I left off last time with a conversation around the leadership environment of modern healthcare and promised a look into Inova’s Human Caring practices. I was able to spend nearly an hour in discussion with Inova’s Director of Professional Practice, Kalpana Satyal, who has an exceptional background, not only with the development of nursing practice methodology, but also with the integration of informatics technologies. Our discussion focused initially on a specific grant Inova received from the Health Resources and Services Administration (an arm of the U.S. Department of Health and Human Services). The Nursing Retention Grant was designed to improve nurse satisfaction and retention by decreasing work intensity, improving processes, and integrating human caring concepts into the work environment as a means of improving nurse retention and the work experience.
The project was rolled out in a two-phase approach approximately five years ago in collaboration with Dr. Jean Watson. The first phase sought specific interventions to improve worker satisfaction by decreasing work intensity through process improvements in administration, admissions, documentation, communication, etc. Phase Two focused on the implementation of a human caring environment.
In the first phase, the Inova nurses focsued on improving time investments of RN’s, specifically to enhance the amount of time available for patient interaction. Several improvements were implemented, such as the introduction of the, “admissions nurse,” to improve communication and redce confusion as patients shifted on and off units. A second intervention involved the implementation of a, “Voice Care,” system, which acts essentially like a voice mail system connected to specific patients so that instructions can be left via a phone system and picked up by any nurse involved in the care of a specific patient. Not only has this reduce the time nurses spend during shift changes, but it has greatly improved the quality of communication, especially when multiple nurses, doctors, or clinical staff are involved with a patient. Most notably, the Voice Care system has allowed nurses to spend more time on the floor and less time engaged in the reporting and turnover process.
The second phase involved four pilot units across the Inova Health system. According to Ms. Satyal, the foundation of Dr. Watson’s work is the concept that you must first take care of yourself before you can effectively care for others. From there, individuals must learn to care for their peers, thus creating a more effective environment for "intentional caring" to take place. Ms. Satyal noted, “The pilot units created ‘caring lounges’ where the staff could take time out … to re-focus, and collect.” In addition, small visible symbols and sayings were placed around the unit, like magnets on every door with the phrase, “caring moments heal all souls,” and small cards with inspirational quotations at hand-washing stations, both as reminders of the heart of nursing, and also to improve intentionality in and during work activities. Additionally, nurses would start each shift by giving quality time at eye level with patients to establish a clearly connection.
The purpose of this project was to directly address the stress of the environment, and the residual impact of daily encounters and experiences and proximity to those moments of ultimate consequence. And in so doing, to improve the time and quality of the time spent with each patient. I've attached a brochure that you can download to learn more about the human caring model at Inova Health System. Download InovaHumanCaring.pdf
To date, Inova has also started to expand this model into clinical support units, recognizing the need to address cultural challenges in modern healthcare, even as we tackle the talent and resource challenges inherent to the industry.
When next I write, I'll cover the specific discussion I had with Ms. Satyal regarding the challenge for leaders in clinical settings. Once again, the concept of authenticity rose to the forefront as a vital characteristic for leaders .... but I think you'll also find her experiences as a nurse leader as a very valuable look into the challenges of balancing care for staff when mistakes and errors occur.
If you have experience with the human caring model, please post and let us know!