Catholic Health Initiatives (CHI) is a large integrated healthcare system that sought to standardize nursing procedures and competency evaluation across its 73 hospitals. CHI chose Elsevier Clinical Skills as a solution to reduce variation, validate clinical competence, and promote evidence-based practices. Over a 6-9 month period, CHI implemented Clinical Skills system-wide which involved gap analyses, policy revisions, training, and communications. The implementation of Clinical Skills helped CHI accomplish its goal of delivering standardized, evidence-based care across its network and led to improvements in operational efficiency and quality of care.

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A Success Story:
Aligning Nursing Procedures & Competency
Evaluation Across an IntegratedHealth Care System
Catholic Health Initiatives (CHI) investigated several electronic,
evidence-based referential solutions to create a more robust and
reliable nursing education system for its 73 hospitals. CHI’s
Nurse Executive Council chose Elsevier Clinical Skills as its
solution for reducing variation in skills and procedures,
validating technical clinical competence and promoting the use
of web-based resources alongside evidence-based practices.
For a network as large as CHI, adapting procedures and
changing their culture at scale requires a concerted, powerful
and thoughtful solution that can be understood and
implemented in many different contexts. CHI’s National Clinical
Practice Oversight Team (NCPOT), consisting of representatives
from its seven national divisions, developed a comprehensive
approach on how to educate staff on utilizing Clinical Skills.
Implementation at each facility was executed over a 6-9 month
period, which required a gap analysis of policies with nursing
procedures, Use & Revision Policy adoption, training sessions,
internal communications and supporting documents to ensure
Clinical Skills success system-wide.
In adopting Clinical Skills, CHI Clinical Leadership set out to
accomplish its destination metric (or long-term vision) of
delivering evidence-based practice throughout its network. This
created meaningful improvements, ranging from greater
operational efficiency, to employing new, standardized
procedures across all facilities and departments.
1 / CATHOLIC HEALTH INITIATIVES & ELSEVIER CLINICAL SKILLS
Copyright © 2016 Elsevier
About CHI
Catholic Health Initiatives
(CHI) is a faith-based healthcare
system that works throughout
the U.S. to deliver high-quality
patient care. As one of the
largest health care networks in
the country, CHI delivers
services that are steeped in
community and innovation. CHI
also plays an essential role in
educating young professionals
throughout the country,
boasting four academic health
centers and teaching hospitals
as part of its network.

2. How Does Clinical
Skills Align with
Clinical & Operational
Excellence?
● Reduces variation in
nursing practice.
● Provides greater access to
leading practices and current
clinical evidence.
● Supports professional nurse
practice framework.
● Improves quality and
patient outcomes.
● Improves patient satisfaction
with care delivery.
“When our current practice is different than practice as
outlined in Clinical Skills, we will change our practice to align
with the evidence found in Clinical Skills.”
Alison Mason, MS, RN
National Director, Quality Informatics, CHI
Promoting Consistent,
Standardized Care
A uniform set of expectations, workflows and digital resources
was essential for CHI in realizing greater standardization of
nursing practice and alignment across its network. By
leveraging the evidence-based skills and procedures from
Clinical Skills alongside other clinical reference solutions, such
as Elsevier ClinicalKey for Nursing, CHI developed a
framework for alignment and improved connectivity to
decrease practice errors, reduce risk and improve patient
outcomes.
“One of the main reasons we use a resource such as Clinical
Skills is to reduce the burden of review and research on our
facilities and the redundancy of work effort.”Alison Mason
Driving Adoption of
Evidence-BasedPractices
Clinical Skills is critical in not only promoting standardization,
but also in ensuring clinicians have quick and easy access to
the latest, evidence-based content across the organization.
Clinical Skills has been foundational in the development of
CHI’s Evidence-Based Toolkits and OneCare, which is its
clinical informatics implementation and standardization body.
Through integrating Clinical Skills in workflows at CHI’s
national level, each facility’s policies are aligned to the same
evidence-based skills, procedures and training modules.
“Clinical Skills represents our source of truth for evidence-
based practice across our enterprise" says Ms. Mason.
2 / CATHOLIC HEALTH INITIATIVES& ELSEVIER CLINICAL SKILLS
Copyright © 2016 Elsevier

3. AchievingRegulatory and
ComplianceGoals
An approach that emphasizes standardization, the use of
evidence-based procedures and competency management is key
in satisfying specific state and federal regulations. Particularly,
this strengthens CHI’s alignment with The Joint Commission
National Patient Safety Goals and competency requirements
because educators can create detailed reports that document
and track clinician competency across all levels of the
organization. Likewise, increased continuity and accountability
also gives CHI the flexibility to adapt to future changes or legal
imperatives.
Realizing Operational Efficiencies
Though adoption of Clinical Skills may seem inherently valuable,
ensuring a successful rollout across the CHI network required
more targeted goals. This led to coordination among executives
and administrators, including a thorough analysis of any gaps or
issues that could arise for certain hospitals or facilities. Likewise,
CHI implemented protocols for system-wide communication,
remote access and training procedures. Ms. Mason says that
“During the gap analysis process the implementing facility looks
at their policies, pulls out the procedural pieces and cross walks
it to the procedures as found in Clinical Skills." Ms. Mason
elaborates, "What I have found is that their policies go from
being 8-12 pages to a couple of paragraphs where they are
defining the policy of what care looks like at their facility... Then
they will have a procedures section that just has the title of the
skill with the durable URL that is embedded on the page that
they can click on to be taken to the procedure from the policy.”
3 / CATHOLIC HEALTH INITIATIVES & ELSEVIER CLINICAL SKILLS
Copyright © 2016 Elsevier
“Having one consistent
source for all nursing
procedures helps us
achieve our system-wide
care and quality goals
and meet federal and
state regulatory
requirements for
compliance with facility-
specific policies linked to
standardized, evidence-
based procedures.”
Alison Mason, MS, RN
National Director, Quality
Informatics, CHI

4. Developing Talent Internally
Specific administrators were identified at each hospital to
champion the rollout of Clinical Skills and spearhead training.
CHI worked with Elsevier to amend and review specific
solutions, creating even better policies and training programs
in the process. CHI leveraged a diverse array of tools from the
Elsevier Resource Center including informational posters,
flyers, quick-reference cards, guided tours and monthly
webinar trainings.
Continued Improvement with
CHI & Elsevier
In adopting Clinical Skills, CHI was able to implement new
standards and evaluation policies for clinicians in the face of a
changing healthcare landscape to promote high-quality care
and improved clinical results.
Since partnering with Elsevier, CHI has expanded on its
mission of education and enrichment. Today, there are 105
hospitals within its network, including ten Magnet facilities and
six Pathway to Excellence facilities. CHI uses this educational
framework with Clinical Skills alongside workshops and other
information sessions to continually provide clinicians with the
tools and resources they need to perform at their best. This
partnership addressed the specific challenge of ensuring that
the entire CHI network was ready for a new chapter in
healthcare delivery that supported their destination metric of
providing evidence-based practice.
4 / CATHOLIC HEALTH INITIATIVES & ELSEVIER CLINICAL SKILLS
Copyright © 2016 Elsevier
“The use of the evidence-
based procedures in
Clinical Skills and
assignment of modules to
validate technical clinical
competency supports and
elevates evidence-based
practice across CHI.”
Alison Mason, MS, RN
National Director, Quality
Informatics, CHI