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Darren Clark, A/Nursing Director Workforce and Patient Flow, Princess Alexandra Hospital - PAH’s Magnet Journey: Developing a Strong and Capable Workforce

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Darren Clark, A/Nursing Director Workforce and Patient Flow, Princess Alexandra Hospital delivered this presentation at the 2012 Clinical Training & Workforce Planning Summit. …

Darren Clark, A/Nursing Director Workforce and Patient Flow, Princess Alexandra Hospital delivered this presentation at the 2012 Clinical Training & Workforce Planning Summit.

The 2012 Clinical Training & Workforce Planning Summit discussed the future of Australia's nursing workforce, exploring ways to ensure the capacity and experience to provide high quality care for our nation's increasing healthcare needs.

For more information, please visit http://www.informa.com.au/clinicaltraining12

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  • 1. Princes Alexandra Hospital’s Magnet Journey: Developing a Strong and Capable Workforce Darren Clark a/Nursing Director, Workforce and Patient Flow Princess Alexandra Hospital
  • 2. Metro South Health and Hospital Service (MSH)
  • 3. MSH Metro South Health & Hospital Service (MSHHS) is a large health district serving an estimated population of 1 million people, approximately 23 percent of the Queensland‟s population. Metro South activity profile in 2009-2010 • 176,333 patients admitted • 218,288 emergency department presentations • 977,933 outpatient appointments • 41,877 operations performed • 419,538 medication items dispensed • 371,438 occasions of services to community and primary health
  • 4. Metro South Workforce by Headcount Managerial and Clerical 14% Medical incl VMOs 13% Nursing 43% Operational 15% Trade and Artisans 1% Professional and Technical 14% Managerial and Clerical Medical incl VMOs Nursing Operational Trade and Artisans Professional and Technical
  • 5. Princess Alexandra Hospital (PAH)
  • 6. PAH • Tertiary – Adult • Trauma centre – South Brisbane • Statewide spinal and brain injury service • Transplant and cancer • Other specialties
  • 7. PAH
  • 8. PAH – Nursing Workforce
  • 9. Princess Alexandra Hospital 2000 Agency Usage Record High Bed Closures Vacancy Rates 12% Turnover 25-28%
  • 10. A New Hospital
  • 11. The Facts – PAH • 2000 Independent Company - Nursing Cultural Survey • Staff Feedback: Leadership/Management skills Communication Visibility of Leaders Retention Factors Message in a bottle • Results of Culture = BLAME
  • 12. http://www.nursecredentialing.org/magnet.aspx
  • 13. The Vision • Evidence Based quality program focuses on optimal environments for Nurses and Patients • Magnet facilities demonstrate: 1. High Staff Culture 2. Patient Satisfaction 3. Lower turnover rates • Better Patient outcomes
  • 14. Magnet Recognition Program Magnet Recognition Program© is a: • International Evidence Based Quality Accreditation Program • 3 Decades of Research proving Magnet© Accredited Healthcare facilities have  higher nursing culture  nursing retention  lower vacancy rates  better patient outcomes. PAH Nursing Services: • Used MRP© outcome criteria as a benchmark quality framework • Leadership and Management strategies aimed to create a „Magnet‟© culture
  • 15. The Challenge • To be recognised as a Magnet Facility • an organisation must demonstrate an optimal work environment • Undertake a gruelling evaluation to identify if stringent criteria under 5 Components are met.
  • 16. Leadership & Management Strategies The PAH utilised the criteria as a benchmark to develop Strategies which would rebuild Nursing Services
  • 17. Transformational Leadership • Vision for future direction • Committed, Energetic • Visible • Strong leadership • Dedicated, Passionate • Has the ability to transform an organisations (Bass, 1990) JoyVickerstaffPaulineRossVeronicaCasey PAH EDNS
  • 18. Leadership & Management Strategies Magnet Champions 2004 – 60 Magnet Champions Today – 370 Magnet Champion Role: Educate clinical units Evaluate ward environment Today: Role formalised Clinical Ladder Education Pathway
  • 19. Leadership & Management Strategies Learning Ladder
  • 20. Tools developed to enable staff to evaluate patient environment 2005 Unit Specific Nursing Scorecard Aim: Direct care nurses with a snap shot report enabling staff to review, analyse, benchmark NSI 2009 ACHSE Review – “Excellent Initiative” Aim: Develop a standardised reporting process to capture NSI
  • 21. 2009
  • 22. 2012 – Statewide NSI
  • 23. Tools developed to enable staff to evaluate nursing environment 2005 Magnet Quality Workbook 2009 90% Completion Rate 2012 Magnet Quality Workbook on- line
  • 24. Enhance image of nursing Hospital Posters – • Educating all Staff of the • benefits of Magnet: • Screen Savers, Hospitals Posters, • Ward Posters
  • 25. Enhance image of nursing
  • 26. Enhance image of nursing 2007 – 2012 Nursing Thankyou Card - International Nurses Day
  • 27. Enhance image of nursing Magnet Expo 2004 and 2008 International Nurses Day
  • 28. Web Page
  • 29. Professional Practice Model 1. Creating a culture of excellence 2. Clarifies expectations 3. Accountability for practice 4. Achieving high quality healthcare 5. Staff satisfaction
  • 30. Reward and Recognition • Foster a culture of growing performance through building capability and capacity to reward high performance • Develop and implement a formal reward and recognition plan that recognises outstanding achievement for practice
  • 31. Peer Review • Enhance self awareness • Support continuous learning • Recognise and build strengths and positive behaviours • Structured and constructive way of understanding impact on others
  • 32. Magnet Recognition Program Outcomes 2004 1st Hospital in Southern Hemisphere to be Designated Magnet©
  • 33. Magnet Recognition Program Outcomes 2009 1st International Hospital to be Re-Designated Magnet©
  • 34. Magnet Recognition Program Outcomes 2009: Scored 8 „Exemplars‟ during Magnet© Re- Designation for exceptional nursing practice • Quality of Nursing Leadership – 1 Exemplar • Management Style – 1 Exemplar • Professional Models of Care – 1 Exemplar • Consultation and Resources – 1 Exemplar • Nursing Autonomy – 2 Exemplars • Community and the Healthcare Organisation – 2 Exemplars
  • 35. Magnet Recognition Program Outcomes 2012: Nursing and Midwifery Office, Queensland recommended PAH establish QH first Centre of Nursing Excellence Clinical Performance, Nursing Standards and Innovation to provide leadership and mentorship in elements of the Magnet Recognition Program©
  • 36. BPA Results at PAH Type of engagement culture
  • 37. Turnover and Length of Health Service With over 13,000 employees only 1,125 staff separated from Queensland Health in 2010/11. This equates to a turnover rate of 8.61% which has decreased compared to 9.78% in 2009/10 The trending of the PAH‟s Turnover risk from 2002 to 2011 appears in the graph below (a low score is a good outcome). Since 2002, the PAH has reduced its Turnover risk by 13%. PAH’s turnover risk at 26% is significantly lower than the norm 40%
  • 38. PAH Nursing Vacancy Rate 0 20 40 60 80 100 120 140 160 Jan- 08 Feb- 08 Mar- 08 Apr- 08 May- 08 Jun- 08 Jul- 08 Aug- 08 Sep- 08 Oct- 08 Nov- 08 Dec- 08 Jan- 09 Feb- 09 Mar- 09 Apr- 09 May- 09 Jun- 09 Jul- 09 Aug- 09 Sep- 09 Oct- 09 Nov- 09 Dec- 09 Jan- 10 Feb- 10 Mar- 10 Apr- 10 May- 10 Month FTE
  • 39. Risk in Culture
  • 40. Nursing BPA results
  • 41. Employee Attraction – Nursing
  • 42. Employee Retention – Nursing
  • 43. Changes Since Last Survey
  • 44. OUR CHALLENGES Potential impacts to attracting and retaining our employees have also been acknowledged by: • The expected opening of the Transitional Research Institute (TRI) in 2012 • The new Gold Coast Hospital expected to open in 2013 • The Queensland Children‟s Hospital expected to open 2014 • Innovation and implementation of the national eHealth initiatives • Ongoing competition and attraction for our staff by the private sector
  • 45. Our Challenges – Nursing • Magnet Re-designation 2013 • Maintaining and improving culture, resilience and educational standard in current fiscal environment • Improving patient outcomes and NSI‟s • Maximising workforce efficiencies and effectiveness
  • 46. Princess Alexandra Hospital Designated Magnet 2004-2008 Re-designated Magnet 2009-2013