Bob Dent is the Senior Vice President, Chief Operating and Chief Nursing Officer for Midland Memorial Hospital in Midland, Texas. He is also the President-Elect with the American Organization of Nurse Executives. He is the coauthor (with Joe Tye, CEO and Head Coach of Values Coach, Inc.) of Pickle Pledge: Creating a More Positive Healthcare Culture – One Attitude at a Time. His next book, Building a Culture of Ownership in Healthcare: The Invisible Architecture of Values, Culture, and Attitude (with coauthor Joe Tye) will be published by Sigma Theta Tau International in March 2017.
Building a More Positive Culture of Ownership in Healthcare
There have been more than 155 articles and books published over the past five years on toxic emotional negativity including incivility, gossiping, and bullying behaviors. These types of behaviors have a lasting impact on nurse’s well-being and contributes to employee stress, burnout, and turnover. Associated with toxic emotional negativity in healthcare is the impact it has on the patient’s experience of care. Nurses and others of our interprofessional colleagues are more inclined not to speak up in a toxic workplace environment that may lead to poor quality outcomes and patient safety issues. This is a plague that nurse managers and leaders can help eradicate.
Midland Memorial Hospital is a 471-bed hospital located in west Texas. The old hospital was in need of replacing as the infrastructure would cost too much to repair. Through the Campaign for Action, leaders raised more than $65 million in private donations and another $100 million in a bond election. The community fully supported a new patient tower where all care related to inpatients would be provided. Over the course of the next several years, design blueprints were drafted and many site visits occurred to identify best practice designs. Mock rooms were established for staff, medical staff and community members to provide feedback on design elements. Design blueprints were adjusted based on this feedback. We created a blueprint with all of the state-of-the-art features for improved workflow and patient experience outcomes. The year prior to opening we conducted staff training on new equipment and processes and intensive orientation to the new facility.
During this time, patient satisfaction scores began to decline. This was dismissed as everyone thought that once we moved into the new patient tower with all of the bells and whistles, we would see our scores come back even stronger. After nine months into the new building, though, patient satisfaction and employee engagement scores continued their slide.
Executive leadership established a team to create a plan to improve the patient experience. Patient experience expectations were created and all employees were educated on these. Through this assessment we recognized we also needed to work on our “Invisible Architecture” of core values, organizational culture, and workplace attitude.
We learned that it is just as important to “blueprint” the Invisible Architecture of a healthcare organization as it is to blueprint the physical facilities. The work of creating a culture of ownership is important that it come in the form of a grassroots movement and not just another management program. I will share ideas for sparking such a movement and illustrate with several specific practical tools for creating a Cultural Blueprint that helps hospitals and other healthcare organizations promote a stronger culture of ownership. I recognize that people will be and do their best with the tools they have. As nurse managers and leaders, we must be sure they have the tools to do their job well. Some of the practical tools I will provide will include:
- A Leadership Pledge
- The Daily Leadership Huddle (featured in H&HN Daily, March 2016 as 14 Minutes to Improve Hospital Operations)
- A Culture of Ownership (Joe Tye and I are co-authoring a second book to be published by Sigma Theta Tau International in early 2017 entitled, Building a Culture of Ownership in Healthcare: The Invisible Architecture of Values, Culture, and Attitude)
- The Self Empowerment Pledge (including the story I wrote for Chicken Soup for the Soul: An Inspiration for Nurses entitled Promises … the nurse in the story actually said it was a miracle)
- The Pickle Pledge. Joe Tye and I co-authored the book, Pickle Pledge: Creating a More Positive Healthcare Culture – One Attitude at a Time and featuring The Pickle Challenge for Charity.
- The Power of a Leadership Philosophy (as published in Nurse Leader, Nov/Dec 2016)
- Leading with Levity (my profile of Setting the Tone, chapter 26, in Karyn Buxman’s book Lead with Laughter)
- Describe the impact of toxic emotional negativity on employee stress, burnout, and turnover, along with its impact on the patient’s experience of care including patient satisfaction, quality outcomes, and patient safety.
- Assess their leadership competencies and practices related to establishing healthy workplace environments.
- Identify practical nurse leader applications to build a more positive culture of ownership in healthcare by focusing on the invisible architecture, the culture of an organization.
Lauren Inouye, MPP, RN
Director of Government Affairs
American Association of Colleges of Nursing
Lauren Inouye is the Director of Government Affairs for the American Association of Colleges of Nursing, which represents over 790 baccalaureate and graduate schools of nursing across the country. In this role, she works to advance policy and advocacy initiatives surrounding higher nursing education, research, and practice. Lauren also manages AACN’s Grassroots Network, which is comprised of over 11,000 AACN member deans, faculty, students, and practicing nurses.
Prior to her role at AACN, Lauren practiced as Registered Nurse in the Adult Medical ICU at Georgetown University Hospital and served as co-chair of the hospital's Legislative Council from 2009-2011. In this capacity, she collaborated with the administration and her colleagues to host interprofessional events surrounding end-of-life care policies and legal implications for hospital clinicians, and convened staff nurses with a passion for advocacy. She was a 2011 recipient of the Sigma Theta Tau Honor Society of Nursing’s “100 Extraordinary Nurses” award.
Lauren received her Bachelor of Science in Nursing from the University of Michigan and her Master of Public Policy from Georgetown University. She is a member of Women in Government Relations and the Campaign for Action’s District of Columbia Action Coalition.
New Congress, New Administration, New Ballgame
On January 3, 2017, the 115th U.S. Congress convened. Both Congress and the new Presidential Administration will embark on shaping the healthcare landscape for the American people. Learn how the policy and political climates will likely impact health care and the nursing profession.
- Understand of the policy and political landscape of the 115th Congress.
- Understand the priorities of the Administration and their impact on healthcare.
- Understand how the new Congress and Administration will impact the nursing profession.
Sharon Mathai, BS, RN
Clinical Resource Nurse
University of Texas M.D. Anderson Cancer Center
Sharon Mathai is a Clinical Resource Nurse at MD Anderson Cancer Center on the medical telemetry and phase one trials unit. She has five years of experience in oncology nursing with one year as a clinical resource nurse. As a CRN, she concentrates on quality improvement through coordination and continuity of care with the interdisciplinary team and patient-focused, evidence based practice. The Clinical Resource Nurse serves as the clinical expert and change agent at the microsystem level, with a focus on quality outcomes.
Improving Communication through Collaboration: Nurse Physician Rounding
The 48-bed, intermediate care, medical oncology unit provides care to a complex patient population with various cancer diagnoses. The average length of stay is 4 to 6 days-making a brief hospitalization a demanding one, filled with multiple consults, diagnostic imaging and procedures, a rapidly changing plan of care and a variety of discharge needs. Consequently, the diversity of the patient population and demands of the floor leads to multiple physician teams rounding on the unit throughout the day. Physician rounding often occurs without the nurse or without having discussed a plan of care with the nurse. These gaps can lead to confusion and delays in care, while indirectly leading to frustration for all involved. Inadequate communication is identified as a crucial factor for delays in care, increased medical errors, decrease patient satisfaction, and poor patient outcomes (Rimmerman, 2013). Interdisciplinary communication and coordination of care has been shown to be beneficial to patients through decreased errors, decreased delays, and duplication in orders, as well as increased patient satisfaction (Prttsand Hiller, 2013). This project focuses on communication between healthcare providers and the patient in order to improve the quality of care delivered, sustain safety, and increased efficiency. The aim was to increase patient satisfaction in the domains of "communication with nurses" and "communication with physicians" each by 10%, by the end of the fiscal year. We chose to utilize established patient satisfaction scores in the domains of nurse communication and physician communication as they are the most sensitive and applicable to our project. Unit leadership gathered a group of experienced nurses to participate in a focus group to discuss the need and benefit of rounding with physician teams. The clinical nurse leaders also collaborated with physicians from the general internal medicine inpatient service to ensure buy in and participation. Based on the literature, the group selected the use of a template and script for rounding. With the help of the CNL's, a structured rounding template was created and then tailored to fit the needs of the patient population. The group built role expectations for the rounding process, thus ensuring that each member (physician, nurse, nursing assistant, and ancillary staff) had distinct roles and input. A condensed version of the template was provided to nurses to utilize prior to rounds to increase efficiency and knowledge. Team rounds were conducted daily at an established time to ensure consistency.
- Identify methods utilized to enhance communication between healthcare providers and the patient.
- Describe how structured interdisciplinary rounds were implemented on a busy medical telemetry unit.
- Explain how nurse-physician rounding improved specific patient satisfaction outcomes.
Shannon Stone, MSN, RN, CCRN, SCRN, NEA-BC, CNML
Interim Director of Quality
Las Palmas Medical Center
Shannon Stone, MSN, RN, CCRN, SCRN, CNML, NEA-BC is the Interim Director of Quality at Las Palmas Medical Center in El Paso, TX. She is finishing her Doctorate of Nursing Practice at Texas Tech University Health Sciences Center in Lubbock, Texas and will anticipate graduation in May 2017. She is a member of American Nurses Association, Texas Nurses Association, Texas Organization of Nurse Executives, American Association of Critical Care Nurses, Society of Critical Care Medicine, National Association for Healthcare Quality and the American Association of Neuroscience Nurses. She received a Masters of Nursing Administration in 2014, a post-masters certificate in Nursing Education and her Bachelors of Nursing in 2012 from the University of Texas at El Paso where she had previously obtained a Bachelors of Arts in 2009. She is also a part-time clinical instructor at UTEP in the graduate program. She is the 2017 treasurer/secretary for the American Board of Neuroscience Nurses and was awarded the 2016 Rising Star in Clinical Practice by the American Association of Neuroscience Nurses in New Orleans at the annual conference. She completed Quality Texas training in 2016 and is certified as an examiner.
EVOLVE-ing Nurse Leaders through an In-House Development Program
A succession plan can help healthcare organizations mobilize resources quickly in the face of demanding changes and respond quickly to meet the needs of a continually evolving business environment. A pilot study was introduced to determine the effectiveness of an in-house nurse manager succession plan. The purpose was to determine if a leadership fellowship program promoting an in-house succession plan reduced nurse manager turnover and increased satisfaction. Results were examined using the Mann-Whitney U test, P charts and word clouds for the open-ended questions. The pilot indicates that more research is needed to determine the applicability of similar findings on larger healthcare campuses.
- Evaluate the effectiveness of an in-house nurse manager succession plan through the creation of a leadership development fellowship
- Determine if a leadership development fellowship program that promotes an in-house manager succession plan reduces nurse manager turnover and increases nurse manager satisfaction
- Develop a program sustainability plan for the mentor program established through the leadership development fellowship
Rear Admiral Sylvia Trent-Adams, Ph.D., R.N., F.A.A.N.
Deputy Surgeon General
U.S. Department of Health and Human Services (HHS)
As Deputy Surgeon General, Rear Admiral (RADM) Sylvia Trent-Adams advises and supports the Surgeon General regarding operations of the U.S. Public Health Service (USPHS) Commissioned Corps and in communicating the best available scientific information to advance the health of the nation. She served as the Chief Nurse Officer of the USPHS from November 2013 through May 2016. In this role, she advised the Office of the Surgeon General and the U.S. Department of Health and Human Services (HHS) on the recruitment, assignment, deployment, retention, and career development of Corps nurse professionals.
RADM Trent-Adams has held various positions in HHS, working to improve access to care for poor and underserved communities. As a clinician and administrator, she has had a direct impact on building systems of care to improve public health for marginalized populations domestically and internationally.
Prior to joining the Office of the Surgeon General, RADM Sylvia Trent-Adams was the Deputy Associate Administrator for the HIV/AIDS Bureau (HAB), Health Resources and Services Administration (HRSA). She assisted in managing the Ryan White HIV/AIDS Treatment Extension Act of 2009 (Ryan White HIV/AIDS Program). The $2.3 billion program funds medical care, treatment, referrals and support services for uninsured and underserved people living with HIV disease as well as training for health care professionals.
RADM Trent-Adams began her career in the Commissioned Corps of the USPHS in 1992. She has published numerous articles, participated in research studies, and presented to a variety of domestic and international organizations and professional groups. Prior to joining the USPHS, RADM Trent-Adams was a nurse officer in the U.S. Army. She also served as a research nurse at the University of Maryland. RADM Trent-Adams also completed two internships in the U.S. Senate where she focused on the prospective payment system for skilled nursing facilities and scope of practice for nurses and psychologists. She has served as guest lecturer at the University of Maryland and Hampton University. Her clinical practice was in trauma, oncology, community health, and infectious disease. She has also served as the Chair of the Federal Public Health Nurse Leadership Council, and the Federal Nursing Service Council.
RADM Trent-Adams received her Bachelor of Science in Nursing from Hampton University, a Master of Science in Nursing and Health Policy from the University of Maryland, Baltimore, and a Doctor of Philosophy from the University of Maryland, Baltimore County. She became a Fellow in the American Academy of Nursing in 2014.
Nursing’s Role in Leading Healthcare Transformation
- Leadership in the healthcare setting
The impact of policy on nursing practice
- Building a foundation for strong business practices
- Nurses as leaders
- Preparing the way for change
Creating our new normal
- Developing an understanding of policy
- Getting engaged
- Our seat at the table
- Role re-definition
- Identifying opportunities we did not know were there
- Creating a value proposition for nursing
- Where are we and how did we get here?
- Where do we want to go?
- Explore principles of leadership and how they relate to the nursing profession
- Identify opportunities for nurses to lead in the policy arena
- Describe ways nurses and APNs can engage to improve the health care delivery system
LeAnn Thieman, Hall of Fame Speaker, Nurse, New York Times Best Selling Author of 14 Chicken Soup for the Soul books including her newest, Chicken Soup for the Soul, Inspiration for Nurses has already reached over million minds, hearts and souls of healthcare givers. Now her mission is to reach at least one million nurses via SelfCare for HealthCare, Your Guide to Physical, Mental and Spiritual Health. This transformational program is a movement/philosophy that creates behavior changes, resulting in positive culture impact, increased employee engagement, morale, retention, patient satisfaction scores, outcomes and reimbursements.
Recounting stories from her dramatic experiences from the Vietnam Orphan Airlift and from her Chicken Soup books, LeAnn shares life-changing lessons for coping in our "war zones" today. Her inspirational, poignant, yet humorous presentations teach tools to balance our lives, truly live our priorities, and make a difference in the world.
LeAnn has been featured in Newsweek Magazine's Voices of the Century issue, on FOX-TV News, PBS, BBC, NPR and on countless radio and television programs. Her messages of hope inspire people all over the world. So many say, “Just when I thought I couldn’t do it anymore, I listened to LeAnn.”
Pre-Conference Presentation: SelfCare for HealthCare
Most nurses didn’t choose their professions because of great hours, pay, and working conditions! LeAnn Thieman reminds them why they did…and why they stay. This fun interactive workshop is based on LeAnn’s new SelfCare for HealthCare™ program, teaching nurses specific tools to care for their minds, bodies, and spirits. By sharing her adventures from the Vietnam Orphan Airlift and stories from Chicken Soup for the Nurse’s Soul, plus those from her own 30 years of nursing, LeAnn encourages, uplifts and honors nurses and champions their daily contributions and sacrifices. She provides scientific evidence along with fun, hands-on practicing of techniques to balance their lives. With love and humor, LeAnn re-energizes nurses with hope, health, and healing during these challenging times, inspiring them to continue their compassionate service.
All leaders agree that a nurse who is strong physically, mentally and spiritually will deliver better patient care, resulting in better patient outcomes , higher satisfaction scores, and ultimately, reimbursements. The best way to care for the patient, is to care for the nurse.
- Participants will identify factors contributing to stress and “burn-out” and review the various symptoms of stress.
- Participants will learn tools to achieve physical, mental and spiritual balance to help alleviate stress caused by individual, team, organization and patient needs.
- Participants will learn positive workplace attitudes that transform to positive patient care, including mentoring and team building.
Keynote: What’s This Generation Coming To?
This decade is the first time in American history that four different generations are working side-by-side. “Generational tensions” is ranked among the top major issues affecting U.S. workers. In this fun, interactive, highly educational session, nurses will learn the history, traits, and values of the four generations and identify ways to relate to, manage, and even appreciate the differences. This information is critical, not only to better understand coworkers, but to attract, interview and hire the right staff. Sharing this knowledge with all workers and caregivers decreases negativity, resentment and turnover in the workplace and increases cooperation, retention and productivity. This knowledge is also appreciated to better understand and care for those we serve…which is the common goal of all.
- Develop understanding and appreciation for all generations, creating a harmonious, engaging, productive workplace
- List reasons why generational differences are critical to teambuilding.
- Identify ways to engage and retain Millennials and Gen Xers and increase cooperation, morale, loyalty and productivity.Identify ways to retain Traditionalists and Boomers to increase satisfaction, cooperation, and productivity
Paula Webb, DNP, RN, NEA-BC
Associate Professor and TONE President
Texas Tech Health Science Center
Faculty at Texas Tech Health Sciences Center School of Nursing in Lubbock, Texas. Prior to her transition to academia, she served as CNO of a Magnet designated Children’s hospital. She is Treasurer of the Texas Organization of Nurse Executives, Treasurer of the DFW Great 100 Nurses, Inc., and Treasurer of the North Central Texas Organization of Nurse Executives. She is an active volunteer board member of community organizations. She received her Associate Degree in nursing from Cooke County Junior College, undergraduate and graduate nursing degrees at University of Texas at Arlington, and her Doctor of Nursing Practice degree from Rush University in Chicago.
Eryn Beard, RN, PhD., WHNP-BC, CCNE
Baylor University Louise Herrington School of Nursing
Women's Health Nurse Practitioner in Denton, TX. Recent Graduate of University of Texas at Tyler Doctoral Program (PhD). Dissertation title: The effect of a yogurt intervention on adiposity and metabolic outcomes in women. Research interests include women's health, nutrition, obesity, dairy consumption.
Lauren Olvera, BSN, DMP©, RNC-OB, SNM
BSN, DMP©, RNC-OB, SNM
(Louise Herrington School of Nursing)
Lauren Olvera is a 3rd-year student nurse-midwife at Baylor University, and will graduate with a Doctor of Nursing Practice (DNP) degree in Nurse-midwifery in May 2017. She received her Bachelor of Science in Nursing degree from Baylor University in 2009, and practiced as a labor and delivery RN for 6 years. She is NCC-certified in Inpatient Obstetrics, and currently works for an NCLEX exam preparation company as an obstetric nurse reviewer and consultant. She also teaches childbirth preparation classes to expectant families at UT Southwestern Medical Center, Clements University Hospital in Dallas.
Olvera serves as Baylor's student liaison to the Student and New Midwives Section of the American College of Nurse-midwives (ACNM), and as the student representative on the BirthTOOLS subcommittee of ACNM. Her DNP project implemented a quality improvement collaborative with a local free-standing birth center, local EMS, and hospital staff on Emergent Birth Center Transfers.
Olvera is passionate about promoting evidence-based maternity care and empowering women with choices in childbirth. She looks forward to providing exemplary, compassionate midwifery care to women in the DFW area.
Staff Registered Nurse
San Antonio Military Medical Center
Donna L. Jackson-Arbuthnot is a confident and committed Registered Nurse with over 20 years of diversified clinical experience. Her proven resilience and dedication to the nursing profession is evident by her continued education, excellent clinical skills and knowledge in the Trauma Intensive Care Units. Donna has spent the last 11 years of her career practicing in a Level 1 Military Teaching Facility and has been involved with various projects to include Unit Based Practice Council, Unit representative for Hospital level process improvements such as Organ Donation and charge nurse committee. Donna possesses strong supervisory, interpersonal and professional communication skills with all levels of authority and promotes, facilitates and encourages team work. Donna is extremely passionate and compassionate about caring for patients and their families.
Donna is currently enrolled in a Doctorate of Nurse Practice program in Executive Nurse Administration at the University of South Alabama and anticipates graduation in July of 2017. She has also finished her Post Master’s Certificate in Executive Nurse Administration from the University of South Alabama. In addition, Donna completed her Masters of Science in Nursing and Business in 2003 from the University Phoenix, Bachelors of Science in Nursing in 2000, and her Associates of Applied Science in Nursing in 1996. Donna has been recognized as the first civilian female employee in her organization to complete the three week long Civilian Intermediate Leadership Course Residency at the Army Management Staff College in Ft. Leavenworth, Kansas in 2016.
Donna is an active member the American Association of Critical Care Nurses (AACN), her local church and co-founder of a non-profit organization that promotes Organ Donation Awareness and Education. When not working, Donna enjoys spending time with family, traveling and giving back to her local community.
Stephanie Woods, RN, PH.D.
The Houston J. and Florence A. Doswell College of Nursing at Texas Woman’s University Dallas
Dr. Stephanie Woods is the Associate Dean for the Houston J. and Florence A. Doswell College of Nursing, at Texas Woman’s University, Dallas Center.
Dr. Woods is an accomplished leader holding positions including nurse manager, administrator and chief nursing officer in hospitals in San Antonio and Dallas Texas. She has also served on the faculties of the University of Texas Health Science Center in San Antonio and the University of the Incarnate Word, also in San Antonio. Stephanie is an alumnus of the TWU undergraduate nursing program. She also holds a master’s degree from the University of Texas Health Science Center in San Antonio and a doctoral degree from the University of Texas at Austin.
Dr. Woods has over thirty years of experience in nursing as an administrator, educator, researcher, and practitioner. Her clinical area of expertise is cardiac nursing, and in particular cardiac rhythm disturbances. Her research has focused on the culture of patient care units and its effect on the retention of nursing staff. She has served on the national board for the American Association of Critical-Care Nurses, and is active with the American Organization of Nurse Executives and the Texas Nurse’s Association. She previously served on the Texas Health Dallas Presbyterian board, and the board of managers for the Parkland Health and Hospital System. She is currently on the Dallas-Ft. Worth Hospital Council Foundation Board.
Nursing Doctorates: DNP vs. PhD
When deciding on an advanced degree path, nurses must determine whether a Doctor of Nursing Practice (DNP) or Doctor of Philosophy (PhD) will best meet their professional goals. Through a panel discussion with both DNP and PhD students and graduates, this session will identify the differences in degree programs and curriculum, discuss the pros and cons of online and traditional courses and identify the outcomes and roles for graduates from each program.
- Examine the differences in curriculum between DNP and PhD doctorate degrees (practice-based vs. research-based).
- Verbalize the pros and cons of online, hybrid and traditional courses.
- Discuss the outcomes and roles for graduates from each program through interaction with in-person panel.
Mary Lou Wilson, BC-NE
Dir Nrsg Womens/Children Svcs
Texas Health Harris Methodist Hospital HEB
Mary Lou Wilson is a nurse executive, educator and nurse mentor with over 50 years of experience in healthcare. She was a nursing leader for most of her career, serving as nurse manager, instructor in nursing, director of Women's Services, physician practice administrator, administrator of a breast center of excellence, and chief nurse executive for five different hospitals varying in size from a 24 bed critical access hospital to a 325 bed regional referral medical center. She presently is the Director of Women's Services at Texas Health Harris Methodist Hospital Hurst-Euless-Bedford in Bedford, Texas. Her primary work involves building leadership skills and transforming organizational culture to support of a more positive, productive and professional workplace. She is passionate about her beliefs that caring is the difference between a good and great nurse. Her past experience in teaching nursing in a university setting, and her many years as a nurse executive, provide a rich background from which to draw, and make her "at home" in any educational setting. She is a graduate of Washington University in St. Louis (BSN), American Sentinel University (MSN), and is certified as a Nurse Executive from ANCC.
Texas Health Harris Methodist Hospital HEB
BACKGROUND: Caring has been associated with higher patient satisfaction and improved patient outcomes. Caring affects the safety and well-being of patients and families. The ultimate goal is to find a tool which measures the caring within the nurse.
METHODS: Using Nkongho's Caring Ability Inventory, nurses in four different units in two separate hospitals were measured in knowing, courage, and patience. The inventory was distributed in meetings and collected by the nurse scientists of both hospitals. RESULTS: There was no correlation between the Caring Ability group average score to HCAHPS scores or to patient outcomes. However, there was significant reverse correlation between the HCAHPS score and CAUTIs, CLABSIs, HAPUs. The strongest reverse correlation (1.0) was seen between the HCAHPS scores and falls with injuries.
CONCLUSIONS: Nurses' interactions with patients lead to improved healthcare outcomes. There are methods of assessing and measuring nursing staff in caring. If the correct tool is used, there is the potential to either train staff to improve caring behavior or hire staff with higher caring aptitudes. More research should be done with different tools.
- To identify the Caring Ability Inventory's three categories and their relevance to caring.
- To heighten awareness of impact of caring upon patient outcomes.
- To explain the correlation between patient satisfaction and patient outcomes.