Aligning Clinicians for Quality Care with Advanced Practice Strategies
The Central Valley Network of Adventist Health System, which owns and operates four hospitals, has chosen to implement GNOSIS™ for Obstetrics. Adventist Medical Center – Reedley, including its five clinics, has been an APS client since 2008 when it was operating as the Sierra Kings District Hospital1. For nearly five years now, the 49-bed hospital, which has been consistently focused on quality per its “Quest for Zero” initiative, has had APS perinatal content in place to ensure that Women’s Services are delivered with excellence. The Central Valley Network expanded their relationship with APS in June 2013 to include all three of their birthing centers: Adventist Medical Center – Reedley, Adventist Medical Center – Selma, and Central Valley General Hospital in Hanford. All three will be on the GNOSIS platform.
Adventist Health System is a faith-based, not-for-profit integrated health care delivery system with nearly 30,000 employees serving communities in California, Hawaii, Oregon, and Washington. The organization provides compassionate care in 19 acute care hospitals, more than 150 clinics, 39 rural clinics, 14 home care agencies, six hospice agencies, and four joint-venture retirement centers.
Need for a Common Language
The APS perinatal educational content at all three medical centers includes Fetal Assessment & Monitoring, Shoulder Dystocia, Updates in Postpartum Hemorrhage, and Operative Vaginal Delivery. Additionally, the centers provide clinicians with SBAR+R content on structuring communications in healthcare, which focuses on clear and accurate communication across the healthcare team, which is ever so important in maintaining patient safety. Adventist Medical Center – Reedley has reaped the benefits of these efforts over the years, leading to an important cultural shift, and now Selma and Hanford are taking part. From the consistency instilled by the training, clinicians at Adventist Medical Center – Reedley now have a shared mental model for better, safer care – right down to the specific terms they use with standardized definitions. This impact has been seen broadly across clinical communications, as well as specifically in the important area of Electronic Fetal Monitoring, for which the National Institute of Child Health and Human Development (NICHD) has called for common clinical nomenclature across clinicians. “Through the APS program, physicians and nurses have been brought together with a shared understanding,” said Susie Alday, RN, RNC, BS, Director of Women’s Services. “The importance of speaking the same language where clinical knowledge and reasoning are concerned has minimized any chance for miscommunication – a root cause of medical errors.”
Making it Official
After two years of voluntary participation, the results at Adventist Medical Center – Reedley spoke for themselves. Clinicians found the courses valuable and insightful. The cultural change and shared mental model strengthened the focus on quality and the use of consistent language was catching on throughout the organization. A mandate was instituted requiring completion of the content for both physicians and nurses and compliance continues at 100% today. While initially there was some resistance, as is expected with any type of mandate, it was not long before the requirement was accepted broadly as a quality
differentiator. As one nurse, Renee Davis, RN, RNC described, “The content is very thorough and up to date, and I can complete it how I want and when I want since there is no set “class” time. Our days are already so stretched it is great to be able to do this when I can. I really like the flexibility and like knowing that I am getting rigorous training that keeps me current every year.”
Next Steps
With the mandate well-received, and the culture thriving, Adventist Medical Center – Reedley has upgraded to APS’ newest offering, GNOSIS, as of June 2013, through which clinicians receive feedback on their performance and are then matched with content where they need it most. Adventist Medical Center – Selma and Central Valley General Hospital – Hanford have signed on as well, citing the experience of – Reedley as instrumental in their decisions. Said Vice President of Women’s Services of the Central Valley Network, Kristen Johnson, MHA, BSN, RN, “We are following the lead of Adventist Medical Center – Reedley, based on their great experience working with APS. Their clinicians are engaged and have been really happy with the content they receive. We’re looking forward to these new agreements and using the newest innovation, GNOSIS, so that clinicians in Selma and Hanford can realize the same benefits and continue to deliver excellent care.”
