re a JNSD subscriber, you can download a copy of Margaret’s article here.

In Nurse Leader, June 2010, Steven Shaha, PhD, DBA, reveals research that quantifies predictive relationships with nursing care, financial success, and satisfaction for both nurses and inpatients.  This study shows that when nurses have developed efficient and effective care models that reflect understanding of the patient’s actual needs, there are positive effects.  Sounds like RROHC to me!

Key: AMI:  Acute Myocardial Infarction, HF, Heart Failure, CAP, Community Acquired Pneumonia 

The Impact of Nursing Care on Patients:

1. As smoking cessation counselling rates increased for AMI, HF, and CAP, so did inpatient satisfaction. 
2. As pneumococcal vaccine rates improved, so did patient satisfaction. 

The Impact of Nurses on Organizational Performance:

1. As smoking cessation counselling rates increased, supply costs decreased for AMI patients.  Supply costs also correlated with shorter LOS (length of stay).  (attentive to patient’s actual individualized needs?)
2. For CAP patients, supply costs decreased as timing and appropriateness of blood cultures improved, and timing and activity levels for antibiotics improved (p. 38)

The Effect of Organizational Success on Nurses:

1. As labor costs fell, nurse satisfaction improved.  (Could this be due to more confusing, inefficient environments mean less satisfaction and more overtime?)
2. Financially healthy organizations experienced less nursing associate turnover.  (Is this because the organization is spending fewer hours on hiring, firing, retraining?)
3. As average LOS decreased, perceptions of attention to the needs of associates improved.  The author intuits that “improvements in care processes and standardization of care result in shorter LOS; predict greater associate engagement,  involvement, and ownership; and reflect higher perception of the associates needs being met.” (p 38)

The Effects of Organizations Financial Health on Patient Satisfaction

1. As paid hours of nursing increased, inpatient satisfaction improved.
2. Nursing productivity correlated with patient satisfaction.  (Busy and attentive nurses perhaps?)
3. Lower supply costs predicted better patient satisfaction.

“Nursing Makes a Significant Difference: A Multihospital Correlational Study”

 Knowing your patients well enough to be able to address, or at minimum, refer a patient to explore the patient’s spiritual needs,  will affect the last days of  incurable diseases patients.  The Dana Farber Cancer Institute found better quality of life at the end of life when spiritual needs are discussed, and often patients do not ask for aggressive medical care.   This study appeared in the December 2009 online version of Journal of Clinical Oncology.  Well-being scores averaged 28% higher in this study of 343 patients. 

From Janice Simmons, December 17, 2009 Healthleaders Media, Recognizing Patient Spirituality Could Improve Quality of Care.

“How to Thrive Under Pay for Performance: Leading Home Care Organizations toward Patient & Family Outcomes and Quality Results” was presented for the first time to a national home care agency audience on June 16th.  Ginny Kenyon, RN MN, from Kenyon HomeCare Consulting, Ruth Hansten RN PhD FACHE, and Linda Pullins RN MS were faculty for this presentation.   We discussed how to use RROHC principles for home care, and our RROHC home care bundle of best practices and a RROHC home care indicator tool were provided.   Contact Kathy.Watkins@hansten.com for PPT slides.  We know that home care will be a prime focus in healthcare reform and we expect more home care agencies to use RROHC as a model.  Linda Pullins shared the excellent results at the Marion Home Care agency that she led.   More to come from home care!
Ruth

Welcome back everyone! Hacking  has been deleted from our websites (www.Hansten.com, and www.RROHC.com) andour blog is back functioning thanks to our wonderful support team!  Thanks to Jim at Newwebtech, his team, and of course Kathy and Marcie.  We appreciate  your assistance!

Thank you! Ruth Hansten and the RROHC faculty

This is a test of the RROHC blog.

Norwalk Hospital has been recognizing nurses for their dedication. Many times nurses need to get  an incentive to keep going up the way to achieve the best . At the same time, is a way to remind to the rest of our colleagues that our performance is recognized.

Suzi Waddill-Goad led our nursing salon over pizza and beverages to describe the impact of leadership principles in actual case studies.   As you can see, all were rapt as they listed to Tales from the Field.  The RROHC Intensive facilitators rated Suzi’s input as one of the most enjoyable of the retreat! Thank you Suzi for joining us!
Ruth and Kimberly