Nursing Annual Report - Akron General Medical Center

2010
Nursing Annual Report
Pursuing Excellence
Transformational Leadership
Structural Empowerment
Exemplary
Professional Practice
New Knowledge, Innovations
& Improvements
Empirical Quality Outcomes
www.akrongeneral.org

TABLE OF CONTENTS
Letter from the Chief Nursing Officer ........... 2
Transformational Leadership
Quality of Nursing Leadership ....................................... 3
Management Style ........................................................ 4
Structural Empowerment
Organizational Structure ................................................ 6
Personnel Policies and Programs ................................. 6
Community and the Healthcare Organization ............... 7
Image of Nursing ........................................................... 8
Exemplary Professional Practice
Professional Development ............................................ 9
Professional Models of Care ....................................... 10
Consultation and Resources ....................................... 11
Autonomy .................................................................... 11
Nurses as Teachers ..................................................... 12
Interdisciplinary Relationships ..................................... 12
New Knowledge, Innovations & Improvements
Quality Improvement ................................................... 13
Empirical Quality Outcomes
Quality of Care ............................................................. 14
Pursuing Excellence .......................................... 15
Editor: Anita Sanford, MSN, RN, NE-BC
Director, Nursing Special Operations
www.akrongeneral.org

Transformational Leadership
Structural Empowerment
Exemplary
Professional Practice
New Knowledge,
Innovations & Improvements
Empirical Quality Outcomes
1 Akron General

Pursuing Excellence
Dear Nursing Colleagues:
Thank you for another great year that demonstrated the
commitment to excellence that the nurses at Akron General
consistently deliver to our patients and our community. This
commitment resulted in exceptional patient outcomes and
produced a safe healing environment for our patients.
The 2010 National Research Corporation (NRC) Market Guide
Study in Summit County ranked Akron General number one in
28 of 31 indicators. I am confident that our nursing staff directly
impacted those results in the following areas:
• Best nurses
• Top of mind (which hospital comes to your mind first)
• Most personalized care
• Highest patient safety
• First choice in all healthcare needs
• Best quality care
Please take a moment to review the many accomplishments of our
Nursing Department in 2010, including:
• High quality patient outcomes
• Revised Shared Governance structure
• Caring Connections workshops
• Low nursing turnover rates
• Grand opening of our Operation Center
These and other achievements, advances, contributions, and
innovations are described in detail in the enclosed report. Through
the commitment and dedication of our nurses we have enhanced
professional nursing practice and improved the lives of our patients
and community.
Congratulations to our nurses on a “Year of Excellence!”
Thank you for all you do for our profession.
Respectfully,
Beverly Bokovitz, MSN, RN, NEA-BC
Senior Vice President, Chief Nursing Officer
2010 Nursing Annual Report 2

Transformational
Transformational Leadership
FORCE 1
Quality of Nursing
Leadership
Sigma Theta Tau International
Excellence in Nursing Award
Each year, this recognition is given to an
individual who has demonstrated strong
nursing leadership and vision for the
growth of the nursing profession. The
2010 recipient was Deb Pisciotta, MSN, RN,
CNS-BC, Trauma Clinical Nurse Specialist.
(pictured top left)
Denise Myricks, MSN, RN, ESRI, was
appointed a member of the National League
of Nursing Accrediting Committee.
(pictured top right)
Beverly Bokovitz, MSN, RN, CNO, was
the recipient of the Women of Achievement
Award, Open M Leadership Award and
Crain’s Cleveland Business Health Care
Hero Award. (not pictured)
Karen Mascolo, MSN, RN, Director,
Professional Practice was appointed to
Sigma Theta Tau’s Board of Directors.
(pictured bottom right)
Diabetes Walk
3 Akron General

Leadership
“The right patient in the right bed,
the first time, as quickly as possible”
Management Style
Bev’s Blog
The blog was created to enable vertical and
horizontal communication. In 2010, there were
more than 460 comments, 20 topics and more
than 100 changes implemented as a result
of the blog.
Operation Center (pictured below)
“The right patient in the right bed, the first time,
as quickly as possible”
In 2010 the Operation Center (OC) and the
Discharge Desk were developed to improve
throughput. All direct admissions, ED and
surgical patients are assigned a bed through the
OC, 24 hours a day/seven days a week. The OC
is composed of RNs and admitting clerks. The
discharge coordinator scans all armbands of
discharged patients between 11:30 am and 8 pm.
This process improves throughput by alerting the
OC RNs when a bed is available. Since April 19,
2010, nearly 7,000 armbands have been scanned,
thereby reducing clean bed wait times!
Unit-Based Councils
Akron General completed Waves VI & VII of the
Relationship-Based Care (RBC) Initiative. All units
are now live with RBC have a unit-based council
responsible for the implementation of RBC and
primary nursing on their unit.
FORCE 3
2010 Nursing Annual Report 4

Structural Em
Structural Empowerment
5 Akron General

powerment
Organizational Structure
FORCE 4 FORCE 2
Nursing Council Approved:
• Changes to the Shared Governance structure
• SBAR reporting for safe patient hand-offs policy
• Incontinence Associated Dermatitis policy
• Discharge Insulin form developed as an addendum to the patient’s
home-going medication information for sliding scale insulin
Shared Governance
Shared Governance supports
professional nursing practice
by promoting clinical autonomy,
professional development and
evidence-based practice through
nurse representation on hospitalwide
and unit-based councils.
Shared Governance has
been at Akron General
for more than 20 years.
In 2010, new bylaws were
developed, integrating the
Unit
Based
Councils
14 Forces of Magnetism and the
principles of Relationship-Based
Care to the structure and process
guidelines. The new councils and
members were initiated at the
beginning of 2011.
Personnel Policies and Procedures
DEPARTMENT OF NURSING
SHARED GOVERNANCE STRUCTURE
Magnet
Council
Evidence
Based Practice
& Research
Council
Professional
Practice
Council
Nursing
Coordinating
Council
Quality &
Patient Safety
Council
Staff
Development
& Education
Council
Advanced
Practice
Council
Nursing Turnover and Vacancy
The Staff RN turnover rate for Akron General was 5.3 percent and the
vacancy rate was 2.3 percent. The Ohio Hospital Association (OHA) reports
an average RN turnover of 14.1 percent and average RN vacancy of 6.5 percent.
OB Expansion
Postpartum expanded, creating 15 additional private rooms and 16 nursing beds
for a total of 37 private rooms. This provided for Akron, Ohio’s first private room
birthing experience.
2010 Nursing Annual Report 6

Structural Empowerment
Community and the Healthcare Organization
FORCE 10
Open M
During Nurses Week, our nurses raised nearly
$12,000 for Open M and our SOS fund. This is
an increase of 50 percent from 2009!
(pictured below left)
Reflections Breast Health Center
Akron General’s Reflections Breast Health
Center was awarded a grant from the
Susan G. Komen Foundation for $58,141.
(pictured below right)
The grant supports:
• Free screening mammograms and
biopsy or surgery
• Outreach programs by educating the
community about the importance of an
annual breast health assessment
Nurses Volunteering
in the Community
During 2010, Akron General nurses extended
their expertise to our community. Through
the Speakers’ Bureau, health fairs and other
community events, more than 14,000 people
connected with our nurses. Seventeen
presentations drew people to hear about
women’s heart health, new treatment options
for heartburn, advances in cancer treatment
and stress reduction. Our nurses worked at
36 different community events to educate and
provide health screenings. Additionally, the
nurses participated in various fund-raising
walks (pictured below). These nurses play a vital
role in Akron General’s mission to improve the
health and lives of our patients and community.
7 Akron General

1 2 3 4 5
Image of Nursing
Nurses Make a Difference
The Nurses Make a Difference award
recognizes nurses who provide
outstanding care. They were
nominated by patients and families.
The recipients were:
Vicky Erdman, RN, HBO (1)
Cy Mattis, RN, 42B (2)
Shellee Wandel, RN, 5400 (3)
Caring Nurse Recipients
Tom Thomas, RN, 5400
Claudia Loffelman, RN, ED
Mary Backer, RN, 4100
Amy Hudak, RN, 4200A
Amy McConhie, RN, 7100
Tom Ponyik, RN, 8100
Ann Kaser, RN, CTC
Des Hunt, RN, PACU
Cameos of Caring
Cameos of Caring is awarded to RNs
promoting and contributing to the
nursing profession. (Award pictured right)
FORCE 12
The recipients were:
Shellee Wandel, BSN, RN (3)
Faith Gingerich, RN, BSN (4)
Paula Sherrill, RN (5)
Akron General
Akron City Hospital
Akron Children’s Hospital
Cleveland Clinic Foundation
Cuyahoga Falls General Hospital
Barberton Citizens Hospital
St. Thomas Hospital - Akron
University Hospitals - Cleveland
Other Facilities
Marymount Hospital
Hillcrest Hospital
MetroHealth Medical Center
Wadsworth-Rittman Hospital
Which Hospital has the Best Nurses
N = 519
0% 5% 10% 15% 20% 25% 30% 35%
2010 NRC Results
2010 Nursing Annual Report 8

Exemplary Profe
Exemplary Professional
FORCE 14
Professional Development
Susan Moats, BSN, MBA, RN, executive director,
Heart & Vascular Center and Tamara May, RT,
systems specialist, Heart and Vascular Center,
wrote an article entitled, “Akron General Medical
Center Implements ProVation MD Software to
Speed UP Reporting.” It was published in Cath
Lab Digest in August and the art was accepted
for publication.
Peggy Zanin, BSN, MS, RN, coordinator,
Heart & Vascular Center, Bobbie Gross,
MSN, RN, coordinator, Cardiac Registry, and
Kathleen Burns, RN, CNS Student, University
of Akron, published an article in the Journal of
Community Health Nursing (October-December
2010 edition) entitled, “Cardiovascular Risk
Study: A Comparison between Northeast Ohio
Cardiovascular Nurses and the Nation.”
Anita Sanford, MSN, RN, presented a poster
entitled, “Improving Patient Throughput,
Satisfaction and Quality by Developing an
Admissions Operation Center” at the OONE
Conference in October.
The following nurses received a national
certification:
5400
Christine Dean, RN
Chrissy Hoover, RN
Stacey Skrzyrpek, RN
Athena Stamulous, RN
Diane Moriconi, RN
Barb Greve, RN
Gill Myers, RN
Julie Imani, RN
Regina Sares, RN
ED
Diana Shaffer, RN
Edwin Shaw
Beth Hendricks, RN
Sarah Carper, RN
Valerie Horton-Darnell, LPN
ICU
Christina Muller, RN, CRN
The following nurses earned their advanced
degree:
Nancy Doolittle, MBA, MSN, RN, received her
Master’s from the University of Phoenix.
Anita Sanford, MSN, RN, received her
Master’s in Nursing Administration from The
University of Akron.
Gillian Myers, MSN, RN, ACNS-BC, OCN,
received her Master’s from The University
of Akron.
Continuing Education Provided by
Nursing Staff Development
• 228 CE Programs
• 1,275 number of contact hours
• 5,533 RNs in attendance
• 214 general in-services
• 3,333 employees in attendance at
the in-services
• 20 Nursing Grand Rounds and
Clinical Symposiums (Pictured right)
9 Akron General

ssional Practice
Practice
The mission of the Integrative Medicine
Committee is to promote holistic care
for our patients and community.
FORCE 5
Professional Models of Care
Relationship-Based Care
Relationship-Based Care (RBC) is our interdisciplinary practice model that places patients and
families in the center of care. The model is based on Jean Watson’s Theory of Human Caring.
RBC is fully implemented in all inpatient departments and throughout the hospital.
Caring Connections
Caring Connections was created in 2010 and customized to Akron General. It is a three-day
workshop focused on reconnecting with the core purpose of our work--caring for our patients.
Laurie Patterson, Ombuds, Jane Ragozine, RN, NLC and Todd Feemster, LPN, 5200A
facilitate the Caring Connection workshop. More than 300 employees attended in 2010.
2010 Nursing Annual Report 10

Exemplary Profe
Exemplary Professional
FORCE 8
Consultation and Resources
Autonomy
Northeastern Ohio Nursing Initiative
(NEONI)
Nursing Staff Development coordinated three
days of shadowing for 23 high school students
interested in a nursing career.
Schools of Nursing
Nursing Staff Development coordinated
placement of 113 clinical groups totaling
1,054 students from nine schools of nursing.
Coordination was provided for 96 practicum
students for 11,200 practicum hours, including
12 Nurse Externs from Kent State University
(pictured above). Our advanced practice nurses
mentored 17 graduate nursing students.
80%
70%
60%
50%
40%
30%
20%
10%
11 Akron General
Observation Floor
The collaboration between the Observation
Unit (4200A) and Operation Center (OC)
provides evidence that placing observation
patients accurately decreases their length of
stay. Since the OC opened in May, the
placement of medical observation on
4200A has also improved (see graph below).
Medical Observation Patient Placed on Observation Floor (4200A)
OPERATION CENTER
OPENS
JAN FEB MAR APR MAY JUNE JULY AUG SEPT OCT NOV DEC
FORCE 9

ssional Practice
Practice
FORCE 13 FORCE 11
Nurses as Teachers
Barbara Donoho Award
The Barbara Donoho
Distinguished Leadership
for Learning Nurses Award
recognizes outstanding
clinicians who help educate
students from Kent State
University’s College of Nursing.
The 2010 recipients were:
Britney Larimore, BSN, RN-C,
Labor and Delivery
Linda Jacobs, BSN, RN, 6100
John Flavelle, BSN, RN, HVC
Amy Stineman, BSN, RN, 5200A
Dianne Boyle, RN, 6400
Health Care Educator Award
The Health Care Educator Award recognizes direct caregivers that are excellent
teachers to peers, patients and family members. The recipients are Tammy
Pinchot, RN, 2400, and Denise Myricks, MSN, RN, ESRI.
Interdisciplinary Relationships
Integrative Medicine
The mission of the Integrative Medicine Committee is to promote holistic care
for our patients and community. Integrative Medicine was proud to present a
series of conferences during the fall of 2010. The presenters included Dr. Moshe
S. Torem, Julie Imani, MSN, CNS, CHPN, Oncology, and Dr. Patrick Mok.
Julie Imani, MSN, CNS, CHPN, presented “Integrative Medicine and Chronic
Pain” on the WAKR Ray Horner morning radio show.
2010 Nursing Annual Report 12

New Knowledge,
Innovations & Improvements
Core Measures
Quality Improvement
Nursing Informatics: (pictured left)
• Hired, educated and trained eight new
system administrators.
• Completed staff training (300+ employees)
and implemented AdminRX and Horizon Expert
Documentation at ESRI and Lodi Hospitals.
• Played a pivotal role in the development,
ongoing construction and implementation of the
Computerized Patient Order Entry (CPOE) plan
for Akron General.
• Trained and implemented phase one of Horizon
Perinatal Care.
• Worked on a new nursing patient acuity system
to be implemented in Spring 2011.
Skin Champion Program
The Skin Champions decreased the incidence
of hospital-acquired pressure ulcers, saving the
hospital approximately $46,830 in 2010.
100%
80%
60%
Perfect “Care” Stroke 2010
Perfect ”Care” Acute Myocardial Infarction 2010
100%
80%
60%
40%
20%
0
JAN. 2010
FEB. 2010
MAR. 2010
APR. 2010
MAY. 2010
JUN. 2010
JUL. 2010
AUG. 2010
SEP. 2010
OCT. 2010
NOV. 2010
DEC. 2010
40%
20%
0%
JAN. 2010
FEB. 2010
MAR. 2010
APR. 2010
MAY. 2010
JUN. 2010
JUL. 2010
AUG. 2010
SEP. 2010
OCT. 2010
NOV. 2010
DEC. 2010
FORCE 7
13 Akron General
Akron General
Akron City Hospital
Cleveland Clinic Foundation
Akron Children’s Hospital
Cuyahoga Falls General
Barberton Citizens Hospital
Other Facilities
University Hospitals - Cleveland
St. Thomas Hospital - Akron
Marymount Hospital
Wadsworth-Ritman Hospital
MetroHealth Medical Center
“Which Hospital has the Highest Patient Safety” N = 501
0% 5% 10% 15% 20% 25% 30%
2010 NRC Results

Empirical Quality Outcomes
Quality of Care
FORCE 6
100%
80%
60%
40%
20%
0
Homeland Security
Nineteen Akron General ED employees
attended Homeland Security Training at the
Center for Domestic Preparedness (CDP) in
Anniston, Alabama. The CDP is operated by
the United States Department of Homeland
Security’s Federal Emergency Management
Agency. It is a weeklong hands-on training
session geared toward preparing our
community and hospital for a disaster.
Patient Satisfaction
Press Ganey Associates, Inc., named Lodi
Community Hospital a Summit Award winner
for the fifth consecutive year. Press Ganey
currently partners with more than 10,000
health care facilities to measure and improve
the quality of care. The company’s databases
are the largest in the industry and allow
facilities nationwide to benchmark their results
against peer organizations. The Summit Award
recognizes top performing facilities that sustain
the highest level of customer satisfaction
for three or more consecutive years. Lodi
Community Hospital is the only Emergency
Department in the state of Ohio and one of
only three in the nation to receive this award
for five consecutive years. (pictured top right)
100%
80%
60%
40%
20%
0%
100
80
60
40
20
0% 5% 10% 15% 20% 25% 30%
0
Nurses always communicated well
Patients always received help ______
Patients pain was always __________
Staff always explained medicines
State Average
2010 HCAHPS Scores
Patients room & bathroom were ______
The area around the patients __
Patient was given information _________
Rated the hospital 9 or 10
Akron General
Patient would definitely _________
Akron General
Akron Children’s Hospital
Akron City Hospital
Cleveland Clinic Foundation
Cuyahoga Falls General
Barberton Citizens Hospital
St. Thomas Hospital - Akron
University Hospitals - Cleveland
Other Facilities
Marymount Hospital
Hillcrest Hospital
Wadsworth-Ritman Hospital
“Which Hospital has the Most Personalized Care” N = 533
0% 5% 10% 15% 20% 25% 30%
2010 NRC Results
2010 Nursing Annual Report 14

Pursuing Excellence
The Chest Pain Center was reaccredited
by the Society of Chest Pain Centers.
Cardiac Testing received full accreditation
in Adult Transthorasic Echocardiography,
Adult Transesophageal Echocardiography
and Adult Stress Echocardiography
by the Intersocietal Commission for
the Accreditation of Echocardiography
Laboratories.
The Diabetes Center achieved the American
Diabetes Association Recognition. This
recognition verifies that Akron General
meets the national standards for diabetes
self-management education.
NorthCoast 99 award recognizes the 99 best
places to work in the 22-county Northeast
Ohio region. Akron General was presented
this award by the Employers’ Resource
Council for the eighth consecutive year.
Akron General’s Stroke Program was
recertified by the Joint Commission as a
Primary Stroke Center.
Edwin Shaw Rehabilitation Institute (ESRI)
was accredited by the Commission on the
Accreditation of Rehabilitation Facilities
(CARF) in the following programs:
• Inpatient Rehabilitation Program-Hospital
(Adult)
• Inpatient Rehabilitation Program-Hospital
(Children and Adolescents)
Inpatient Rehabilitation Program- Hospital:
Brain Injury Program (Adult)
• Inpatient Rehabilitation Program- Hospital:
Brain Injury Program (Children and
Adolescents)
• Inpatient Rehabilitation Program- Hospital:
Stroke Specialty Programs (Adult)
• Interdisciplinary Outpatient Medical
Rehabilitation Programs (Adults)
• Single Discipline Outpatient Medical
Rehabilitation Programs (Adults)
15 Akron General

www.akrongeneral.org

Akron General Medical Center
400 Wabash Avenue
Akron, OH 44307-2433
For more information or to request
additional copies, please contact
Anita Sanford at 330-344-1555 or
anita.sanford@akrongeneral.org
www.akrongeneral.org