Nanne Finis, Vice President, Advisory Services and Maria Romano, Clinical Client Success Director join us on this episode of the Patient Flow Podcast to discuss National Nurses Week [May 6-12, 2018] and the DAISY Award for Extraordinary Nurses in Patient Flow.
Nanne Finis, RN, MS | VP, Advisory Services | TeleTracking
On May 5, after a stellar career, Nanne Finis is retiring from TeleTracking. Since 2013, Nanne has led TeleTracking’s seasoned team of former hospital nurses and administrators in helping clients apply Lean Six Sigma methods and technology to process redesign and workflow automation.
A passionate and collaborative nurse leader, Ms. Finis brought her expertise in health reform and regulatory policies, front-line leadership, and years of experience in patient safety and quality initiatives. As a certified change agent she has worked across the industry with many teams of professionals pushing creative approaches and innovation.
Nanne spent more than a decade with Joint Commission Resources [JCR], a not-for-profit affiliate of The Joint Commission, as Executive Director of Solutions Services, Ms. Finis focused years of attention on the safe adoption of new technologies, preparation for accreditation by The Joint Commission, infection prevention and control, medication safety, and the requirements of the physical environment in which safe care must be rendered. Ms. Finis administratively led several years of activity of the JCR Hospital Engagement Network (H.E.N.) and several AHRQ initiatives that resulted in the transfer of evidence to practice.
Previously, she served as executive director of Northwestern Memorial Hospital, capping a 22-year career during which she held several nursing administrative positions and was operationally responsible for more than 300 full-time employees, and several in-patient and out-patient care areas. Ms. Finis received her undergraduate degree in nursing from St. Mary’s College, Indiana, and earned a master of nursing degree from the University of Illinois at Chicago.
Maria Romano RN, BS | Clinical Client Success Director | TeleTracking
Prior to joining TeleTracking, Maria spent more than seven years at St. Peter’s Hospital in Albany, NY where she built and managed the Patient Logistics & Transfer Center. Maria’s abstract was chosen as a podium presentation at the Magnet Conference where she presented on: How Maslow’s Hierarchy of Needs has a Direct Effect on Nursing Retention.
Introduction: Welcome to the Patient Flow podcast, powered by TeleTracking. On today's episode of the Patient Flow podcast, we celebrate National Nurses Week (May 6 – 12) by welcoming Nanne Finis, Vice President Advisory Services for TeleTracking and Maria Romano, Clinical Client Success Director for TeleTracking. The two will discuss the DAISY Foundation, a TeleTracking collaboration dedicated to recognizing the important work that nurses do. Nanne starts the conversation.
Nanne: I'm very proud to talk about the DAISY Foundation and the very personal relationship and partnership we have with them. The DAISY Foundation, and DAISY stands for Diseases Attacking the Immune System, it was created to express gratitude to nurses for extraordinary skills that nurses deliver, the compassionate care that they provide to patients and their families.
The foundation was established by the family J. Patrick Barnes, who died from complications of ITP in 1999. During is hospitalization, his family and particularly Bonnie and Mark who are now the co-founders of the DAISY Foundation, wanted to show their deep appreciation for the immense clinical skills, the expertise, that the nurses showed to Patrick and all of their family through their nursing support. So when Patrick died, in 1999, they felt compelled to say thank you to nurses in a very personal way. That is really the beginning of the DAISY foundation and it has grown significantly over the years to now partnering with over 2,000 healthcare facilities and schools of nursing internationally. We are very proud to be partnering organization as well with the DAISY Foundation.
Susan: I understand that they have recently expanded the rewards that they offer, and that they have created a patient flow recognition. What has the interest been in this new award?
Nanne: With the DAISY recognition and as a nurse myself, and certainly you'll hear from Maria as well, we go in and out of hospitals across the country and see the DAISY influence. It is the most highly recognized and extraordinary award that nurses can receive for compassion and excellence. And because nursing and clinical focus, and particularly the patient is so central to our mission at TeleTracking, we thought that to extend a partnership with the DAISY Foundation was really a way for us to demonstrate more visibly to the market, to the industry at large, our, the importance of nursing to the work that we do.
So last year we started with the DAISY award for extraordinary nurses and patient flow. And we came to this award and considered it because so often nurses, particularly nurses or nurse led teams, work with patient behind the scenes, streamlining and coordinating their care. And we know that influence of the nurse or the clinician behind these teams often is so critical to making sure that the patients receive care in the right time and the right place that is needed. So we've developed an extraordinary nurses and patient flow award and this is year two, so we've had a lot of success. We have somewhere in the range this year, we just closed our nominations for 2018, but we have 67 nominations, and we are looking forward to honoring our esteemed colleagues who have nominated their peers but also our award winner at our client conference in October.
Susan: Maria, turning to you, why is a nursing role focused on improving patient flow so critically important in today's healthcare operations?
Maria: I think in light of Nurse's Week that's coming up in two weeks, this is extremely important because we are looking at the aging population in our country, the increase that healthcare needs, the complex in patient care that is needed for the patient coming in, the rising cost, and of course with all of that what to the hospitals have but shrinking reimbursement. So, as a result of that, nurses still are doing the same job that Florence Nightingale did that started our profession, right. She was driving exactly what DAISY is looking for too: compassion and excellence within the nursing profession. She inspired us. She started this. And with all of this complex situation going on right now with our healthcare situation, I do believe that the nursing overall is so imperative to focus on improving patient flow, to get back to that grass root that we have to get the right care, do it compassionately because that's what drives us the most as nurses, and with excellence. And as the result, that's why this nursing role is being more focused on being effective with patient flow. To give that need to the patients. In a timely matter.
With TeleTracking, our mission is to ensure that no one will ever wait for the care that they need. Our mission is really at the nurse's heart and we want to align with this to make sure that we give that right patient the right care at the right time. And that's any nurse that you talk to, and they want to give it compassionately and with excellence.
Susan: Maria, is this role, do you consider this one that will continue to emerge, and do all hospitals have a focus on this important function?
Maria: As a clinician working for TeleTracking and so many different hospital systems, it is a growing role, it's an emerging role, because the hospitals are seeing that the clinicians, the nurses, are the ones that really are leading a culture change with patient flow. So, they are enabled to do the mission, to make sure that they can take care of sick people. So, again, across the country, this is a growing position to have TeleTracking- to have nurses in power with leading patient flow in hospital systems.
Susan: Maria, we all know the stories of ED and boarding, length of stay issues, for the organizations that do put that type of focus on patient flow, what are some of the outcomes that they are starting to see at their facilities?
Maria: Well immediately, the number one outcome that has happened and continued to happen is that when nurses are leading this you see a decrease in the ED boarding hour and the boarding hour really mean that those patients are holding in the Emergency Room, waiting for a bed any longer, they're getting directly into the right bed, the right level of care at the right time, so they can have their treatment started.
Nurses know effectively that they need to make this transition quickly because of outcomes that happen when there's increase in ED boarding hours. So that's one of our top outcomes that we see when clinicians really take hold of the patients that are put in their hospital.
Susan: What is your advice to any hospital who is starting their journey to improve patient flow?
Maria: You have to have the right organizational structure for patient flow and they need to engage their senior leadership team to make sure that it's part of their corporate objectives in their healthcare system, that they are going to reduce the time that patients wait to get in the right level of care. And from top down they have to make sure that they have the right organizational structure for this.
Nanne: You mentioned corporate objective and when we look at our hospitals and healthcare systems, as well as pre- and post-hospital settings, organizations are focusing on increasing access for their patients. So, what is the strategic goal that's driving the need to look at flow in your system or your organization? I think that's very important. If you're focusing on improving access, I think that will drive some of your actions, so very important, as Maria said, to have champions that are senior leaders whether it's positions, nurses, administrative leaders that can propel the change that's necessary to focus on flow.
It really is looking at every point of the care continuum, and focusing on what is waste, where is the patient and their family waiting needlessly, and to ideally eliminate that waste in that process so that patients do get to treatment and services at the right time for them.
Just a couple of other thoughts I would say that were learning is start small. Sometimes flow, if you think about patient flow in these organizations, is absolutely overwhelming with the volumes of priorities, but also volumes of care delivery.
So start small, identify a couple of metrics that you want to monitor and measure, and continue to learn and iterate as you think about where is there waste in our system and how can we help to streamline care and efficiency for these patients. We also often talk to our clients, and our leaders about starting with discharge.
We see great waste and inefficiency in that process, as patients are sitting in our hospital beds particularity waiting to be discharged or transferred to their next level of care, and when focus on discharge occurs obviously beds are more readily available for incoming patients. We often say to start there and really do a deep dive on those prosecutions and see how to make that process more efficient and effective for our patients.
Maria: And I really think the format that needs to be used is having a counsel for patients in their organization. Just like there's a nursing counsel that meets regularly every month, this would be a patient counsel that meets on a regular basis, that looks at all of those great points, Nanne, that you just outlined, to see how can they improve, which are aligned to the corporate goals.
Nanne: That's great and Maria, I think what you would say too, is that this is not just a nursing or physician issue, this really, the whole concept of patient flow spans across multi disciplines. So to have a environmental services and transportation services and management or management, along with leaders, it really does take that full team to look at flow and to work together to coordinate this in a much more seamless way.
Maria: It would be an interdisciplinary team meeting right, it's a patient input interdisciplinary meeting which hospitals are moving with us, and they see the importance of it because of the aging population these points that are effecting the care for the patients, with nurses taking care of patients I mean, so this is all great stuff, and I think nursing can absolutely embrace the 100%, so they can drive more effective compassion when they care for their patients and excellence when there's efficient patient throughput.
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