Improving Recruitment, Retention and Reimbursement by Strengthening and Promoting Nursng at Your Hospital

Are you read for ACA, CMS compare--don't lose your reimbursement. If you're not measuring nursing quality timeliness and effective care, statins, stroke education, discharge instructions. Voluntary at first, later will be tied to reimbursement. Are nurses trained on EMR, mandate for reimbursement, why not email, patient status, where family could submit information

Environment of hospital, bring it back to Nightingale

Medicare

Recruitment and retention is one of the

http://www.beyondintractability.org/bksum/fisher-beyondreason

Hospital Compare by Medicare http://1.usa.gov/1DuqYSm

Patients who reported that:

Nurses communicated well

Physicians communicated well

Received as soon as they wanted

Pain well controlled

Medicines explained before giving it to them

Clean bathrooms

Quiet rooms

They were given information about what to do during their recovery at home

They understood their care when they left the hospital

Hospital acquired infections

Death rate

Readmissions

Hospital-Acquired Conditions:

Falls and trauma, with 7,954 HAC-associated live discharges in FY 2009 and the first 10 months of FY 2010.

Deep vein thrombosis or pulmonary embolism (DVT/PE) following certain orthopedic procedures, with 4,195 HAC-associated live discharges in FY 2009 and the first 10 months of FY 2010.

Vascular catheter-associated infection with 5,167 HAC-associated live discharges in FY 2009 and the first 10 months of FY 2010.

Nurses should consider creating or enhancing websites to explain nursing, including the sites of their employers and professional groups. Websites are now the public face of an organization. Nursing schools often profile their faculty, letting the public know about professors’ credentials and interests. But it is still rare to find much about nurses on hospital websites, as we explained in chapter 10 in discussing the Truth’s 2012 analysis of the sites of leading U.S. hospitals.

Few websites highlight nursing care or the people who deliver it in any detail, much less the detail devoted to physicians. And site sections that do describe nursing seem to be aimed mostly at nurses themselves. For example, we have seen no websites that advertise a hospital’s Magnet status as a draw to patients—we have only seen it used as a nursing recruitment tool.
Massachusetts General Hospital’s site (www.massgeneral.org) does list the credentials of a small number of nursing leaders in some detail and it describes the work of many nursing teams, units, and programs. However, the descriptions appear with those of other non-physician professions under “Patient Care Services.” They appear to be directed at nurses rather than patients. And they are brief and bland, paling in comparison to the extensive, high-production-value promotion of the hospital’s medical departments, which boast about the qualifications and care of physicians. The site also has a page with links to information about the hospital’s Magnet Recognition, but little effort to make it comprehensible to anyone outside nursing; it’s hard to imagine a lay person spending time there.

Make sure that your institution’s website conveys to the public the key role nurses play in patient care. To develop a website, ask media relations professionals for help. You might profile each nursing service and individual nurses. The public should be able to learn who is doing the nursing, including the nurses’ educational background and credentials, as well as contact information so families and the public can get answers to their questions. Include headshots and contact information for each nurse, not just the top executives. What innovations have your nurses played a role in? Have their achievements been in the news or recognized by nursing groups? Explain how your institution is working to improve nursing care. Consider including photos, audio, and video. Be sure it is easy to get to the nursing material from the site’s main page. It may be more effective to integrate information about nursing in the site areas that promote the institution’s health field-specific institutes, centers, and departments—you know, where the sites tend to boast about their great physicians and suggest the physicians are doing or directing everything that matters—rather than in site areas labeled “nursing” or “patient care services,” where, let’s face it, members of the public are less likely to go. Some sites have a “Find a Physician” link from the main page. Consider adding a “Find a Nurse” link right next to it, so visitors can contact any nurse in the hospital.

Many people look for general health information on the Internet. Nurses can create websites to educate their patients or communities about health, and in doing so, illustrate nursing expertise. In today’s managed care environment, many patients get home after a hospital visit with little idea how to manage their conditions. They may not understand how to use their crutches, monitor their wounds, test their blood sugar levels, exercise, or avoid foods that put them at risk. Even when hospital nurses manage to give patients this information, patients may forget or simply be overwhelmed. The Internet can be a great way to fill this need and perhaps prevent future hospitalizations. If you do set up an informational website, consider becoming certified by Health on the Net Foundation, an international non-governmental organization that guides consumers to reliable health websites.

Electronic environment

Physical environment

Professional environment

Institutional Environment

Emotional environment?

Committees / Boards

Electronic environment

Website

Electronic health record

Physical environment

Signage

Structure of the floors

Parking spaces

Photos of hospital leaders listed on wall? Do they include nurses?

Professional environment

Is education about nurses included in physician orientation

Do physicians follow nurses in a shadowing program

Are M&Ms just for physicians?

Emotional environment

Decreasing violence and bullying, zero tolerance

People who throw scalpels go to jail

Committees / Boards

Nursing grand rounds

Are nursing committees fully funded and given power to effect change?

Continuing education for nurses--covered by hospital?

Patient satisfaction higher when nurses have a work environment in which they feel vallued

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores and other core measures in value-based purchasing will affect their payments.

"Medicare is very clear about this. Average performers won't break even"

Who matters? If the hospital's public face is that of physicians, and as patients travel through their hospital stay, they will experience a nurse-intensive stay they will be disappointed because they will feel as though they were ripped off, cheated because hospitals are supposed to be about physicians, right? That's

Medicare Surevey of patient experiences

Patients who reported that

they were given information about what to do during their recovery at home
they understood their care when they left the hospital
they would definitely recommend the hospital
who gave their hospital a rating of 9 or 10 on a scale from 0 (lowest) to 10 (highest)

Death rate for heart attack patients

Readmissions, complications and death

Website

Nursing leaders on the website held in similar esteem to others?

Magnet on the main page? Is it directed at patients or just used as a nurse recruting tool?

Staff nurses held in as much esteem as staff physicians

Magnet directed at nurses, not patients

No nurses linked from mail, about us, providers pages

Signage

Institutional Environment

Public relations professionals promoting only physicians?

Board of directors, any nurses?

Find a Doctor / Find a Provider

Are nurses important to your institution?

Do they do outreach in terms of health minutes, health education through a website? Are nurses creating these educational materials? Publications that are sent to the local community, do they feature nurses? Is health educational material written by nurses?

Is nursing depicted as gendered? (Getting makeovers for nurses week?)

Is nurses week all about teddy bears and candy, or does it honor real nursing achievement?

Forms / computer / papers

Nurse-friendly language on records, software and to the public?

Medical / health homes

Name of institution a "Hospital" or "Medical center"

Names of committees

Use of the word "resident" and "doctor" are they limited to physician?

Electronic health records, do physicians see nursing notes?

Maps internal and external, nursing deparments identified?

Explanation about nursing units, what type they are?

Staffing ratios listed every shift?

Nursing mix, pride in increased education?

Nursing CEUs matter?

Are nurses invited to committees?

Nursing research celebrated?

Do physicians or medical students have nurse shadowing days?

Is there a PR person just for nursing?

Each nurses face and bio appear on the website?

Nursing research and ideas promoted within and to the public?

Physician rounds done with nurses?

Nurses identified as such with badges? Are they pink?

Nursing uniforms look professional?

Artwork

Physician-only dining room

Physicians free food

Online or other videos aimed at the public or at health professionals

The public should be able to learn who is doing the nursing, including the nurses’ educational background and credentials, as well as contact information so families and the public can get answers to their questions. Include headshots and contact information for each nurse, not just the top executives. What innovations have your nurses played a role in? Have their achievements been in the news or recognized by nursing groups?

Explain how your institution is working to improve nursing care. Consider including photos, audio, and video.

Be sure it is easy to get to the nursing material from the site’s main page. It may be more effective to integrate information about nursing in the site areas that promote the institution’s health field-specific institutes, centers, and departments—you know, where the sites tend to boast about their great physicians and suggest the physicians are doing or directing everything that matters—rather than in site areas labeled “nursing” or “patient care services,” where, let’s face it, members of the public are less likely to go.

Some sites have a “Find a Physician” link from the main page. Consider adding a “Find a Nurse” link right next to it, so visitors can contact any nurse in the hospital.

Sandy Summers' biography

Rich Kimball's biography

Speaking engagement schedule

Contact Sandy by email ssummers@truthaboutnursing.org

Office phone 410-323-1100

Cell 443-253-3738