An edited, and reedited, version of the story I wrote for RPS on the need for Person Centered Hospital Care in 2015. We ALL hope to avoid the past experiences of 4 point restraints, isolation rooms and punitive care that is so often experienced as re traumatization. It wasn't helpful for the clients or the staff either. That's what we are all working together to CHANGE.
New graduate nurses experience a significant "reality shock" as they transition from the student to professional role. Awareness of potential issues and development of preventative self-care strategies helps ensure a good foundation for life-long career satisfaction. This presentation explores common first-year practice struggles and provides methods to cope with stressors.
The retarded development of nursing and nursing profession seems to be mainly due to the fact that no serious thought has been given to this discipline.
New graduate nurses experience a significant "reality shock" as they transition from the student to professional role. Awareness of potential issues and development of preventative self-care strategies helps ensure a good foundation for life-long career satisfaction. This presentation explores common first-year practice struggles and provides methods to cope with stressors.
The retarded development of nursing and nursing profession seems to be mainly due to the fact that no serious thought has been given to this discipline.
reflection on a conflict situation
critical thinker
critical care
decision maker
analyzing and reflecting on a conflict or any situation being an advocate of a patient how to protect the patients right of right and fair care.
By Jason Vickers, occupational therapy student at the University of Salford, addressing What is Reflection? Reflective Practice Within Practice Education and the Reflective Cycle. COT Annual Conference 2010 (22-25 June 2010)
Enhancing & Improving Health Outcomes of Your Residents: A Collaborative Appr...BCCPA
This panel presentation will take a closer look at three key areas of seniors health in residential care (falls, pressure sores, and meaningful engagement in everyday activities) and how collaborating with occupational therapy can lead to reducing injury, hospitalization and associated costs in residential care. Presentation will share best practices for mobility assessment and prescription, pressure sore management and prevention. It will also share experience of a BC residential care providers and OT provider to highlight a successful collaboration in action to improve health & well-being of residents/staff.
Speakers:
- Michelle Whitehouse, Director of Care, Zion Park Manor
- Amit Kumar, Occupational Therapist and Director
- Giovanna Boniface, National Director of Professional Affairs, CAOT
Therapeutic Environments - Devising space designs that provide measurable pos...bharti sharma
Threads of time and space weave human life, the pattern so weaved dictates its every aspect. If the effect of space on human mind and spirit is so intense then why not mould it to heal people. This presentation was the foundation of the graduation project of my MDes at NIFT Mumbai. It deals with the nuances of health care design unravelling the ways in which environment can act as a catalyst in the healing process.
PART 1
For the purpose of a more lucid account of my research, it has been divided into two parts. The first part i.e this presentation is the foundation of the research and deals with the objectives of the research and identification of the contemporary healthcare design pattern.
Nine characteristics of good-quality care in district nursing taken from interviews with patients, carers and staff.
We hope this framework and these slides will be a useful resource for you – please feel free to use them in your work, in documents and presentations.
The Health Employers Association of BC (HEABC) provides a broad range of services to member organizations.This talk will outline a number of the programs and services provided.Topics touched on will include collective bargaining, joint benefit trusts, health human resource planning and knowledge management. Time for questions from the audience will also be available.
Presented by: Michael McMillan, CEO HEABC
reflection on a conflict situation
critical thinker
critical care
decision maker
analyzing and reflecting on a conflict or any situation being an advocate of a patient how to protect the patients right of right and fair care.
By Jason Vickers, occupational therapy student at the University of Salford, addressing What is Reflection? Reflective Practice Within Practice Education and the Reflective Cycle. COT Annual Conference 2010 (22-25 June 2010)
Enhancing & Improving Health Outcomes of Your Residents: A Collaborative Appr...BCCPA
This panel presentation will take a closer look at three key areas of seniors health in residential care (falls, pressure sores, and meaningful engagement in everyday activities) and how collaborating with occupational therapy can lead to reducing injury, hospitalization and associated costs in residential care. Presentation will share best practices for mobility assessment and prescription, pressure sore management and prevention. It will also share experience of a BC residential care providers and OT provider to highlight a successful collaboration in action to improve health & well-being of residents/staff.
Speakers:
- Michelle Whitehouse, Director of Care, Zion Park Manor
- Amit Kumar, Occupational Therapist and Director
- Giovanna Boniface, National Director of Professional Affairs, CAOT
Therapeutic Environments - Devising space designs that provide measurable pos...bharti sharma
Threads of time and space weave human life, the pattern so weaved dictates its every aspect. If the effect of space on human mind and spirit is so intense then why not mould it to heal people. This presentation was the foundation of the graduation project of my MDes at NIFT Mumbai. It deals with the nuances of health care design unravelling the ways in which environment can act as a catalyst in the healing process.
PART 1
For the purpose of a more lucid account of my research, it has been divided into two parts. The first part i.e this presentation is the foundation of the research and deals with the objectives of the research and identification of the contemporary healthcare design pattern.
Nine characteristics of good-quality care in district nursing taken from interviews with patients, carers and staff.
We hope this framework and these slides will be a useful resource for you – please feel free to use them in your work, in documents and presentations.
The Health Employers Association of BC (HEABC) provides a broad range of services to member organizations.This talk will outline a number of the programs and services provided.Topics touched on will include collective bargaining, joint benefit trusts, health human resource planning and knowledge management. Time for questions from the audience will also be available.
Presented by: Michael McMillan, CEO HEABC
Interview with Ronald G. Spaeth, FACHE, president, Evanston Northw.docxmariuse18nolet
Interview with Ronald G. Spaeth, FACHE, president, Evanston Northwestern Healthcare Foundation, Northbrook, Illinois
Ronald G. Spaeth, FACHE, is the recipient of the American College of Healthcare Executives's 2005 Gold Medal Award, an honor conferred on outstanding healthcare leaders for their contributions to the field. Mr. Spaeth joined Evanston Northwestern Healthcare in January 2000, when Highland Park Hospital (Highland Park, Illinois) merged with Evanston Northwestern Healthcare (Evanston, Illinois). Before this merger, he served as president and chief executive officer of Highland Park Hospital from 1983 through 2002. From 1972 through 1983, he served Evanston Hospital in various roles: as vice president of administrative services, vice president of corporate services, assistant secretary, of the board of directors, senior executive vice president, and chief administrative officer. In addition, he has served on numerous boards, including the Board of Trustees of the Illinois Hospital Association, Board of Directors of the American Hospital Association, and Board of Governors of the American College of Healthcare Executives. He is currently on the Board of Commissioners of the Joint Commission oil Accreditation of Healthcare Organizations. Mr. Spaeth is a Fellow of the American College of Healthcare Executives. He earned his bachelor of arts degree from Western Reserve University in Ohio and his master's in business administration degree from the University of Chicago in Illinois.
Dr. Grazier: You have experience as a faculty, member, president, and chief executive of different types of institutions and systems. How has each role contributed to the success of your career?
Mr. Spaeth: The benefit of the career path I have taken has been the opportunity it has afforded me to view different types of institutions and different forms of physician-hospital-community relationships. I have worked in an academic medical center, the Ohio State University Medical Center in Columbus; in a non-university-owned academic medical program, Evanston Hospital Corporation, which is now Evanston Northwestern Healthcare; and in a community hospital, Highland Park Hospital. Seeing the relationships between the communities and those institutions and particularly their ties with the physicians, has given me a broad understanding of the healthcare business.
Over the years, I have also been a faculty member at several university programs in healthcare management, including at the Ohio State University in the 1970s and at the University of Chicago in the 1980s. Bringing to the students real-world experience and teaching them how to apply what they learned in these programs were fulfilling; the experience gave me a chance to see the links between education and practice. My involvement in a major merger in 2000, in which Highland Park Hospital and Evanston Northwestern Healthcare became one system, was momentous as well. These experiences have helped me to grow.
Running head: PROFESSIONAL GOALS 1
PROFESSIONAL GOALS 2
Professional Goals
Janeika Barnes
Walden University
NURS 6565 Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings
Professor: Amy Hamlin
March 3,2018
Professional Goals
Short-term goals and their impact
The short-term goals that I will set include; becoming a certified board member, choosing the patient population to serve as well as evaluating potential employers carefully. Becoming a certified board member will help me become more confident as a nursing practitioner, as well as boost my marketability in the competitive industry. In an effort to ensure that I become a certified board member in record time, I will undertake to apply for the exams before I leave RN and ensure that I am able to sit for them within three or four months after application.
The selection of the patient population encompasses the finding of the perfect position from which I will be able to grow and I will thus have to decide on a specific population that I will serve such as cardiac or the old age people. This will help ensure I am able to easily network within that given specialty area. The third goal that I will set is critical evaluation of the potential employers in which I will undertake to ask about job expectations, such as work hours, patients to be served as well as growth opportunities such as training programs. This will help ensure I land an employer that offers growth opportunities as well as an enabling environment to hone my skills as a nursing practitioner (Masters, 2017).
Long-term Goals and Their Impact
These goals include; get my name out there, engaging in research as well as advancing my qualifications. In an effort to increase my marketability, I will ensure that I stay in touch with the various individuals that I completed my practice with and who are likely to help with recommendations in the event I decide to advance career-wise. I will also ensure that I engage other nursing practitioners who are in the field whether older or even younger and who might help in giving advice as well as recommending career opportunities that might help in my growth. The engagement in research will help advance my understanding of contemporary issues and nursing topics while also giving me the chance to increase my marketability (Masters, 2017). This will add more value on my portfolio and thus increases my chances of advancing in the field. Academic qualifications will play a crucial role in ensuring I continuously hone my skills as well as improve my employability standings; it will also help me improve my leadership skills thus prepare me for a role as a nursing leader.
Strategic Plan
In an effort to ensure that I am able to achieve these goals I will set in place a strategic plan that will address the short-term as well as the long-term goals. In an effort to ensure that I mee ...
The factors that distinguish highly effective healthcare organizations are discovered through generative internal investigation via Appreciative Inquiry. When the cross section of internal members of the organization are invited to express what happens when extraordinary care is provided, the key strengths are revealed.
Why a Patient-centric Approach Is Best: Stories from a PhysicianHealth Catalyst
Good patient care means patient-centric care. Relying on good mentors during residency training, physicians can learn how to put patients first. For example, during one rotation of mine, I saw a mentor consistently use humor and expertise with patients to connect with them and help them change their environments at home. I was also part of patient-centered teams that worked together to identify potentially life-threatening conditions, and intervene to save lives. We can put people before projects and be patient-centric.
The 10 Best Rehabilitation Centers to Watch in 2019insightscare
In this regard, we have come up with the issue ‘The 10 Best Rehabilitation Centers to Watch in 2019’ Project which features the leading rehab centers that deliver astounding services to its client.
Saving Lives: Effective Healthcare Communication Empowers Care ManagementHealth Catalyst
With an estimated 80 percent of medical errors resulting from miscommunication among healthcare teams, organizations can significantly improve outcomes with better communication. A communication methodology outlines the essential information clinicians need to share, giving care teams the knowledge they need, when they need it, to make informed treatment decisions.
One communication toolkit, SBAR (Situation, Background, Assessment, Recommendation), defines the essential information clinicians must share when they hand off patient care from the inpatient to the ambulatory setting:
1. S (situation): The patient’s current situation.
2. B (background): Information about the current situation.
3. A (assessment): Assessment of the situation and background and potential treatment options.
4. R (recommendation): Recommended action.
Similar to Recovery to Practice Newsletter 5 dec_2015 (20)
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
1. Practicing Recovery: Incorporating a
Recovery Orientation in Hospital Settings
I s s u e 5 : J a n u a r y 2 0 1 6
In This Issue
A Note from the Project Director���������� 2
Putting Individuals at the Center of Care.......................... 2
A Note from the Field: Becoming a Recovery-oriented
Agency............................................................................... 3
Thought Leader: Implementing Recovery-oriented
Practices at Cone Health.................................................... 4
Recovery Story: What About Me? I Am a Person, Not a
“Case”................................................................................ 6
Program Spotlight: Statewide Initiative to Train
Practitioners in Recovery Practices.................................... 8
5 Tips: Five Tips for Adopting a Recovery Framework.... 10
RTP Presentations��������������� 11
Resources������������������� 12
Conferences Events�������������� 13
2. RTP@ahpnet.com
www.samhsa.gov/recoverytopractice
Laurie Curtis, MA, CPRP
Project Director, Recovery to Practice
People who work in behavioral health organizations have daily
opportunities to promote wellness and recovery through their
approaches to treatment and support and their many interactions with
the people they serve. In her 2009 article, “A Wellness and Recovery
Model for State Psychiatric Hospitals,”1
Dr. Peggy Swarbrick offers
a framework to help hospitals shift toward more recovery-oriented
environments and services. She makes an important point that wellness
and recovery should infuse all aspects of hospital-based services,
from the environment itself to staff attitudes and language to person-
centered treatment; discharge planning; and assumptions about
individual strengths, capacity, and resiliency.
In this issue of Practicing Recovery, we look at concrete steps
undertaken by several organizations to help transform their systems
to promote and support recovery and wellness. Two psychiatric
nurses report on how they have used the American
Psychiatric Nurses Association (APNA) Recovery to
Practice curriculum to help build knowledge and
understanding within their workforces. A psychiatrist
reflects on his organization’s journey of transformation
toward recovery-oriented services, and a certified peer
specialist shares her thoughts about how hospitals can
both help and hinder the personal process of recovery.
While this issue offers the perspectives of three distinct
types of healthcare employees, a recurring theme is
woven through each of their articles: recovery-oriented
practice incorporates attention to individuals’ overall
wellness, rather than spotlighting only problems and
diagnoses. l
1. Swarbrick, M. A Wellness and Recovery Model for State
Psychiatric Hospitals. Occupational Therapy in Mental Health, July
2009, pp. 343-351.
A NOTE FROM THE PROJECT DIRECTOR
Putting Individuals at the
Center of Care
The Centers for Medicare Medicaid Services
(CMS) proposed to revise the discharge
planning requirements that hospitals must meet
to participate in the Medicare and Medicaid
programs. The proposed rule puts the person
using services and their caregivers at the center
of care delivery, and prioritizes the goals and
treatment preferences of the person using
services during the discharge planning process.
These improvements should better prepare
people seeking services and their caregivers to be
active partners in planning for their needs during
the next step in their care.
Published in the Federal Register on November 3,
2015, the proposed rule is available online at http://
federalregister.gov/a/2015-27840. We invite Practicing
Recovery readers to review the proposed rule change
and comment during the 60-day comment period. For
more information, visit https://s3.amazonaws.com/
public-inspection.federalregister.gov/2015-27840.pdf.
2
3. Christopher Gordon, MD,
Senior Vice President, Clinical
Services, Medical Director,
Advocates, Inc
Christopher Gordon, MD, is
senior vice president of clinical
services and medical director of
Advocates, Inc., in Framingham,
Massachusetts. In this capacity,
Chris is responsible for all clinical
programs, including residential
services, outpatient, emergency
services, employment, and
other supports for people with
psychiatric and development
disabilities, brain injury, and
substance use disorders. He is
also an associate professor of
psychiatry at Harvard Medical
School (part-time), where he
has taught on faculty since
1976. Chris is a member of
SAMHSA’s Recovery to Practice
Steering Committee, which
provides input and guidance on
all RTP activities, events, and
products. You can reach him at
chrisgordon@advocatesinc.org.
Becoming a Recovery-oriented
Agency
Iwas honored by the invitation to write an introduction to this issue on
recovery-oriented practice. While I am happy to share a few thoughts
about our journey here at Advocates, I do not want to overstate our
accomplishments. Advocates, Inc., is a nonprofit, human services agency
providing services to people with a range of challenges, including
psychiatric conditions, developmental and cognitive disabilities, brain
injuries, and other behavioral health conditions. We have come a great
distance, but we have further to go to become the recovery-oriented
agency we aspire to be.
In my experience, transitioning to a recovery-oriented practice involves
both positive actions that promote recovery in addition to softening,
avoiding, or tempering factors that may hamper recovery. One
critical positive action that an organization should take is clarifying
the organization’s values. At Advocates, this is an ongoing process of
exploring our values and philosophy through a task force including
people receiving services, staff providing direct care, and administrators.
This group created a document and companion video, The Advocates
Way, to serve as a guide to our practice approach. We use these
materials to orient new staff members and empower the people we
serve to hold us accountable to our ideals.
Fundamental to these values is creating authentic relationships with
the people we serve. In this authentic relationship, the person has a
substantial voice in all decisions affecting that person. To the greatest
extent possible, we afford the person the respect and dignity to
make all critical decisions about his or her own life. Even when we
must act unilaterally or in direct contrast to the person’s wishes—for
example, committing an individual to a hospital for their own or others’
safety—The Advocates Way provides guidance for how to protect the
individual’s rights and dignity, while doing all that we can to mitigate the
trauma of these events.
For us, nothing has been more powerful than heeding and honoring
the voices of people receiving services and their support networks. Peer
specialists and peer advocates are the true paradigm shifters, helping
us appreciate the many paths people may take to leading fulfilling
lives. The concept “nothing about us without us” is a powerful mantra.
Including the people we serve in clinical meetings, operational planning,
and quality improvement changes everything.
For me as a psychiatrist, becoming more recovery-oriented has involved
appreciating that my medical training, which can be of such great
service to many people, holds unintentional risks to recovery. The very
language of illness and disease conveys ideas of irredeemable damage,
diagnoses can feel like life sentences, and medical assertions often carry
Continued on page 11
A NOTE FROM THE FIELD
3
4. My 40 years’ practice as a psychiatric nurse in
mental health and substance use is rooted in
the fundamental value that all people deserve dignity
and respect. In 2012, I completed the APNA (American
Psychiatric Nurses Association) RTP course on integrating
recovery-oriented practices into the care provided to
people with behavioral health conditions. As Cone
Health’s nursing professional development specialist, it
was my job to get the word out and incorporate this
evidence-based practice throughout our six-hospital
system. This article presents some of the ways in which we
have launched those changes at Cone Health.
The need to embrace hope for a better future and deliver
person-centered, trauma-informed, culturally sensitive
care to people seeking services drove changes to the
clinical culture at Cone Health. The administration
charged my colleagues and me with ensuring that
recovery-oriented values would drive Cone Health’s
cultural transformation. Our approach to operationalizing
this transformation was first to form a team that was
inclusive, collaborative, contagious, and inspiring. Key
sponsors and stakeholders, including the hospital’s
president, vice president, and supervisors; local mental
health organizations; psychiatrists; counselors; and people
who receive services and their families joined us in this
Implementing Recovery-oriented Practices at
Cone Health
By Barbara Akins, RN, BSN, FCN
Barbara Akins, RN, BSN, FCN,
Accreditation/Quality Patient Safety
Coordinator and Professional Nursing
Development Specialist, Cone Behavioral
Health Hospital
Barbara “B” Akins is a registered nurse with
Cone Behavioral Health Hospital in Greensboro,
North Carolina. In 2012, she completed the
American Psychiatric Nurses Association (APNA)
Recovery to Practice curriculum, Acute Care
Psychiatric-Mental Health Nurses: Preparing
for Recovery-oriented Practice, which aligns
with SAMHSA’s national initiative and The Joint
Commission’s standard on patient-centered
communication. You can reach B at
Barbara.Akins@conehealth.com.
THOUGHT LEADER
4
5. effort. Everyone was enthusiastic about
making these changes across our large
regional healthcare system.
In 2013, we launched a hospital-
wide project, “Recovering
Recovery in Mental Health,
Substance Abuse, and
Chronic Illness,” which
emphasized serving the
whole person while also
acknowledging that we
cannot split a person
into pieces as they
navigate their mental
health, substance use, and
medical conditions. Since
many of those we serve are
admitted with chronic illness
diagnoses, we recognized
the need to educate staff
throughout the hospital system.
To meet this need, we developed
print materials and posters and
conducted in-service training for staff
during lunch sessions at all six hospitals.
Simultaneously, staff developed and
conducted psychoeducational group sessions for
psychiatric nurses and mental health technicians across
Cone Health’s nursing units. These group learning sessions covered topics such as support systems, wellness,
recovery, personal development, leisure and lifestyle changes, relapse prevention, and healthy coping skills.
This training required significant resources: meeting rooms, refreshments, registration and coordination
capacity, and trainers.
In 2013, we conducted our first Psychiatric Nursing Academy, an annual program for RNs who recently
graduated and passed their boards; the RTP training is part of the Academy curriculum. In addition, we trained
certified substance abuse counselors within the community in SAMHSA’s 10 Guiding Principles of Recovery,
including their application to chronic illness.
Throughout the transformation, the hospital’s surveys of people seeking services have shown significant
improvement. Our baseline 71 percent rate of satisfaction in April 2013 increased to 88 percent in September
2013. We continue to disseminate the RTP Program and now have 10 staff trainers. We also provide Handle
with Care training, a crisis intervention system and verbal de-escalation program that incorporates recovery
approaches in how we talk, listen, and engage with the people we serve. This practice is interwoven
throughout our hospital, Cone Health System, and the community.
Taking steps toward recovery requires great courage, self-
acceptance, developing a positive and meaningful sense of identity,
and regaining belief in one’s self. We know that it starts with
speaking, and although breakdowns may occur, breakdowns create
breakthroughs. Our journey continues. l
SAMHSA’s
10 Guiding
Principles of
Recovery
Learn more about SAMHSA’s 10
Guiding Principles of Recovery.
5
7. the room and down the hall, where five psych techs
jumped me and proceeded to restrain me in a room
for eight hours. Another time, I was put in seclusion
after reporting an urge to harm myself. I screamed
through the tiny window: “Don’t leave me!”
When institutions
hinder recovery in
these ways, who are
they helping?
These are just a
couple of my early
experiences of being
in a mental hospital.
They illustrate how
hospitals can retraumatize people with impersonal
protocols and policies. This is what we are attempting
to change through a recovery-orientation to care.
Person-centered care begins with the question “What
happened to you?” Do not expect to know the
answer, but do try to understand the answer.
Progress in person-centered hospital care is slowly
coming around. This type of change must occur
at every level from programmatic changes to the
individual interactions that can shape recovery.
The two examples I share here demonstrate my
experience as a person seeking services and an
advocate. At the suggestion of my primary care
physician, I trained one of my dogs, Pip, as a
psychiatric service animal to cue me to practice
my DBT skills (my former career was dog training
and canine behavior consulting). DBT is a cognitive
behavioral treatment that applies mindfulness,
interpersonal effectiveness, emotional regulation, and
distress tolerance skills.
INOVA Fairfax
Hospital accepted
Pip as my therapy
dog and allowed
me to keep her
with me during
my hospitalization.
Once, I began to
disassociate and
felt overwhelming
urges to self-harm.
Intuitively, Pip ran to the nurse’s station and started
barking, alerting staff who followed her to me. They
were able to bring me back to the present. After that
episode, the head nurse instructed staff to watch Pip
for cues to best support me.
In 2011, while working as an advocate, I helped a
person who was experiencing irritability and psychosis
while hospitalized. Because I was listed as a supporter
on her crisis plan, I was able to notify staff of her
extreme sensitivity to the medications they were
prescribing. They listened to me and immediately
adjusted her medication. She soon stabilized.
When we ask to see a person’s pictures, we see the
person, not a “case” file. l
Person-centered care begins with the
question “What happened to you?” Do
not expect to know the answer, but
do try to understand the answer.
7
8. Remarkable advancements paired with profound
policy and system failures characterize the current
healthcare environment. The healthcare system
continues to base psychiatric care on long-standing
beliefs that mental health conditions are both long-
term and permanently disabling. A fundamental
element of any plan to improve psychiatric care
must challenge healthcare practitioners’ current
understanding and role in obtaining successful
treatment outcomes.
The experience and evidence of recovery from
psychiatric illnesses challenges many professionals’
understanding of these conditions and existing
healthcare models. While a number of programs for
recovery training exist, few are available to the 90,000
hospital psychiatric nursing staff who work daily with
people in acute crisis.
To promote long-term change in psychiatric care,
the endowment for the Psychiatric-Mental Health
Nursing Program at the University of Colorado
began sponsoring the American Psychiatric Nurses
Association (APNA) Recovery to Practice (RTP)
curriculum across Colorado. In collaboration with
the Colorado-APNA chapter, regional and statewide
training began in 2014 with a facilitator-training
program.
PROGRAM SPOTLIGHT
Statewide Initiative to Train Practitioners in
Recovery Practices
By Michael J. Rice, PhD, APRN-BC, FAAN, and Kerry Bastian, BSN, RN
Michael J. Rice,
PhD, APRN-BC,
FAAN, Endowed
Chair and Professor,
College of Nursing
Anshutz Medical
Center, University of
Colorado
Kerry Bastian,
BSN, RN, Assistant
Director of Nursing
and Director of Staff
Development, Fort
Logan Mental Health
Institute of Colorado
8
9. Two staff from the Colorado Mental Health Institute
at Fort Logan attended the APNA RTP facilitator
training offered in May 2014. The program fit with the
Institute’s ongoing
training and helped
raise the level of
sophistication
of the existing
trauma-informed
care program. With
hospital administration
support, facilitators
have now integrated
the RTP materials
into new employee
orientation. All
clinical disciplines—
including nurses,
psychologists, and
new psychiatrists—must take the class. As experience
and studies indicate, the workforce is often resistant
to new training. Often by the end of this eight-hour
class, however, attitudes have changed and some
people report it as being the most important class
they have taken at the hospital.
As one of the APNA RTP curriculum trainers, I find
that the participants’ review of their worst day and
best day at work makes them more receptive to a
presentation by a person in mental health recovery.
This perspective breaks down barriers that staff may
have built up, giving them an opportunity to reflect
on their own practices. Many staff report that they
had not previously viewed hospitalization through the
eyes of the person using these services. For veteran
staff, this perspective is
an awakening. Changing
our thoughts from “what
is wrong” with a person to
“what has happened” to
him or her evokes more
empathy and compassion,
increasing job satisfaction,
and helping staff recognize
that recovery is possible.
The curriculum review of
the Nursing Scope and
Standards also helps get
nurses back to basics. As
one nurse stated, “We’re
taking back our practice.” The curriculum validates
nurses’ responsibility to view the people they serve in
the best light and promote their healing. Developing
recovery-oriented treatment plans in collaboration
with an individual helps to reduce prejudice and
prepare the individual for a full life in recovery. The
peer recovery stories in the curriculum are especially
powerful for nursing staff who often see people only
at their worst.
As one staff member said, “This is what I’ve always
felt in my heart was how we should be caring for our
clients. It always felt like we could be more human.”
This is what psychiatric nursing is all about. l
“This is what I’ve always felt in my
heart was how we should be caring
for our clients. It always felt like we
could be more human.”
… some people report [this class] as
being the most important class they
have taken at the hospital.
9
10. Five Tips for Adopting a Recovery Framework
Developing and implementing recovery-oriented systems of care can be a rewarding but difficult and
complex process. The shift to a recovery orientation requires training and a conscious effort to accept
a major philosophical change. Here are five recommendations from states, hospitals, organizations,
and communities that have begun this process.
Ground what you do in what science tells us works. Train practitioners not just in recovery
orientation, but also in evidence-based techniques, such as cognitive therapy and trauma-informed
care. The city of Philadelphia, for example, has trained hundreds of providers to use cognitive therapy
and its principles in inpatient and outpatient settings, with children and adults, and for mental health
and substance use conditions.
3
4
Commit to peer recovery support services. People who have firsthand experience with mental health
and substance use conditions are very effective at engaging people, keeping them connected to
services, and helping them maneuver their own personal recoveries.
Redefine roles. A recovery orientation encourages people to drive the process of their own recovery,
redefining the role of the person in recovery from “patient” to full partner in the recovery process. The
role of the professional shifts from “expert who treats behavioral health disorders” to consultant and
ally. While these changes challenge the way clinicians see themselves, their roles, and people with
behavioral health conditions, they may come to see their professional roles enhanced. While helping a
person learn how to manage symptoms is important, it is more complex to help a person see a life path
that goes beyond treatment goals. When the practitioner is a partner in the process and there to help
the individual, this partnership becomes the cornerstone of the recovery orientation and reflects the
strengths-based approach advocated by researchers in the mental health field.
5
2
Shift the service emphasis from an acute care model to longitudinal recovery self-management.
In substance use treatment, this means moving from treatment models that focus primarily on brief,
episodic modalities that help people to achieve abstinence or “get clean” to services that go beyond
crisis stabilization. In mental health treatment, this means expanding the focus beyond symptom
reduction and working collaboratively with people to help them learn how to manage their conditions
and draw on support beyond the healthcare system to achieve high levels of personal wellness and
connection with their communities.
Develop core values and principles based on input from people in recovery and use this feedback
to revamp programs and policies and retrain your workforce. The state of Connecticut put this
philosophy into practice by creating a program in hospital emergency departments that used peer
support specialists in crisis intervention units to provide support and practical assistance to others with
behavioral health conditions.
1
5 TIPS
Changing attitudes is a process that takes time, and persuading traditional providers to embrace a recovery
orientation is not always easy. Those who are on this path report that they believe that their efforts toward
systems change will ultimately benefit service providers, practitioners, communities—and most importantly—
the individuals with behavioral health conditions and their families. l
Sources: “Embracing Recovery” by Rebecca A. Clay in Monitor on Psychology, October 2013; and Provider Approaches to Recovery-
Oriented Systems of Care: Four Case Studies (2009) by A. Halvorson, J. Skinner, and M. Whitter.
10
11. Upcoming RTP Webinars
Creating Environments of Hope and Wellness: Recovery in Hospital Settings
The popular RTP webinars are back, beginning in early January 2016, with a presentation focused on recovery-
oriented approaches in hospital settings. Expanding on the themes covered in this issue of Practicing
Recovery, this webinar will explore guiding principles and concrete steps for transforming hospital-based
services to promote and support recovery and wellness.
Three-Part Webinar Series:
Crisis and Recovery: Opportunities for Healing and Growth
In January, RTP will also offer a three-part series examining ways to integrate recovery-oriented approaches
into response and support services that help individuals experiencing emotional or psychiatric crisis. It will
present models and approaches that exemplify the value of a recovery orientation in these crucial periods.
Topics will include
• Supporting recovery in acute care and emergency settings
• Recovery-oriented, community-focused responses to behavioral health crises
• Hospital diversion and alternatives in crisis response
Watch your email for dates, times, and registration information.
RTP PRESENTATIONS
more weight and certainty than current knowledge
justifies. Together, these influences can silence, mute,
or marginalize the creative efforts of the person at the
center of concern (AKA “the patient”). If we overvalue
the power of neuroscience, personal crises that
may have importance and meaning can be reduced
to misfiring neurotransmitters, or we may miss the
significance of a psychiatric crisis in the effort to stifle
symptoms, a process akin to removing the battery
from a beeping smoke detector.
I have come to embrace a radical humility about
my medical training and what my clinical skills can
offer. I must speak carefully, listen deeply, appreciate
strengths and capacities at least as much as identify
problems, offer ideas and treatments tentatively, be
open meaningfully to shared decision making, and
engage fully as a human being in relationships with
the people and families I serve.
These positive actions and tempering practices guide
us on our journey toward being a recovery-oriented
agency. l
A Note from the Field
Continued from page 11
11
12. RTP Training Curricula
Like Cone Health and the Fort Logan Mental Health Institute of Colorado, organizations can use the Recovery
to Practice curricula to help train the workforce. SAMHSA supported six membership associations as they
developed curricula to promote recovery principles and practices among behavioral health practitioners. The
intent was to transform the concepts of recovery from a set of beliefs to recovery-oriented practices. Here is a
brief description and link to each curriculum. We invite readers to explore the curricula and learn more about
the participating professional organizations.
Addiction Specialists Curriculum from the Association for Addiction Professionals
The RTP Addiction Specialists Curriculum educates addiction professionals about the recovery-
oriented model of care, addiction recovery, addiction professionals’ specific role in promoting it, and
the competencies needed to integrate addiction recovery concepts into practice.
Peer Specialists Curriculum from the InterNational Association of Peer Supporters (iNAPS)
iNAPS designed and developed the RTP Peer Specialists Curriculum with input from peer support
practitioners nationwide. Throughout the development process, leading content experts in the
recovery and peer support movements reviewed and helped shape the curriculum.
Psychiatric Nursing Curriculum from the American Psychiatric Nurses Association (APNA)
APNA developed its RTP Psychiatric Nursing Curriculum in collaboration with people with lived
experience and psychiatric-mental health nursing leaders. The curriculum and related training materials
aim to increase nursing knowledge of recovery-oriented care and how it translates into nursing practice.
Psychiatry Curriculum from the American Psychiatric Association (APA) and the American
Association of Community Psychiatrists (AACP)
APA and AACP designed a nine-module RTP Psychiatry Curriculum to provide a basic understanding
of recovery from mental health and substance use conditions and recovery-oriented care. The intent
of the training materials is to bring recovery-oriented practice into the mainstream of professional
psychiatric practice.
Psychology Curriculum from the American Psychological Association (APA)
APA’s RTP Psychology Curriculum provides psychologists and other mental health professionals
with information about issues facing people with serious mental health conditions. Based on current
scientific literature, the curriculum provides training in the latest assessment and intervention
approaches with the intent of assisting individuals with severe mental illnesses to achieve their full
functional capability.
Social Work Curriculum from the Council on Social Work Education (CSWE)
The RTP Social Work Curriculum aims to introduce social workers to the recovery model. It focuses on
defining mental health recovery, tracking its origins and development over time, and discussing the
alignment of the recovery model to social work practice. CSWE offers web-based events and webinars,
supports a virtual recovery learning network, and provides social workers with a number of recovery-
oriented training resources.
RESOURCES
12
13. February is American Heart Month
American Heart Month increases awareness
about heart disease and how people can prevent
it. Download a toolkit of resources and tips for
planning an observance, and visit Million Hearts
Initiative for the latest research, proven tools,
and best practices for preventing heart disease
and stroke.
SAMHSA’s 12th Prevention Day
The Power of Prevention!
National Harbor, Maryland
Visit the site to learn more or
register to attend.
Community Anti-Drug Coalitions of
America 26th National Leadership
Forum
Forum 2016: Coalitions –
Monumental Impact!
National Harbor, Maryland
Visit the site to learn more or
register to attend.
National Council for Behavioral Health
Conference
Las Vegas, Nevada
Visit the site to learn more or
register to attend.
29th Annual Research Policy
Conference on Child,
Adolescent Young Adult
Behavioral Health
Tampa, Florida
Visit the site to learn more or register to attend.
6th Anniversary of the
Affordable Care Act
MAR
7 – 9
MAR
13 – 16
CONFERENCES EVENTS
FEB
1
FEB
1 – 4
This product was developed [in part] under contract number HHSS283201200038I/ HHSS28342001T (Reference No. 283-12-3801) from
the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). The
views, policies, and opinions expressed are those of the authors and do not necessarily reflect those of SAMHSA or HHS.
MAR
23
13