FY22
AnnualNursingReport
“ “ It’s —yourThankofleadcontributionsmakeopportunityandfeelhavethatessentialournursesavoice,appreciatedhavethetomeaningfulthattoalegacyexcellence.youforchoosingtosharemanygiftswithallofus.Dr.KathleenD.Sanford
FY22 Annual Report 1
Nursing is challenging work. It requires special people who balance their intelligence, concern for others, courage and grit to dedicate their lives to this profession. As you read this report I hope you share my pride in our CommonSpirit nurses who support their patients and each other, pursue innovative solutions to our problems, and share human kindness every day. When more than 16,000 of our CommonSpirit nurses shared input for our nursing vision during the peak of the COVID-19 pandemic, we made a commitment to move the vision beyond an aspirational statement into an actionable plan that would ultimately benefit our patients, nurses, our healthcare colleagues and communities. As you read this year’s annual report and learn more about the strategic priorities and supporting tactics developed to implement our nursing vision, I’m certain you will see why we are so proud of our nurses. And this is just the beginning. In the coming weeks and years, you will see more strategic milestones that truly make our nursing vision a reality, while ultimately transforming and elevating the nursing profession at CommonSpirit and industry wide. We want CommonSpirit to be known for outstanding nursing care delivered by nurses who choose to pursue their careers with us because they know they are valued and will have opportunities to grow, learn and make a difference to individuals, communities and the world. Thank you, CommonSpirit nurses, for choosing this profession and for sharing your gifts and talents with our ministry.
Dr. Kathleen D. Sanford DBA, RN, FACHE, FAAN, CommonSpirit EVP and Chief Nursing Officer
This is the second CommonSpirit Health Annual Nursing Report. While much larger than our FY21 publication, it barely scratches the surface of all that our nursing colleagues accomplished during FY22.
In spite of the numerous challenges, including those caused by two years of a worldwide pandemic, nurses from our system continued to bring their intellect and love to their various job titles in support of our ministry.
Sincerely,
2 CommonSpirit Nursing Contents Vision04and Future Nursing by the Numbers ................. 04 The NursingCommonSpiritVisionStatement 06 Aligning the Visions of CommonSpirit and Nursing............ 07 Our Strategic Nursing Priorities .... 08 Nursing Keepsake Pins ....................... 12 National54 Nursing Teams Advanced Practice Providers .........54 Behavioral Health 55 Nursing Informatics 56 Clinical Command Centers and Contingency Workforce Management 57 Patient Experience..............................59 Acute Care Coordination ................ 60 Ambulatory Triage Nursing 62 Nursing Transformation and Innovation 62 Patient Care Services (Education and Research) ................ 63 Features44 Centura Health .................................... 44 CommonSpirit Health at Home ....46 Faith Community Nurses 48 CHI Living Communities ................. 50 Rural Community Nursing ............... 52 Divisions14 The Communities We Serve (Map) ......................................14 Northern California 16 Southern California ............................ 20 Pacific Northwest ................................. 24 Midwest ....................................................28 Texas 32 Southwest ............................................... 36 Southeast ............................................... 40
FY22 Annual Report 3
4 CommonSpirit Nursing Please note that this does not include registered nurses who are practicing their profession in other than a patient care department. Data effective May 1, 2022. ofCompriseNursesNearlyCommonSpirit’sWorkforce 33% 37,851 RN 1,353 Nurse Practitioner 1,650 LVN/LPN NumbersbyNursingtheNursesareessentialhealthcareprofessionals.AtCommonSpirit, we recognize the quality care that nurses provide, as well as their important role as patient advocates. This infographic details who our nurses are. 40,854 Total Nurses 78+ Years Old<23 Years Old 39–60 Years Old 1.01% 46.37% 0.03% 23–39 Years Old 60–78 Years Old 41.67% 10.92% TotalsAgeNURSING NUMBERS
CDU is the second most diverse four-year private nonprofit college in the nation, with over 80 percent of students and over 71 percent of faculty from communities of color. LORMA is a degree granting nursing school with a global perspectiveemphasizing quality, Christian values and leadership skills. These two universities have missions that complement ours and we look forward to developing specific plans for our partnerships during FY23.
• SCAN QR CODE FOR VIDEO
Years at CommonSpirit New CommonSpirit Health
FY22 Annual Report 5 2 3 Ethnicity 4.74%18.27%9.12% Asian 64.16% White Hispanic or Latino Black or AmericanAfrican 2.13%0.28%1.04% Unknown 0.26% Two or More RacesNative Hawaiian or Other Pacific Islander American Indian or Alaskan 15+ 10 15 5 10 3 5 1 2 0 1 13.66% 13.55% 13.13% 19.97% 19.59% 11.34% 8.76% Tenure
National Academic Partnerships
Part of our nursing strategy is to work with academia to increase the number of nursing graduates and the diversity of our profession. There are longstanding partnerships between universities and our local markets. In FY22, we partnered, for the first time, as a national system with one US and one international university. CommonSpirit Health signed Memorandums of Understanding (MOUs) with the Mervyn M. Dymally School of Nursing at Charles R. Drew University (CDU) in Los Angeles, and the LORMA College of Nursing in the Philippines. CDU is “committed to cultivating diverse health professions leaders who are dedicated to social justice and health equity for underserved populations through outstanding education, clinical service and community engagement.”
Today and every day, we will work together with humankindness for all to advance the science and art of nursing. This means we will… Be stronger together, achieving excellence in all we do, collaborating across the field and growing our collective knowledge.
CommonSpirit Nursing VISION AND FUTURE
Let humankindness guide us as we treat every person with holistic, personalized care for the body, mind and spirit. Advance the science and art of nursing as innovative leaders who demonstrate the power of evidence-based, compassionate care. Our goal is for CommonSpirit Health to be the employer of choice for nurses and their teams in a system that is widely known for outstanding patient care.
The journey toward creating one, unifying nursing vision began in 2019*, when our CommonSpirit nurse executives across the country took time to collaborate and envision this possibility. A subcommittee was formed, and several focus groups and surveys were launched to gather feedback about our new nursing vision statement. In total, nearly 16,000 CommonSpirit nurses shared their thoughts about our nursing vision statement.
Our NursingCommonSpiritVisionand Goal
*Summer 2019: The concept of a nursing vision is born. Fall 2019: All CommonSpirit Chief Nurses invited to provide feedback about the proposed nursing vision. Spring 2020: A formal nursing vision subcommittee launches. Summer 2020: Nursing vision focus groups begin. Fall 2020: Nearly 8,000 nurses share feedback about the proposed nursing vision statement. Spring 2021: Another 8,000 nurses share final feedback. Fall 2021 to Spring 2022: The first three Nursing Strategic Priorities are defined and implemented.
6
FY22 Annual Report 7
As a ministry, CommonSpirit has begun a five-year strategic journey to realize our vision to create a healthier future for all — inspired by faith, driven by innovation, and powered by humanity. Called CommonSpirit 2026, our ministry-wide strategic roadmap includes tactics to ensure we are taking care of our people, providing excellence in all that we do, and proactively preparing for our future. Our CommonSpirit nursing vision and five-year strategic plan are aligned with complementary priorities to meet our nursing goal: to be the employer of choice for nurses and their teams in a system that is widely known for outstanding patient care. We know this will require that CommonSpirit nurses have a voice, that they know they are appreciated and that they have support throughout their professional journeys. We want them to have long-term, satisfying and fruitful careers with CommonSpirit. Our CommonSpirit nursing vision is also about excellence and empowering our nurses and teams to feel they have a place where they can work at the top of their licenses and provide the best quality of care. It’s this level of excellence that will ensure our nurses have a bright future, just like our CommonSpirit ministry. •
Aligning the Visions of andCommonSpiritNursing
8 CommonSpirit Nursing
VISION AND FUTURE
“We want to help enrich the roles of our nurses in every stage of their career, as well as attract and retain these sought after individuals.”
— Dr. Kathleen D. Sanford, DBA, RN, FACHE, FAAN, EVP and CNO SCAN QR SANFORD’S
Building a Legacy
Each year one priority is part of CommonSpirit’s proactive approach to address the nursing shortage and reduce nursing turnover rates within our ministry. Focus groups of frontline staff members are being led by our mission colleagues to learn what nurses think the next set of priorities should be for implementation in years two and three of our strategic plan.
CODE FOR KATHY
The pathway to our first strategic nursing priorities.
• Developing a comprehensive, ministry-wide Nurse Residency Program • Expanding our Virtual Nursing capabilities
VIDEO
• Creating a new Internal CommonSpirit Nurse Staffing Agency
After the launch of the CommonSpirit Nursing vision in Spring 2021, planning began to develop a pathway and infrastructure to make this aspirational statement a reality. This involved engaging nursing leaders across CommonSpirit to determine our top priorities to help meet the needs of CommonSpirit nurses. Multiple priorities were suggested, including ideas such as creating and implementing a systemwide nurse orientation program, and providing more university partnerships to help nurses access advanced education and training. To evaluate proposals, nurse leaders participated in numerous feedback sessions to determine what would make the greatest impact to workplace satisfaction and to the careers of CommonSpirit nurses. In the end, three distinct priorities were chosen for year one of our five-year nursing strategic plan:
FY22 Annual Report 9
Nurse ProgramResidency
The ministry-wide nurse residency program will also provide the framework and infrastructure to serve as a foundation for new nursing workforce development programs that will be available for all CommonSpirit nurses.
Built upon the best practices from individual nurse residency programs throughout CommonSpirit, our ministry-wide Nurse Residency Program is providing what research shows new nurses need in their transition to practice: purpose and connection, professional development, coaching, mentorship, consistent feedback loops, and the ability to grow and relish their strengths.
“Our ministry-wide Nurse Residency Program uses science to improve the care delivery for nurses, as well as compassion and caring to deliver on our hello humankindness brand promise.”
Recruitment for the first residency cohorts will begin in mid-2022. For more information, email nurseresidency@commonspirit.org.
RN Residency Fellowship group from the Southeast division
Ensuring that every nurse at CommonSpirit has support.
SCAN QR CODE FOR NURSE RESIDENCY PROGRAM VIDEO
— Dr. Connie Clemmons-Brown, DNP, RN, MBA, CENP, System SVP, Patient Care Services
The Southeast Division Nurse Residency and Fellowship team
Providing around the clock care for the most vulnerable.
10 CommonSpirit Nursing Virtual Nursing VISION AND FUTURE
“Our virtual integrated care model provides many benefits. For bedside nurses, virtual nurses relieve them from certain tasks. For patients, virtual nurses are reassurance that an entire care team is focused on their needs.”
— Linda Goodwin, MSN, MBA, FACHE, System Senior Vice President, Nursing Transformation, Virtual Care & Innovation SCAN QR CODE FOR VIRTUAL NURSING VIDEO
Virtual Nursing services for hospitalized patients have been in place in some CommonSpirit markets for many years. During COVID-19 the value of these services to complement on-site nursing care was demonstrated, when the virtual nurses performed time intensive tasks such as admissions and discharges. Given the dire forecasts about the shortage of nurses in the next 5-10 years, CommonSpirit is expanding its virtual services in markets where on-site and virtual nurses will work together to provide safe, coordinated care. The new virtual care team works in partnership with our Clinical Command Centers to develop virtually integrated care models. For more information, email gail.daly@commonspirit.org and linda.goodwin@commonspirit.org
FY22 Annual Report 11
Our Internal Staffing Agency offers many benefits to CommonSpirit nurses, including enabling them to keep seniority and health benefits while pursuing new nursing opportunities. It eliminates the need for CommonSpirit nurses to seek travel positions elsewhere. This internal agency will help streamline the onboarding/orientation process for travel nurses because they will already know our CommonSpirit values, policies and procedures, which creates a more consistent patient experience. For more information, email gail.daly@commonspirit.org our CommonSpirit nursing expertise at home.
Internal Staffing Agency
“The Internal Traveler program redefines the way clinical nurses work. You can now gain new skill sets across CommonSpirit locations that will accelerate your ability to care for patients across the care continuum.”
. • Leveraging
— Gail Daly, RN, MSN, System SVP, Clinical Operations, Integration Optimization
SCAN QR CODE FOR INTERNAL STAFFING AGENCY VIDEO
12 CommonSpirit Nursing
These engraved, enameled gifts serve as beautiful reminders of our CommonSpirit Nursing Vision and represent the second year of our CommonSpirit Nursing Vision and Five-Year Strategic Plan. We recognize that each location has different guidelines for uniform pins, so please know the pins are designed to complement handbags and other apparel outside of work just as easily as they can adorn your normal work attire. They also can serve as a meaningful keepsake, reminding you that you chose to care for others in 2022. We intend to release a new customized CommonSpirit nursing pin each year of our current 5-year strategic plan. If you collect all five you will have a series of pins with a list of words that describe a CommonSpirit Health nurse (just a reminder: the Nursing 2021 pins said “Head, Heart, Hands”). You might want to save them to show you were a CommonSpirit Nurse during each of these years. • If you have questions about the pins, please contact Linda Pickett at
In honor of Nurses Day and Nurses Week 2022, all CommonSpirit Registered Nurses (RNs), Licensed Vocational Nurses (LVNs), Licensed Practical Nurses (LPNs) and Advanced Practice Registered Nurses (APRNs), received a 2022 CommonSpirit Nursing Commemorative Pin
VISIONShowLinda.Pickett@commonspirit.orgYourSpiritANDFUTURE
“ Nurses shape the experience that patients and their families have, their outcomes and their perceptions of their experience in our facilities. They are the heart of humankindness.
“
— Marvin O’Quinn, President and Chief Operating Officer
CaliforniaNorthern Pacific Northwest Southwest Communities We Serve CaliforniaSouthern
The Chief Nursing Officer of each division, along with the nurse leaders from Home Health, Senior Services, and Physician Enterprise, are part of the national Nurse Executive Council (NEC). The NEC, which also includes system nurse leaders, meets regularly to address issues important to Nursing, and is chaired by the CommonSpirit Health System Chief Nursing Officer.
14 CommonSpirit Nursing DIVISIONS • MAP
Centura Health
MidwestTexas
FY22 Annual Report 15 Southeast
CaliforniaNorthern Division
Thank you for facing challenges while supporting your“Onecolleagues.thingI’m very passionate about is ensuring that a diverse pool of Californians are offered the opportunity to enter nursing. As a well-paid profession, nursing is the path to a better life for so many, and we want a culturally and linguistically diverse workforce in our hospitals to care for our diverse communities. I feel this work is directly in line with our organizational value of inclusion. There are so many benefits to having a greater diversity in the labor pool, and this is an opportunity to address our staffing shortages while giving people the chance to improve their lives by becoming nurses.”
— Karen L. Buckley, RN, BSN, MHA, CENP Chief Nursing Executive Officer Northern California Division
FY22 Annual Report 17
Northern California Dominican Hospital, Santa Cruz Mercy General Hospital, Sacramento Mercy Hospital of Folsom, Folsom Mercy Medical Center Mt. Shasta, Mt. Shasta Mercy Medical Center Redding, Redding Mercy San Juan Medical Center, Carmichael Methodist Hospital of Sacramento, Sacramento Saint Francis Memorial Hospital, San Francisco St. Elizabeth Community Hospital, Red Bluff St. Mary’s Medical Center, San Francisco Sierra Nevada Memorial Hospital, Grass Valley Sequoia Hospital, Redwood City Woodland Memorial Hospital, Woodland
LocationsDivision
18 CommonSpirit Nursing
Grounded During Change
Now and always, take care of yourself and your
When the pandemic hit, we were asked to drastically change our lives overnight. Suddenly our children were home, our vacations were canceled, we ordered groceries online, and stopped visiting the gym. In ways big and small, our lives were disrupted — but we adapted.
Above, left to right: Methodist Hospital of Sacramento nurses at Walking Trail; Dominican Hospital Santa Cruz Gratitude Tree; St. Elizabeth Community Hospital powered air-purifying respirators; Mercy Medical Center Redding Obstetrics team.
What’s important to remember is that we have always been able to adapt, and that change is part of life. This time represents another transition period for us, but we are up to the task. This is how we cope: we place one foot in front of the other, and we continue on.
Staying
As life slowly returns to normal, it’s okay to feel a little apprehensive. Although the changes are positive, it’s normal to feel unsure about what’s safe. Is it okay to attend that wedding? Should you wear a mask at the park if there are a lot of people around? Some days, just adding in social time can feel almost draining as we’re not accustomed to it anymore.
As the world slowly wakes up from the nightmare that was COVID-19, please remember to be kind to yourself. It’s okay to take time for yourself, it’s good to rest and it’s okay if you feel a little overwhelmed or apprehensive. You’ve been through a lot and conquered so much. We are so grateful to you for sticking with the Northern California Division through all the ups and downs.
DIVISIONScolleagues.•NORTHERN CALIFORNIA
Thank you for your courage and your vulnerability. Please keep checking in with yourself and your colleagues and ensuring you’re taking good care of yourselves. •
n Mercy General in Sacramento is pursuing the Pathway to Excellence designation and will apply for certification in February 2023. As part of that journey, they have established a monthly newsletter called “Seeds of Change.” The newsletter shares how leadership and the bedside nurses collaborate to meet the Pathway to Excellence standards.
FY22 Annual Report 19
North State Hospitals offer cancer care, heart care, maternity, neurology, orthopedics, telestroke technology, and wound care. in charitable care and services provided by Dignity Health in the greater Sacramento region. 4 Bay Area hospitals have received national recognition for superior safety and quality from Healthgrades, a leading provider of physiciansinformationcomprehensiveaboutandhospitals.
— North State Market CNEO Team
Noteworthy Numbers 3 areas served (San Francisco Bay Area, North State, and Greater Sacramento area)
Fascinating Facts
n In San Francisco, where both St. Mary’s and St. Francis are located, there are views of the iconic Golden Gate Bridge. The famous orange color was not originally intended. It was the color of the primer the steel was coated with that caught the eye of the architect.
“In the last year, our North State Nursing Team demonstrated unwavering resilience, came back each day, and remained committed to delivering compassionate care to our community, patients and one another.”
n In the North State market, there is a partnership between Stanford and the North State to deliver high quality cardiovascular care. A planned Cancer Care Center will also deliver care to all three North State hospitals and communities.
$250M+3
— Dr. Ron Yolo, DNP, MBA, MSN, RN, Chief Nursing Officer, Southern California Division
20 CommonSpirit Nursing
CaliforniaSouthern Division
“As we continue to carry out our mission, I challenge you to stay resilient, focused and determined during these unprecedented times. We are still running this marathon, and at the finish line, we will change aspects of what we know as ‘normal’ in ways previously inconceivable. Our patients depend on us. Thank you for bringing the best version of yourselves to care for our patients and one another. Your defining role is highly regarded and appreciated. It is now, more than ever, a time to be very proud of being a nurse. Onward!”
An environment of respect, education and excellence allows the nurses of Southern California to grow and thrive.
Southern California Arroyo Grande Community Hospital, Arroyo CaliforniaGrandeHospital Medical Center, Los CommunityAngelesHospital of San Bernardino, San FrenchBernardinoHospitalMedical Center, San Luis Obispo Glendale Memorial Hospital and Health Center, Glendale Marian Regional Medical Center, Santa Maria Mark Twain Medical Center, San Andreas Memorial Hospital - Bakersfield, Bakersfield Mercy Medical Center, Merced Mercy Hospital Downtown, Bakersfield Mercy Hospital Southwest, Bakersfield Northridge Hospital Medical Center, Northridge St. Bernardine Medical Center, San Bernardino St. John’s Hospital Camarillo, Camarillo St. John’s Regional Medical Center, Oxnard St. Joseph’s Medical Center, Stockton St. Joseph’s Behavioral Health Center, Stockton St. Mary Medical Center, Long Beach
Additionally, the Southern California Division has approximately 100 outpatient locations, including ambulatory surgery centers, primary and specialty care offices, urgent cares, and Pacific Central Coast Health Centers.
LocationsDivision FY22 Annual
Report 21
DIVISIONStraining,ProgramSouthernOurRetainingandNursesCaliforniaNurseResidencyprovidesopportunitiesforguidanceandsupport.•SOUTHERNCALIFORNIA
Hiring
22 CommonSpirit Nursing Due to the “Great Resignation” that followed the pandemic, nurse residency programs are popping up across the country as health care systems explore ways to gain and retain nursing talent. For many years, the Southern California Division’s Nurse Residency Program has been a successful model. Nearly a decade ago, nursing leadership at Marian Regional Medical Center (Santa Maria and Arroyo Grande campuses) and French Hospital Medical Center knew they had to find a way to solve major problems: low employee morale, nursing retention issues, inefficient onboarding, and declining safety and patient experience metrics. The solution would be the best nursing decision the team ever made — a program to provide training and guidance, enhance skills and confidence and improve the transition into clinical practice. The Nurse Residency Program gives participants the unique opportunity to not only hone Above, top to bottom: Southern California Division’s Nurse Residency Program has been a successful model, and includes training and guidance in various areas, including a Simulation Lab.
“I want you to know you are appreciated — for your courage, for your commitment, and for your together.”tocontinuefacing,Everythingcompassion.wearewewillface
—Julie PresidentSprengel,J. & CEO, Southern California Division
FY22 Annual Report 23 their critical thinking skills but also use evidence-based practices. This approach ensures that high-quality, safe care is delivered to everyone in a compassionate environment, to improve overall clinical outcomes and the patient experience. Depending on the specialty, the program length varies from 16 to 24 weeks and includes on-unit nursing shifts shadowing trained preceptors, rotations with various units to learn how we all work together as one team, and hands-on classes. Equality for All Providing welcoming and knowledgeable care for LGBTQ+ patients is a key part of equitable health care services for all who enter our doors. That’s why every Dignity Health hospital in California participated in this year’s Healthcare Equality Index (HEI), a program of the Human Rights Campaign, the nation’s largest LGBTQ+ organization. The HEI is a rigorous national benchmarking tool that evaluates health care facilities’ policies and practices related to the equity and inclusion of LGBTQ+ patients, visitors and employees.
All the Southern California Division hospitals have been recognized as a “Equality Leader or Top Performer” for their commitment to LGBTQ+ patients, visitors and employees — a testament to the dedication of our compassionate care teams. The success of the program led to its expansion in 2018 to St. John’s Regional Medical Center in Oxnard. Dignity Health copyrighted the program and is quickly moving toward implementation across CommonSpirit. For the Southern California Division, it is a moment of pride seeing the program expand across the country. However, our greatest pride is in knowing our nurses want to work at CommonSpirit.
• Noteworthy Numbers 25,000 Employees 100 Care Sites 18 Hospitals 10,000 Total NearlyNurses
Pacific Northwest
DivisionDemonstratingcourage, resilience and innovative thinking in the delivery of care.“Our nurses keep our patients first. They breathe life into our mission so that it becomes the embodiment and substance of their daily work. Virginia Mason Franciscan Health’s success is not due to any one person, but to the collective efforts of all.”
— Dianne Aroh, RN, NEA-BC, FACHE, PNW Division Senior Vice President & Chief Nursing Officer, Virginia Mason Franciscan Health
Virginia
FY22 Annual Report 25
Franciscan
LocationsDivision
Washington Virginia Mason Medical Center, Seattle St. Joseph Medical Center, Tacoma St. Michael Medical Center, Silverdale St. Anthony Hospital, Gig Harbor St. Clare Hospital, Lakewood St. Elizabeth Hospital, Enumclaw St. Francis Hospital, Federal Way St. Anne Hospital, Burien Bailey Boushay House, Seattle Ambulatory Services Mason Regional Medical Centers Medical Groups Oregon CHI St. Anthony Hospital, Pendleton Mercy Medical Center, Roseburg
DIVISIONS PACIFIC NORTHWEST
FY2022 demonstrated the ability of the Pacific Northwest Division’s nursing team to continually respond to the pandemic from one surge to another — through agility, collaboration and focus on the safety of team members, our patients, and the communities we serve. With ever-changing state mandates, our nurses’ and nursing leaders’ flexibility in the delivery of care demonstrated courage, resilience and innovative thinking. Even with the profound upheaval of the pandemic, it has been quite an eventful time for the PNW Division. In November, we welcomed Dianne Aroh as our Chief Nursing Officer. Dianne came to us from New Jersey where she served as Executive Vice President and Chief Clinical Patient Care Officer at Hackensack University Medical Center. The Division also continued growing and improving its Centralized Operations Center, where several elements of virtual care are provided to facilities across the Pacific Northwest as well as other CommonSpirit facilities. Operations Center services include Virtual ICU, remote cardiac monitoring,
19 UNITS ACROSS THE DIVISION have achieved Zero Patient Harms during FY22.
First
26 CommonSpirit Nursing
Pacific Northwest Division nurses support physical, emotional and spiritual aspects of patients across the entire health continuum — empowering and supporting people is paramount to our community commitment.
Above, left to right: SuperVax COVID-19 Vaccine Clinic in Seattle, WA; the Race to Zero Patient Harms Award recognizes and honors the inpatient units that achieve a sum of zero patient harms in five categories for an entire quarter; RN providing Intensive Care Virtual Services.
Putting Patients
•
• St. Francis Hospital, Federal Way, WA
FY22 Annual Report 27 and remote tele-sitter care to support the direct frontline team members.
Building Community
• St. Michael Medical Center, Silverdale, WA Two facilities received a “B” grade:
achieved American Nursing ExcellenceCenters’CredentialingPathwaystodesignation. 1,485 Beds Across Division Nearly
Throughout 2021, the teams across Virginia Mason Franciscan Health made significant contributions to the COVID-19 vaccination efforts within the communities they serve. Along with vaccinating staff, they partnered with organizations across the region, including Amazon and professional sports teams such as the Seattle Seahawks, Seattle Sounders and Seattle Mariners.
• Virginia Mason Medical Center, Seattle, WA • St. Joseph Medical Center, Tacoma, WA
Our Leapfrog grades demonstrate our success (see below). • 2021 Leapfrog Group Hospital Safety Grade Program Recipients
Pacific Northwest nursing continues to improve our quality and safety practices to consistently provide the best care possible to our communities.
• St. Clare Hospital, Lakewood, WA
“Our System Nursing Shared Governance provides an environment that empowers and engages nurses. It gives them a voice and a sense of value to be involved in clinical decisions that impact their work.”
— Cathy Smith, MN, RN, CMSRN, Clinical Manager 7th floor Med-Surg, St. Joseph Medical Center, Tacoma, WA Michael Medical Center and St. Anthony Hospital)
Five facilities received an “A” grade:
• St. Anthony Hospital, Gig Harbor, WA
• St. Anne Hospital, Burien, WA
Collectively, more than 2,100 team members volunteered to provide over 426,000 vaccines throughout their local communities.
Noteworthy Numbers 5,000 Total Nurses 2 Facilities (St.
28 CommonSpirit Nursing
DivisionMidwestEmpoweringnursesand fostering participative decision-making to drive excellence.
“Call it what you will, most of us have a passion that fuels our profession. For me, it’s a calling — a calling to serve and to stay. As a leader, the people I care for are you. I am honored to work with all of you. I am inspired by your commitment. I am humbled by your compassion, and I am grateful to be a part of such a highperforming team.”
— Timothy Plante, RN, MSN, MHA, Vice President, Chief Nursing - Midwest Division
Senior
Officer
CHI Health St. Mary’s, Nebraska City Iowa CHI Health Mercy Corning, Mercy Corning
Nebraska CHI Health Creighton University Medical Center - Bergan Mercy, Omaha Lasting Hope Recovery Center, Omaha CHI Health Immanuel, Omaha CHI Health Lakeside, Omaha CHI Health Midlands, Papillion CHI Health St. Elizabeth, Lincoln CHI Health Nebraska Heart, Lincoln CHI Health St. Francis, Grand Island CHI Health Good Samaritan, Kearney CHI Health Richard Young Outpatient Clinic, Kearney Richard Young Behavioral Health, Kearney CHI Health Plainview, Plainview CHI Health Schuyler, Schuyler
CHI
CHI
CHI
CHI
Wisconsin CHI
CHI
Minnesota
CHI
CHI Health Missouri Valley, Missouri Valley Health Mercy Council Bluffs, Council Bluffs North Dakota CHI St. Alexius Health Williston, Williston St. Alexius Health Dickinson, Dickinson St. Alexius Health Garrison Memorial Hospital, Garrison CHI St. Alexius Health Turtle Lake, Turtle Lake CHI St. Alexius Health Bismarck Medical Center, Bismarck St. Alexius Health Devils Lake Hospital, Devils Lake CHI St. Alexius Health Carrington, Carrington Mercy Health Valley City, Valley City Lisbon Health, Lisbon Oakes Hospital, Oakes CHI St. Francis Health, Breckenridge St. Gabriel’s Health, Little Falls St. Joseph’s Health, Park Rapids CHI LakeWood Health, Baudette Living
CHI
Communities LocationsDivision FY22 Annual Report 29
CHI
CHI
30 CommonSpirit Nursing
Empowering Nurses, Building Communities
The pandemic has challenged health care workers in an unprecedented manner, not only in our professional lives but our personal lives as well. It has brought about feelings of frustration, doubt and fear. But looking back on 2021, there is also a sense of pride, community and resilience in the Midwest Division. We’re proud to celebrate our strides in empowering nurses to participate in decisions that affect policies and procedures at the point of care. Nursing shared governance and nurse engagement are strong in our division. Bedside nursing staff have a voice in the way they practice and interact with patients, visitors and staff. Their input is vital to building a positive workplace experience and producing the highest quality of care for our patients. Last year, established councils strengthened, paused councils reformed, and hospitals without councils came together for the first time — all during, arguably, one of the hardest times of our Selectioncareers.ofeyewear provided to staff during the pandemic, enhancements to the nurse preceptor programs, creation of a Compassion Fatigue Toolkit, and policy updates for floating best practices are a few examples of how the bedside staff made a difference during 2021. Noteworthy Numbers 1.272,000M Inpatient OutpatientAdmissionsVisits 2,600 COVID-19 Vaccine Doses per week in March 2021 28 Division Hospitals 2x the Charity Care provided by other regional health
Systemic improvements and bedside staff made the difference in FY2022 with pride, resilience, governance and engagement.
DIVISIONS • MIDWEST
Thesystems.Midwest Division provides
The PNAP helps nurses develop professionally, grow as bedside leaders, and demonstrate their ability to support key performance areas that advance our organizational goals and the nursing profession. Nurses are encouraged to take initiative for professional growth to enhance quality of care, improve patient outcomes, and promote nursing and patient satisfaction.
While the pandemic has been the defining health care event in the past three years, there is much more on the horizon for the Midwest Division. We have our eyes on the future. We are excited to continue our integration of the lower and upper Midwest hospitals to take advantage of our strength as a system. This is a great opportunity to build on our success and nursing excellence to better care for the people and communities we serve. The job is truly never done. We have and will continue to do amazing things. We look forward to the times ahead and building upon our strong foundation for the future. • “It’s rewarding to be part of an organization that provides a foundation to leverage experts, integrate best practices, and provide quality education for frontline staff.”
Left: Members of the Recruitment, Retention and Recognition Council of Shared Governance who participated in the two-year project that developed the Professional Nurse Achievement Pathway (PNAP) program.
— Stephanie Leonard, MSN, RN, Market Director, Clinical Education, Center for Clinical Practice
Professional Pathways Through the PNAP Program
FY22 Annual Report 31
Right: Staff ready and waiting to check in and Nebraska,publicmembersvaccinateoftheinOmaha,duringthespringof2021.
The Midwest Division kicked off the Professional Nurse Achievement Pathway (PNAP) program. The PNAP was developed by bedside nurses from the Nebraska and Iowa Market Shared Governance team.
— Dr. Veronica Martin-Posley, DNP, RN, NEA-BC, Division SVP & Chief Nurse Executive, St. Luke’s Health - Texas Division
“The toll of high patient volumes coupled with uncertain outcomes and long hours were some of the greatest challenges we as health care leaders have ever faced, and we succeeded. It’s a testament to the high level of expertise that our nursing team provides every day.”
Division are led by Dr. Veronica Martin-Posley, Senior Vice President and Chief Nurse Executive. The Division is committed to excellence, education, and opportunity in its locations throughout Texas. Throughout the last two years and looking forward into the future, the division has and will remain committed to collaboration and to the community.
DivisionTexasThenursesoftheTexas
32 CommonSpirit Nursing
FY22 Annual Report 33
East Texas (Memorial) St. Luke’s Health - Memorial, San Augustine Hospital, San Augustine St. Luke’s Health - Memorial Lufkin Hospital, Lufkin St. Luke’s Health - Memorial Livingston Hospital, Livingston Houston 610 Market Baylor St. Luke’s Medical CenterBertner, Houston Baylor St. Luke’s Medical CenterMcNair, Houston North Houston St. Luke’s Health - The Woodlands Hospital, The Woodlands St. Luke’s Health - Lakeside Hospital, The Woodlands St. Luke’s Health - The Vintage Hospital, St.HoustonLuke’sHealth - Springwoods Village Hospital, Spring South Houston St. Luke’s Health - Sugar Land Hospital, Sugar Land St. Luke’s Health - Brazosport Hospital, Lake Jackson St. Luke’s Health - Patients Medical Center, Pasadena Brazos Valley (St. Joseph Health) St. Joseph Health Regional Hospital, Bryan St. Joseph Health College Station Hospital, College Station St. Joseph Health Madison Hospital, St.MadisonvilleJosephHealth Grimes Hospital, Navasota St. Joseph Health Burleson Hospital, Caldwell New Mexico CHI St. Joseph’s Children
LocationsDivision
Dynamic Collaboration Makes It Happen
As strong community partners, the Texas Division is committed to providing continued excellence for our nurses, patients, our state and nation. This year, nurses across our division led the way with courage, resiliency and humankindness. We received national recognition for our nursing efforts and developed new strategic partnerships in the midst of pandemic-related challenges.
One example of this exciting work is a new partnership between the University of St. Thomas - Houston (UST-H) and Baylor St. Luke’s Medical Center. This collaboration was recently forged with UST-H’s senior BSN nursing students to expose them to critical care clinical skills through the hospital’s elite ICU Transition Program. The program’s goal is to support the acquisition of nursing knowledge and skills for senior students to effectively prepare them for the transition to professional nursing practice in critical care nursing.
34 CommonSpirit Nursing
Above, left to right: The Healthcare Heroes Campaign is celebrated by St. Luke’s Health –The Springwoods Village Hospital and St. Luke’s Health – San Augustine Hospital; the nursing staff at CHI St. Luke’s Health – The Vintage Hospital.
Texas-style dedication, partnerships, innovative projects, and a legacy of no-fear nursing define a new and more nimble era.
DIVISIONS
• TEXAS
Also in 2021, volunteers from St. Joseph’s Heath, including nurses from St. Joseph’s Health Regional Hospital, worked together to administer over 100,000 COVID-19 vaccines in Brazos County. Meanwhile, nurses throughout our Texas markets lived our value of Compassion while providing comfort and care to patients and their families.
— Dr. T. Douglas Lawson, CEO, St. Luke’s Health and CommonSpirit SVP of Operations
FY22 Annual Report 35
Courage in Action Superstar St. Luke’s Health Nurses across the Texas division were featured in an Emmy Award-Winning PBS Series. When ICU beds were filled with COVID-19 patients during the initial surge, rapid response teams throughout the health system went into overdrive. The urgency of their work was captured in a riveting episode of TESTED, a 12-part video series produced by Houston Public Media in partnership with St. Luke’s Health. The series captured intense images of critical care nurses showing no fear or hesitation while caring for highly infectious patients.
A Collaborative Effort
The planning to make the elite ICU Transition Program opportunity available to UST’s senior nursing students was the collaborative work of Dr. Veronica Martin DNP, RN, Senior Vice President and Chief Nurse Executive for St. Luke’s HealthTexas Division of CommonSpirit; Candice Herman, MSN, RN, NEA-BC, St. Luke’s Health - Texas Division of CommonSpirit, Director for Magnet Programs and PSON Faculty; Michael Sullivan, DBe, HEC-C, FACHE, Associate Professor, PSON; Karen O’Brien, Ph.D., APRN, ACNP-BC, Associate Professor; and Poldi Tschirch, Ph.D., RN, CNE, Dean and Professor. As the Texas Division looks forward, we believe that investing in our nurses is key to proactively addressing the U.S. nursing shortage. By providing relevant professional development and new opportunities throughout the career-span of our nurses, we are confident that we can make the Texas Division and CommonSpirit a preferred workplace where our nurses can thrive for years to come.
In 2021, Baylor St. Luke’s Medical Center received its fifth magnet designation, an honor given to hospitals by the American Nursing Credentialing Center for Excellence in the delivery of care and the practice environment for nurses.
•
“The beauty of working with our dedicated and well-trained nurses is that we are incredibly nimble at responding quickly to crises.”
Noteworthy Numbers +35% of the Texas Division staff are nurses 271 Points of Care 7.8 M Patients Served 2001 Baylor St. Luke’s Medical Center is the facilityMagnet-designatedoldestinTexas
DivisionSouthwestThroughafocusonqualityandeducation,theSouthwestDivisioncontinuesitsexcellencejourney.“Thepandemichighlightedtheboldleadership,innovation,gritandgraceofournursingteams.AstheSouthwestDivision,weadaptedquicklytochangethewayhealthcareisdeliveredtobenefitpatients,families,oneanotherandourcommunities.” — Dr. Robin Shepherd, DNP, MSN, RN Division VP and Chief Nurse Executive Southwest Division
Arizona St. Joseph’s Hospital and Medical Center, St.PhoenixJoseph’s Westgate Medical Center, ChandlerGlendaleRegional Medical Center, Chandler Mercy Gilbert Medical Center, Gilbert Arizona General Hospital, Mesa Arizona General Hospital, Laveen Yavapai Regional Medical Center West, YavapaiPrescottRegional Medical Center East, Prescott Valley Dignity Health Cancer Institute - Phoenix Dignity Health Medical Group - Phoenix Yavapai Regional Medical Group - Prescott Nevada Dignity Health - St. Rose Dominican, Rose de Lima Campus, Henderson Dignity Health - St. Rose Dominican, San Martín Campus, Las Vegas Dignity Health - St. Rose Dominican Hospital, Siena Campus, Henderson Dignity Health Medical Group - Nevada
FY22 Annual Report 37
LocationsDivision
DIVISIONS • SOUTHWEST
New Ways to Care for Patients and Nurses
Nursing Students Rotated Graduate Nurses Hired in 2021 7 M People served
St. Rose Siena achieved Robotics and Bariatrics Center of Excellence accreditation and made a 200% improvement in Hospital Acquired Pressure Injury (HAPI). St. Rose San Martin also achieved Robotics Center |of Excellence accreditation and was voted “Best Place to Have Your Baby” in Las Vegas. St. Rose de Lima championed a Nurse Apprentice program and expanded its Simulation Lab for nursing and clinical education. Chandler Regional and Mercy Gilbert collaborated to create a nurse-driven “Sepsis Power Hour” to improve SEP-1 care and implemented a Patient Experience Coach program that significantly improved patient experience scores. Arizona General Hospitals (AGH) and hospital-satellite emergency departments (HSEDs) developed tele-stroke services with Noteworthy Numbers 2 of the fastest growing counties in the nation (Maricopa County, AZ, and Clark County, NV) are in the Southwest Division 500+3,000+175,000+
Southwest Division nurses lead improvements through optimization and collaboration. The Southwest Division remained true to its legacy of nursing innovation as the pandemic entered its second year in 2021. Interdisciplinary practice between nurses, providers and support services thrived as hospital capacities exceeded 150% during surges. Nurses across our division collaborated to optimize wellness: they designed Caregiver Resilience Rooms at St. Joseph’s Hospital and Medical Center, and formed a 75-person Peer Support Team for employees at both Chandler Regional and Mercy Gilbert.
Arizonians administered through the COVID-19 Vaccination pod model
38 CommonSpirit Nursing
FY22 Annual Report 39
•
Piloting Innovation
Barrow Neurological Institute, ensuring the right care at the right location. The AGH HSEDs developed a program to treat and discharge appropriate observation patients to keep them in their communities, decreasing bed demand at our larger care centers. St. Joseph’s Hospital and Medical Center continued its Magnet strengtheningJourney,nursing shared governance to advance and sustain clinical quality outcomes. As an example, the SJHMC Surgical Services Governance team increased first-case on-time starts from 40% to 76%. In Prescott, AZ, our Yavapai Medical Centers evolved their emergency department processes and met stretch goals for reducing Left Without Being Seen (LWBS) and door-to-doc times for the first time in several years. In addition to the great examples above, the Southwest Division continued to educate thousands of nursing and health care students. St. Joseph’s grew its partnership with Creighton Medical and Nursing School to educate 3,024 nursing students in the Division in 2021. St. Joseph’s nationally accredited Learning Institute and Simulation Center provided 221,487 training hours in 2021.
A Legacy of Leadership Linda Hunt, Sr. Vice President of Operations for the Southwest Division, retired April 1, 2022 after more than 50 years as a nurse. Linda modeled what it means to be ‘a nurse’s nurse’ and led boldly, inspiring nurses and mentoring countless leaders from the bedside to the boardroom and beyond! Thank you, Linda!
The Southwest Division continued to influence public policy and legislation on behalf of nurses. The Southwest Division was the first in CommonSpirit to secure a CMS Acute Care Hospital at Home waiver. Partnering with our government affairs teams, Division nurses advanced legislation allowing Dignity Health to launch this first-of-its-kind pilot program. Division nurses also testified to state legislatures in support of bills that strengthen the nursing workforce, enhance nursing preceptor programs, and improve patient outcomes and access to care.
DivisionSoutheastThroughpatienceanddedication,thenursesoftheSoutheastremainedmission-focusedandpatient-centered.“Myfavoritequoteas a practicing nurse has always been: ‘They may forget your name but they will never forget how you made them feel.” Every day our care team provides excellent, high touch care as part of their personal ministry and makes a difference in the lives of our patients. To our nurses, thank you for choosing to share your gifts and talents with those we have the opportunity to serve.” — E. Melissa Roden, RN, BS, CPHQ, VP Quality & Interim CNE, Southeast Division
FY22 Annual Report 41 Arkansas CHI St. Vincent Morrilton, Morrilton CHI St. Vincent North, Sherwood CHI St. Vincent Infirmary, Little Rock CHI St. Vincent Hot Springs, Hot Springs Kentucky Saint Joseph Berea, Berea Saint Joseph London, London Saint Joseph East, Lexington Flaget Memorial Hospital, Bardstown Saint Joseph Hospital, Lexington Saint Joseph Mount Sterling, Mount Sterling Ohio Trinity Health System Twin City Medical Center, Dennison Trinity Medical Center West, Steubenville Tennessee CHI Memorial Hospital Chattanooga, Chattanooga CHI Memorial Hospital Hixson, Hixson Georgia CHI Memorial Hospital Georgia, Fort Oglethorpe West Virginia Trinity Home Health Pennsylvania CHI St. Joseph Children’s Health LocationsDivision Rhonda Hatfield, MBA, BSN, RN, CCRN, served as the DivisionSoutheastSVPand Chief Nursing Officer through April 15, 2022. Rhonda transitioned her SVP and Chief Nursing duties to Melissa Roden to complete her Doctorate in Business Administration degree. Thank you for your service, Rhonda, and best wishes for the future!
Additionally, CHI Memorial’s RN Residency Program received re-accreditation with distinction as a Practice Transition Program by the American Nurses Credentialing Center’s (ANCC) Commission on Accreditation in Practice Transition Programs. This is the highest recognition awarded by the ANCC, and all three CHI Memorial Hospitals are included in this accreditation with distinction designation. The workplace settings included in this accreditation are medical-surgical, oncology, step down, critical care, operating room, and emergency room.
At CHI Memorial in Tennessee, the team partnered with Hixson High School to form the CHI Memorial Institute of Healthcare and Medical Careers to become the latest Future Ready Institute. This partnership has expanded to five high schools and provides clinical experiences and job shadowing opportunities for students across the Tennessee/Georgia market.
Standing Out From the Crowd
Above, left to right: Timothy Dailey, RN, and Tracey Eggers, PCA, are part of the medicalsurgical unit at Saint Joseph’s London (KY); CHI Memorial Hospital Nursing Team (TN) and Trinity Hospital Clinical leaders (OH).
42 CommonSpirit Nursing
The Southeast Division continues to form partnerships and connections while focusing on facility excellence.
In Arkansas, CHI St. Vincent Infirmary (SVI) Little Rock and CHI St. Vincent Hot Springs (SVHS) achieved the distinguished C Magnet recognition. Only four out of 142 CommonSpirit hospitals have achieved this status, and only 8.9% of U.S. hospitals and 579 hospitals globally have received Magnet Recognition, making this honor more special.
DIVISIONS • SOUTHEAST
The future is looking bright for the Southeast Division, and we are very thankful for the presence and ongoing dedication of our nurses. •
In Ohio, nurses at Trinity Health System now have a competencybased orientation program using standardized evaluation tools for measuring success. Even during the high census and staffing shortages associated with the pandemic, nurses were able to raise some quality scores. The journey continues for our patient satisfaction and employee satisfaction scores as well.
— James L. Middleton, MSN, MBA, RN, NEA-BC, Market Chief Nursing Officer, Trinity Health System - Ohio Noteworthy Numbers
In Kentucky, CHI St. Joseph Health made several investments in our people, including standardized pay rates, bringing salaries in our rural markets to the same pay scale as in Lexington for our clinical positions, including nursing. Additionally, to address the rising costs of travel nurses, CHI St. Joseph Health developed an in-house agency nurse program, offering limitedtime, temporary nursing positions to address staffing shortages throughout the pandemic.
FY22 Annual Report 43
“Today and every day, we will work together with humankindness for all to advance the science and art of nursing. Stay strong and be proud to be a CSH Nurse!”
— Teresa Lambert, MBA, BSN, RN Vice President of Patient Care Services/ACNO CHI St. Vincent Hot Springs - Arkansas “Trinity Health is committed to the physical, spiritual and emotional wellbeing of all our staff. New programs have been introduced to meet staffing shortages such as the development of a Weekender Program, a Parent Shift Program, a Clinical Extern Program, and a ‘buddy system’ for nursing units. ”
465 Advanced Practice Nurses 222 Licensed Practical Nurses 5 States Served 5,000 Registered Nurses Nearly
Listening to nurse feedback to reimagine the nursing practice and implement innovative solutions that improve the practice environment. At Centura Health, a Centura Health, which operates under a CommonSpirit joint operating agreement, our Fiscal Year 2022 priority was to create a series of new innovations based on the direct feedback of our nurses. Throughout FY22
• The hosting of “Policy Bowl” which included multidisciplinary representatives to align and merge policies and practices across the enterprise for patient care
44 CommonSpirit Nursing
• Elimination of the delayed start practice, replaced with the stand by practice
• Implementation of Project Simplify, which allowed front line clinicians to create more efficient documentation paths within EPIC (resulting in a 30-minute reduction of charting per nurse per shift)
HealthCentura
Below: The American Organization for Nursing Leadership (AONL) presentation team shared “Be Our Voice: Nurses’ Experience with COVID-19 – A MixedMethod Qualitative Study.” (Masks were not required at conference.)
Brenda Simpson, SVP & CNO, along with Janet Davis and Rachel Miles, Group Vice Presidents of Nursing Services, held a series of focus groups titled “Focus on Action.” These sessions were open to all nursing associates at all facilities on each shift. These small group sessions helped us create dialogue about front line clinician priorities and learn more about tangible actions we could take to reimagine our nursing practice and address opportunities to improve the nursing practice environment.
Innovation and Changes Implemented in FY22
Centura Health Locations Colorado Avista Adventist Hospital, Louisville Castle Rock Adventist Hospital, Castle LittletonRockAdventist Hospital, Littleton Longmont United Hospital, MercyLongmontHospital, Durango OrthoColorado Hospital, Lakewood Parker Adventist Hospital, Parker Penrose Hospital, Colorado Springs Porter Adventist Hospital, Denver St. Anthony Hospital, Lakewood St. Anthony North Hospital, St.WestminsterAnthonySummit Hospital, Frisco St. Elizabeth Hospital, Fort Morgan St. Francis Hospital, Colorado Springs St. Mary-Corwin Hospital, Pueblo St. Thomas More Hospital, Canon City Kansas Bob Wilson Memorial Hospital, St.UlyssesCatherine Hospital, Dodge City St. Catherine Hospital, Garden City
FEATURE
• Implementation of an RN Clinical Ladder
• Implementation of biannual virtual nursing town halls to keep clinicians updated on the ongoing work and timelines
— Dr. Brenda Simpson, DNP, RN, CENP, SVP and CNO of Centura Health (Colorado/Kansas)
FY22 Annual Report 45 program in January of 2022
Centura Health Highlights Centura Health sees over 94,000 inpatients each year and over 530,000 ED or urgent care visits.
Centura Health serves 15,000 patients through our home health programs, brings 12,000 new lives into the world, and performs over 86,000 surgeries each year.
— Dr. Andreaa Narvaez, DNP, MHA, RN, NE-BC CNO Centura Health Parker Adventist Hospital in Parker, CO.
Noteworthy Numbers 4 Magnet Designated Facilities 18 Hospitals have either an A or B Healthgrades ranking. 10 of our 20 Hospitals have achieved an “A” Healthgrades ranking, many repeats! 42% Improvement on our journey to high reliability
“I’m on a mission to be an advocate for patients, associates and communities served.”
• Hosting of nurse staffing summits at each facility to educate and involve frontline RNs in the development of staffing plans for their units
“I’m on a mission to build a positive culture and make lives better for our associates, physicians, and patients.”
• Development of a combined Centura Nursing Professional Practice Model
• Implementation of a structured communication process to enhance accountability for professional practice while also reducing memos, emails and learning assignments Plans also are underway to launch a revised graduate residency program, improve education structures and processes, and develop a unified nursing professional practice model and shared governance structure across our organization. We are excited to move into FY23 and strengthen our clinician partnerships to enhance the practice of nursing across our enterprise. •
FEATURE
The first was inclusion of telehealth/ virtual visit capabilities, providing our nurses the visual component to phone triage. This supported the nurse’s ability to address the patient’s needs without having to complete an in-home visit.
HealthCommonSpiritatHome
CommonSpirit Health at Home implemented two solutions to address on-call needs:
Telehealth virtual visits also supported nurses with managing daily schedules, allowing nurses to pre-plan telehealth visits on the patient’s plan of care.
46 CommonSpirit Nursing
At CommonSpirit Health at Home, our nursing focus over the past year was centered on caring for those who are caring for our patients. Understanding that the nursing workforce is tired and stressed due to the pandemic, we made it our priority to alleviate this in tangible ways where they would feel the difference. As a result, the gift of time, reducing their stress, and providing a work-life balance became our top priority. After hours/on-call responsibilities are one of the greatest contributors to the burnout of our clinicians. Nurses have always rotated on-call assignments to support our patients’ after-hours needs, but this practice negatively impacts a nurse’s ability to maintain a work-life balance and increases stress levels that are already heightened by the pandemic.
Our second innovative approach included partnership with IntellaTriage, a clinically led on-call triage center to relieve our nurses of the after-hours on-call burden. This has made a huge impact in the work life balance of our already stretched RN workforce. As this rolls out across the Division, it is unburdening our nurses from Focusing on partnerships, technology and caring for our dedicated nurses.
Infusion
FY22 Annual Report 47 after hours responsibilities, giving back the gift of time and work-life balance. As an added bonus, this change in job responsibilities has been a recruiting differentiator. The elimination of on-call coverage by the nursing staff is bringing in more applicants to fill our nursing positions at a rate not seen in the past.
1,600 Nurses 51
Kim Kindred, RN,DivisionasservedBSN,the ClinicalPresident-ViceServices for CommonSpirit Health at Home through April 2022. She’s now serving as the CommonSpirit System VP of Patient Continuum.Experience-CareManythanks,Kim, for your years of service with Health at Home! We’re thrilled to know that you’re still doing great things as part of our CommonSpirit national nursing team. Noteworthy Numbers Home Health Locations Served 6 Locations
As CommonSpirit Health at Home continues its focus on caring for those who care for our patients, we will look for innovative ways to create balance for our nurses while always elevating our ability to address patient needs with humankindness. •
Recent nursing feedback also revealed duplication in our documentation processes. To address the issue, we created a dedicated work group to review, research and discover ways to reduce overall clicks and questions. This work group ultimately recommended a reduction of 29 questions/clicks and removed four category areas. The good news is that we made these changes without disrupting the documentation
“Nurses are the new era of superheroes. In every sense of the word they symbolize hope and have the power to impact the lives of others through their courage, compassion, advocacy and resilience.”
— Karen Snavely, RDCS HeartLand Region
70,245 Patients
Thequality.newly streamlined documentation process was met with resounding approvals. Some of the comments we heard from our nurses were, “Thank you so much for making these changes” and “This saves so much time!”
*Adapted from FaithCommunityNursing:Scope and Standards of Practice, third edition, 2017.
Nurses and Health Ministers 109,180 Patient Contacts 19,689 Hours of Service 154 Participating Organizations FEATUREcommunities.ofCaringNursesCommunityFaithforthebody,mindandspiritpeopleinCommonSpiritHealth
• Establish high-quality documentation of the work of FCNs throughout CommonSpirit.
Within CommonSpirit, six faith community health networks support faith community nurses, or FCNs, in the communities they serve. With financial support from a Mission and Ministry Fund Grant, our faith community health networks are collaborating to:
48 CommonSpirit Nursing
Faith community nursing is the specialized practice of professional nursing focusing on intentional care of the spirit as the foundation of the practice. The delivery of care and the relationship established promotes whole-person health and prevention or minimization of illness within the context of a faith community, faith- or community-based organization, or the larger community.*
• Design a dashboard that will share meaningful information about the impact of faith community nursing programs.
• Create a playbook that will guide others who want to do this work.
• Develop new FCNs by offering a Foundations of Faith Community Nursing course in partnership with Creighton University, to begin in January 2023.
Many FCNs use the places where faith communities gather or the premises of community service organizations as their places of work and practice. They are licensed nurses who may collaborate with health ministers, clergy, health care providers and community-based organizations to care for the body, mind and spirit of those they serve. Some FCNs Noteworthy Numbers 119
— Lois Lane, System Vice President, Mission Integration are paid for all or some of their work, but many work in unpaid roles. FCNs help create healthier communities and they also deliver bottom-line value.
The Faith Community Health Network in our Midwest Division documented savings of $473,638 in costs to individuals, families and health systems as a result of services provided during 2021. As we look ahead, we hope to further expand FCN capabilities across CommonSpirit. This includes making the necessary training for FCN more widely available and sharing best practices with across CommonSpirit to ensure every location has the opportunity to provide these very valuable services.
• Reduced inpatient readmissions
• Better management of chronic health conditions • More successful patient transitions from hospital to home
Left to right: Faith community nurses teaching classes in CPR; our Midwest Division was awarded the Eastern Nebraska Office on Aging’s Spirit of Aging Award in the Medical/ Health Care category.
• Fewer urgent care and emergency department visits
•
FY22 Annual Report 49
The work of FCNs contributes to:
1 Center for Faith Health MinistriesFaith Health Partnership, Arizona: Denise Viker, Coordinator 2 Faith Community Nursing/Health Ministry Program, California Central Coast: Jean Raymond, Coordinator 3 Mercy Faith and Health Partnership, Greater Sacramento Area, California: Susan Taylor, Coordinator 4 Penrose-St. Francis Health Services Faith Community Nurse Program, Colorado Springs, Colorado: Velda Baker, Coordinator 5 Faith Community Health Network, Midwest Division: Nicki Ayer and Susan Ferrone, Coordinators 6 Congregational Health Ministries, Washington: Coordinator position open Faith
2HealthCommunityNetworks64135
“This is a mentorseducatorseffort.collaborativetrulyWeareandforeach other through all the challenges and rewards of faith community nursing. We’re blessed to have grant support from the Mission and Ministry Fund to help expand this work across CommonSpirit.”
• Reduced health disparities
The Gardens of St. Francis, Oregon St. Clare Commons, Perrysburg St. Leonard, Centerville 6 Oregon Linus Oakes Village, Roseburg 7 Wisconsin Franciscan Villa, South Milwaukee Senior Living Locations
—Angela Good, RN, BSN, RAC-CT, RAC-CTA, WCC, Director of Clinical Reimbursement
The Commons of Providence, FranciscanSandusky Care Center, Toledo
With 13 locations across seven states, CHI Living Communities continues to provide excellent care for the elderly and those who are most vulnerable among us. Our dynamic, 1,700-member team is dedicated to fulfilling our sacred CommonSpirit mission by offering seniors numerous safe, convenient living options, including independent and assisted living, skilled nursing, rehabilitation and memory care. Deeply rooted in the CommonSpirit Catholic heritage and continually fulfilling the CommonSpirit mission and vision, our CHI Living Communities team takes great strides to ensure residents feel their selected CHI Living Community is truly their home. We are very honored that in spite of the pandemic, CommonSpirit senior care services have continued to make great strides forward, including:
FEATURE
thecareProvidingCommunitiesLivingCHIsafe,caringseniorservicesthroughoutCommonSpiritMinistry.
5 6 7 31 2 4
The Gardens at St. Elizabeth, Denver Namasté Alzheimer Center, Colorado Springs 2 Iowa Bishop Drumm Retirement Center, Johnston 3 Kentucky Madonna Manor, Villa Hills 4 North Dakota Riverview Place, Fargo 5 Ohio Providence Care Center, Sandusky
“It is very fulfilling to work with an exceptional team of nurse leaders across CHI Living Communities. The focus of working as a team and doing the right thing is always emphasized. ”
50 CommonSpirit Nursing
The CHI Living Communities - Bishop Drumm location was recognized as a 2021 Top Workplace by the Top Workplaces national recognition program. Based in Johnston, Ohio, this location serves nearly 300 residents with independent and assisted living amenities, as well as skilled nursing and rehabilitation services. An innovating Senior Memory Care program was developed (see the additional highlights in this 1 Colorado
“The past few years have been the thechallengingmostthatseniorcare industry has ever faced. However, due to the dedicated leadership — including a new Chief Executive Officer— and maintaining faith, the CHI Living Communities team has weathered sustained periods of uncertainty, proving that our ministry will continue to be a service to those who need us most.”
80,000+
10,000
FY22 Annual Report 51 section) that will be used throughout our CHI Living Communities locations and made available to senior care entities beyond CommonSpirit. Memory care is a unique subset of assisted living and nursing home care and is a key factor in addressing specific social, medical and safety needs of people who have dementia or other form of cognitive impairment. As we look ahead to the future, the CHI Living Communities team is committed to providing the best experiences possible for seniors and their families, as well as our employees. And while no one knows when the pandemic will end, we know that with our collective experiences and resilience, we will continue advancing together and achieve our CommonSpirit vision to create a healthier future for all. •
Memory Care Education Partnership
Noteworthy Numbers Long-term Care Facilities in the U.S. Nursing facility patients received long-term care for 100 days or more Assisted Living Residents in the U.S. Baby Boomers will reach the age of 65 every day until 2030
65,000
78%
CHI Living Communities has joined with Dignity Health Global Education to create a robust memory care program. This program is a 10-module 30-hour course that focuses on both the employee and resident and guides them through everyday interactions. It includes evidence-based practices and supports care using the latest research in dementia/Alzheimer’s care. The course goes above and beyond by further supplying strategies and tips on how the employee can take care of themselves while displaying care excellence daily.
— Dr. Ja’Nay Crippen-Derry, DHA, MSN, RN, Vice President of Clinical Operations for CHI Living Communities
“The difference in rural health is vast. With fewer resources, each team member wears many hats and what we lack in volume and resources, our nurses make up for in experience, grit and innovative care,” Tim says. “For example, it’s not uncommon for our rural community nurses to deliver a baby in the morning and oversee hospice care in the afternoon.”
“Rural membersgroupnursescommunityarearesilient,well-trainedofteamwho are committed to providing services in a highly specialized environment. We thank them every day for all they do.”
The ability to perform numerous roles each day was critical during the peak of the COVID-19 pandemic.
52 CommonSpirit Nursing FEATURE
compassionNursesAmericaCareDeliveringinRuraldemonstrateresilienceandinunprecedentedtimes.
— Dr. Veronica Martin-Posley, DNP, RN, NEA-BC, Division SVP & Chief Nurse Executive, St. Luke’s Health - Texas Division
Dr. Veronica Martin-Posley, DNP, RN, NEABC, Division SVP & Chief Nurse Executive, St. Luke’s Health - Texas Division, leads the Texas Division which includes 16 acute care hospitals, four of which are rural hospitals. Like Tim, she noted how the nurses in these locations provide multiple services, ranging from direct patient care to the registration of new patients and patient meal delivery. She also said most rural community nurses must be well trained in all aspects of care, particularly for the elderly, a primary patient population in rural communities.
“When COVID-19 first appeared in the Midwest Division, our two small rural community nursing homes were
Navigating COVID-19
When Tim Plante, RN, MSN, MHA, Division Vice President of NursingMidwest Division, left his prior role as Chief Nursing Officer at a Lincoln, Nebraska hospital to lead the Midwest, he immediately learned how differently nursing care is provided in rural communities. In his new role, he oversees 18 rurally-based Critical Access Hospitals in Nebraska, Iowa, North Dakota and Minnesota.
Midwest Division 5 3 1 42
“To help, our entire Midwest Division clinical team learned isolation techniques, picked up shifts, and made food for each other so our rural community nurses could focus 100% on the patients.”
Providing nursing care in rural communities presents unique challenges, starting with recruitment. Many nurses who work in our rural settings are approaching retirement and onboarding new nurses requires a special tenacity. Both Tim and Veronica say they’ve had the most success recruiting nurses who live near, or grew up in, rural communities. One of Tim’s nursing supervisors now proudly works in the same rural hospital where she was born and where her mother and grandmother also served as nurses.
1 Nebraska CHI Health Plainview, Plainview CHI Health Schuyler, Schuyler CHI Health St. Mary’s, Nebraska City 2 Iowa CHI Health Missouri Valley, Missouri Valley CHI Health Mercy Corning, Corning 3 North Dakota CHI St. Alexius Health Williston, Williston CHI St. Alexius Health Dickinson, CHIDickinsonSt.Alexius Health Garrison Memorial Hospital, Garrison CHI St. Alexius Health Turtle Lake, Turtle Lake CHI St. Alexius Health Devils Lake Hospital, Devils Lake CHI St. Alexius Health Carrington, CHICarringtonMercyHealth Valley City, Valley City CHI Lisbon Health, Lisbon CHI Oakes Hospital, Oakes 4 Minnesota CHI St. Francis Health, Breckenridge CHI St. Gabriel’s Health, Little Falls CHI St. Joseph’s Health, Park Rapids CHI LakeWood Health, Baudette 5 Texas CHI St. Joseph Health Burleson Hospital, Caldwell CHI St. Joseph Health Madison Hospital, Madisonville CHI St. Joseph Health Grimes Hospital, Navasota St. Luke’s Health-Memorial San Augustine, San *AdditionalAugustineRuralHealth locations exist throughout CommonSpirit. Rural Community Nursing*work. They are masters at all of the areas they work in.”
•
Looking Ahead
FY22 Annual Report 53 devastated with outbreaks among patients and staff, ultimately losing 48% of their residents to COVID-19,” Tim says.
Veronica says the Texas Division rural community nurses performed similar crisis care, including delivering COVID-19 community-based education, vaccine clinics and providing care during COVID-19 surges. This included treating rurally-based patients and receiving overflow patients from the larger, tertiary hospitals.
where“Ruralcommunitynursesonlyknowthenightbeforetheywill
— Timothy Plante, RN, MSN, MHA, Division Vice President of -
Nursing
PeopleOur Employer of Choice: Physician & APP Experience APPs are seeking post grad/fellowship opportunities for specialized training that expeditiously places them as fully competent and productive providers. The size and access to national experts creates a draw for APPs to make CSH their employer of choice.
Dr. Barbara J. Martin PhD, ACNP-BC, MPH System SVP Advanced Practice Pillar 2026CommonSpiritRoadmap Goal APP Post Graduate Training Alignment with Roadmap & Nursing Vision
FutureOur Trusted toFinancialProvider:ContributionOverallOrganization
Leading the Way PracticeAdvancedProvidersFocusingoninnovation, collaboration and collegiality.
NATIONAL NURSING TEAMS
APP leadership team completed an environmental assessment and developed an Advanced Practice 2026 prioritization plan to align with the nursing and CommonSpirit
54 CommonSpirit Nursing Advanced Practice Providers (APPs) partner with physicians, nurses, and operational leaders across the health system to provide mission-driven clinical transformation and APP care model innovation to enhance integrated care delivery services. The Senior Vice President of Advanced Practice provides leadership, direction and resource stewardship of the health system’s Advanced Practice Care function and has oversight theInministry.CommonSpiritacrosspracticeforaccountabilityandadvancedtheFY2022,national
Reducing early turnover for providers has the potential to reduce losses in labor costs and increase revenue.
ExcellenceOur Clinical Excellence: Acute & Ambulatory Quality Providing structured clinical training to new APPs, and leveraging the size and clinical teaching capacity of CommonSpirit will align us around our established clinical quality goals for the providers.
. •
FY22 Annual Report 55
Paul Rains RN, MSN, System SVP, Behavioral Health Behavioral Health
The severalpresentationweInsuicide.wayisProjects’LighthouseColumbiamissiontolightthetoendingFY2022,offeredthistrainingtimesto
Exciting things have happened in the CommonSpirit Behavioral Health Strategy throughout FY2022. The Behavioral Health Service Line is led by Paul Rains, RN, MSH. The two main areas of focus for Behavioral Health are supporting our Emergency Departments and improving access to care. Behavioral Health has supported our Emergency Departments (EDs) by improving the quality of care, improving workflow, decreasing unnecessary lengths of stay, and more effectively planning for care coordination. The Behavioral Health Clinical Council partners with the ED Medicine Council to identify and prioritize opportunities to achieve the objectives noted above. Additionally, standardization of the system-wide suicide risk assessment with the Columbia University Suicide Assessment tool(s) is being supported by a training presentation from the Lighthouse Project.
all CommonSpirit clinicians. We have also improved access to care by connecting our internal behavioral health services across CommonSpirit and identifying/filling gaps in care. Every effort is being made to maximize internal resources by using innovative and cost-effective value based care models. Pilots for Maternal Mental Health and Victims of Human Trafficking via telehealth are underway.
Other contributions have been made through the ongoing work of subcommittees of the Behavioral Health Clinical Council and Behavioral Health Collaborative. • strategic plans. The need for highly educated APPs to be quickly oriented into their specialty practice areas and reach full productivity in a structured and coordinated fashion has been identified as an emerging issue across the clinical enterprise. To address this, the CommonSpirit National Office of Advanced Practice has completed a structured assessment of the need for APP fellowship and post graduate training programs across CommonSpirit. We are currently developing a program proposal with business justification and completing a stakeholder-driven planning process. We will launch the first pilot cohort in the summer of 2023. For more information or to get involved, email commonspirit.orgadvancedpractice-communications@
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• EHR updates/modifications to ensure compliance requirements to support CMS programs for Promoting Interoperability, electronic Clinical quality Measures, Merit Based Incentive Payment Systems. Readiness includes meeting the requirements for CMS, The Joint Commission, public health reporting for the Immunization Registry, Syndromic surveillance, reportable lab results and electronic case reporting. Interoperability compliance for sending and receiving electronic health information and for providing electronic access to health information by patients.
InformaticsNursingRegulatoryInformatics
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Highlights of the past year’s accomplishments include: Ann D. Shepard MSN, RN-BC, SVP, Nursing Informatics and CNIO Nursing
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56 CommonSpirit Nursing Nursing and Clinical Informatics, in partnership with Medical Informatics, provides strategic and operational leadership for the design and development of clinical facing technology within CommonSpirit. This work is part of driving care transformation across the clinical enterprise.
EnhancementsCerner Implementation of annual Cerner upgrade Glendale, CA Cerner Health Check completed Extension of current Cerner standard with registration/ finance functionality at 14 Arizona General sites
EnhancementsEpic Implementation of a successful Epic upgrade Development of an Epic South instance with collaborative EHR governance in support of the Healthcare Operating System Addition of Epic Refuel to the South Instance of Epic (Texas/Tennessee/Georgia)
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Other EnhancementsEHR Collaborative effort for EHRs in achieving Board of Stewardship Trustees approved goals for patient safety, quality and patient experience COVID-19 updates to EHRs as treatment and therapies evolve Development of rapid EHR onboarding processes for supplemental staff and travelers Readiness preparation for Kentucky Epic conversion at 6 hospitals and 92 clinics Optimization and support with ambulatory clinics Successful virtual pilot in Texas for EHR user training
FY22 Annual Report 57 services across the BedCentralizedTransferofferingCommonSpiritpatientsupportingisteletrackingCurrentlysystem.in64locations11,500bedsinCenter,Placement
Clinical WorkforceCentersCommand&ContingencyManagement
and Intercollaborative Services via the Clinical Command Center Virtual RN (vRN) in California, Nevada, Arizona, and Additionally,Kentucky.the Command Centers are piloting and implementing patient standard platforms for remote patient monitoring and offering transitions of
Gail Daly
Clinical
CommonSpirit Command Teams
The Clinical Command Centers and Contingency Workforce Management team facilitates strategic alignment on the CommonSpirit national strategy for operating models, technology, resource management, and standard operating procedures specific to clinical command centers and contingency resources. In FY2022, the Clinical Command Centers implemented a patient standard platform with Teletracking throughout California, Nevada, and Arizona to deliver various centralized RN, MSN, System SVP, ClinicalOptimizationIntegrationOperations,
Center
feature a
platform with
58 CommonSpirit Nursing care services to patients in an acute, post-acute and ambulatory settings. This will offer the ability to optimize services and create one dashboard alert management tool for the clinical team to intervene with the patient to ensure continuity of care and reduce total cost of care.
4,000+ Staffing placements across the enterprise 120 More locations planned for the future NATIONAL NURSING TEAMS
Noteworthy Numbers 41 Locations in
National contracts with travel nurse agencies are managed through our Contingent Workforce Management program. More than 4,000 staffing placements across the enterprise bolstered our staffing in FY22. The program assisted with expediting resources for critical staffing needs during COVID-19 surges. A centralized Communication and Patient Navigation Center (PBX) was developed for six acute hospitals in Northern California. Progress was made in preparation for the continuing spread of centralized monitoring units to provide services for the Virtual Companion program, patient navigation, and remote patient monitoring. Virtual nurses located in the Command Centers provided admission, transfer and discharge services to augment on-site nursing staff during the pandemic. These services decreased lengths of stay, improved patient and nursing experience and decreased readmissions. • CA, NV, and AZ patient standard Teletracking
Clinicians across CommonSpirit Health have continually evaluated and improved their patients’ experience based on these data elements and outcomes. The result has been 3 years of annual improvement in our patient experience scores. Our partners at Press Ganey have shared with us that patient experience scores have declined across the country and in almost every system over the past 2 years. This has been attributed to the challenges of COVID-19 including surges, burnout, and visitation restrictions. However, CommonSpirit facilities have maintained our patient experience percentile ranks in almost every care site. We believe this is due to our nurses and other caregivers who have continued to focus on supporting and caring for
FY22 Annual Report 59
Nurses are recognized for their major role in driving and influencing patient experience across the care continuum. We are in a unique position to understand individual needs in order to partner with those we care for. We also understand that the way patients experience their care can have a direct bearing on their wellbeing and how they heal. To truly transform the care experience for patients and consumers, nurses and their teams must be at the heart of transformation. To support them, the CommonSpirit Health Patient Experience team has developed patient centric tools and evidence-based practices which have been implemented and hardwired as part of our journey to become a system widely known for outstanding nursing care. In addition to the health benefits of positive experiences, how patients perceive their care can be a differentiator and growth driver for our system. It is paramount to understand the patient’s experience across the full care continuum, which is why national goals for patient experience will be established in all care areas. This is part of Camille Haycock MS, APN, PatientSystemNEA-BC,SVP,Experience
Patient Experience our commitment to deliver on the promise
experiencepatientunderstandToeveryeveryhumankindness;ofpatient,time.helpusin
individual hospital units, clinics, virtual visits and other continuum sites, we have developed a “single source of truth” with dynamic and real time analytics.
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MedicarereviewsofimplementationAdditionally,guidelines.CMSaccordancekeyinCoordinationCarecompletingfunctionsinwithregulatorytheretrospectiveof one-day stays and organization-wide auditing of Care Coordination activities will ensure adherence to CMS regulatory requirements and will reduce risk to our organization.
• Creation of a Utilization Management Hub Model in select markets. This model includes Utilization Review RNs and Concurrent Denial Management RNs working together as one team. The model allows for continuity of work flow through the entire Utilization Dana Farley RN, MBA, CCM, System SVP, Patient Coordination-AcuteCare Acute Care Coordination
• In FY2022, Care Coordination, with involvement from staff throughout all levels of the organization, collaboratively identified our mission, vision and values to unite us in purpose across CommonSpirit. Additionally, Care Coordination leaders created a five-year strategic plan, setting out the tasks, the milestones and the steps needed to transform Care Coordination to meet the needs of our patients and stakeholders. We developed system policies, budget support, and other tools designed to share best practices and enable local leaders to devote more time to their teams and the markets they serve. Some examples of this system-level partnership and accomplishments •include:Creation of a new department, Care Coordination Regulatory Review Program, to support
60 CommonSpirit Nursing our patients while utilizing best practices and standardized tools. We’ve observed nurse innovations to better support communications with patients and families during the pandemic. In addition, we’ve seen innovative strategies from our facility leaders who continued leader rounding in support of patients and Evidence-basedstaff.teamwork practices, access to care and improved communication strategies have also been embraced by nurses and providers in our ambulatory clinics and settings. Patient experience goals have been developed for our Virtual Care Clinics with supporting resources and evidencebased practices. In FY2023, we will increase our continuum focus on Home Health and other service lines. We are also continuing to expand our portfolio of resources to include a National “Service Recovery Model” (Humankindness with HEART) and a “Patients as Partners Resource Guide”. We are on a journey to continually improve how our patients, families and others feel about how we care for them, and CommonSpirit nurses are professionals who will lead the way.
• Continuation of post discharge followups to decrease readmissions and improve the patient experience.
Review (UR) process, from admission reviews to challenging payer-issued concurrent denials. Care Coordination also collaborated with Ambulatory Care and Post Acute Care (PAC) to improve the coordination of care across the care continuum (often called 4C efforts).
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• Identification, in collaboration with Community Health and Population Health, of a core social needs screening domain. Care Coordination assisted in the development of a toolkit for core screening of social needs/social determinants of health.
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• Creation of a suicide risk-assessment training and education program for Social Work (SW) staff across
• Development of a new leader orientation to standardize orientation for new leaders in Care Coordination. Additionally, Inter-rater reliability testing was established for all UR nurses and standardized Care Coordination education was implemented across all sites.
Dignity Health Global Education to create Care Coordination RN and SW residency programs.
• Maintenance of collaborative relationships with post acute care providers (including narrowed networks) to facilitate timely and comprehensive discharge and decrease avoidable delays.
Other accomplishments included:
Ambulatory triage nurses treat patients by providing advice and instruction over the phone, recommending the proper level of care when in-person treatment is required, and assisting with managing chronic conditions such as diabetes and hypertension. Our Physician Enterprise Connection Centers (PECC) Ambulatory Nurses have full access to medical records, allowing them to act as an extension of the clinic, reducing operational costs and saving our patients time and transportation expenses. Thanks to our dedicated nurses and staff, there are plans for more CommonSpirit facilities to take part in the benefits of
• Our new
and Mia Kaufman, Director, Nursing Innovation & Technology. The trio previously implemented a VIC model in two CommonSpirit markets, Colorado (Centura) and Iowa (Mercy Des Moines). Their work will be closely aligned with the virtual work performed through our CommonSpirit Command Centers.
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our PECC. Over the past fiscal year, there has been a significant increase in patients using our PECCs. These centers are appointments,schedulingreferrals,forone-stop-shopacoordinating sharing test results and providing guidance. Our compassionate team of PECC Ambulatory Nurses brings immense value to our ministry by handling the influx of calls that require nurse triage, streamlining care and alleviating the workload of PE Physicians and APPs. We look forward to another great year of providing care with excellence to meet the needs of our local communities.
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Shawna Sharp RN, System Director of PhysicianTransformation,ClinicalEnterprise
The newest team to join the Office of the Chief Nurse is small but mighty. Their current focus is on expanding our Virtually Integrated Care (VIC) model as part of the nursing strategy. They will serve as internal consultants to our markets as we develop new care models. Facing the reality of a severe nursing shortage for the next 5-10 years, CommonSpirit is dedicated to creating and implementing patient care teams that utilize a variety of professionals working together to ensure we provide exceptional quality care. It is probable that these models will involve the use of technology.
Transformation&InnovationDirector,Diane&TransformationNursingSystemLindamembersteamare:Goodwin,SVP,Innovation,Murphy,NursingCare
62 CommonSpirit Nursing
andNursingTriageAmbulatoryNursingTransformationInnovation
Linda Goodwin MSN, MBA, FACHE, System SVP, Transformation,NursingVirtualCare&Innovation
Patient Care Services FY2022 brought exciting advancements in the world of Patient Care Services, which collaborates closely with a number of other departments to meet system goals.
Various highlights are shared below:
and regulatory education. In alignment with our nursing vision, the clinical education team has moved forward with initiatives vital to the hiring and retention of our nurses. As an initial offering in a plan to support nurses at every stage of their careers, the first virtual leadership program for frontline nurses was initiated in FY22. This program, Advancing Scholarship in Clinical Excellence and Nurse Development (ASCEND), is an application-based, selective program that recognizes nurses who have demonstrated a passion for leadership.
DNP, RN, MBA, CENP, System SVP, Patient Care Services
Clinical Education Clinical Education at CommonSpirit is overseen by the National Clinical Education Council (NCEC). This council provides oversight for all aspects of clinical education and contributes to the achievement of transformative initiatives where education plays a significant role. Council objectives include standardization of essential clinical education, professional development for nurses, and support of facility education leaders to ensure compliance with required mandatory Dr. Clemmons-BrownConnie
Well-BeingCOVID-19
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PracticeEvidence-BasedandCouncil
In the Spring of 2020 an interdisciplinary “COVID-19 Resilience as Well-Being Task Force” was initiated to support staff as they dealt with emotional stress and trauma of the pandemic. Efforts (see sidebar) were geared toward supporting Employee Assistance Programs (EAPs) onsite in facilities; proposing new HR resources and policies to support staff; educating leaders, collaboratives, and clinical groups on trauma and well-being; and establishing feedback loops. To further increase access to resources,
The CommonSpirit Abuse, Neglect, and Violence policy, applicable to all care settings, was adopted this fiscal year. Designed in partnership with providers, nurses, social workers, chaplains, and other colleagues, it includes the PEARR tool which guides health professionals on how to assist victims in a traumainformed, healing-centered manner. (PEARR stands for Provide privacy, Educate, Ask, Respect & Respond.)
64 CommonSpirit Nursing Nursing ShowcaseExcellence
The CommonSpirit Nursing Research and Evidence-Based Practice Council (NREBPC) is comprised of members from each of the system’s divisions. The council’s mission is “to support the generation of new knowledge and application of Evidence-Based Practice (EBP) through building a culture of inquiry and developing and advancing nursing research and EBP that aligns with strategic organizational initiatives.” Among its objectives is to support and share scholarly activities of CommonSpirit nurses. During its inaugural 18 months, the NREBPC accomplished its goals through subcommittees to help build research and evidence-based practices across the system.
In May 2021, the first Nursing Excellence Showcase (NES) was launched to highlight the outstanding scholarly activity conducted by CommonSpirit nurses. NES is a monthly showcase, conducted virtually. Nurses are selected to present their completed research or evidence-based practice (EBP) projects. Attendance is open to everyone, and the audience is able to ask questions after each of the two 20 minute presentations. To date, 32 registered nurses have presented their projects at the showcase, demonstrating their commitment to advancing the profession through nursing research and EBP.
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Research
n Coordinate
n
FY22 Annual Report 65 a Well-Being Check-In was created. This colorful, friendly approach to asking employees how they’re feeling provides a gateway to link them to helpful resources. In December of 2021, the Task Force transitioned from a committee to a broader system-wide strategy that launched in 2022.
COVID-19 Resilience as Well-Being Task Force Goals (Spring 2020–December 2021) Support resilience and well-being in clinicians, leaders and staff in response to COVID-19 COVID-19 resilience and well-being efforts to ensure seamless delivery and minimize information overload Remain agile, seek feedback, and respond to changing circumstances with meaningful resources
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• Improved patient satisfaction and patient readiness for surgery, while reducing the no-show rate by more than 20% through use of the patient preOp preparation tool, EMMI across the system.
Each division of CommonSpirit has perioperative representation from each state within that division serving on the system Perioperative Council. The Council’s objective is to improve quality, patient safety, patient satisfaction and staff and physician satisfaction through increased systemness. Its work is done through the following subcommittees: Sterile Processing Department (SPD), Policy/Quality, Education, EMR Standardization, Capital Equipment and Business Strategies. The subcommittees have helped to both establish standard work within our Electronic Health Records (EHRs) and create standard orientation and annual competencies for SPD and the Main OR. They have also created more than 10 system policies, and created standardized use of IT platforms for clinical practice across the system.
Contributed to the AORN CineMed video library for their portfolio of Perioperative Nursing practice videos.
66 CommonSpirit Nursing
ServicesPerioperative
• Implemented a systemwide contract for Robotics which has led to additional facilities becoming Robotic Centers of Excellence.
Additional highlights for FY 2022
• Planned for the system-wide implementation of the Enhanced Recovery After Surgery (ERAS) program based on best practices from across the system.
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• Contracted with the Association of periOperative Registered Nurses (AORN) to help support the PeriOp 101 Core Curriculum and eGuidelines for perioperative nursing practice.
•include:Expanded the system’s Prevention of Retained Surgical Items Policy.
• Implemented a perioperative growth tool to right-size surgical blocks across the organization and release unused blocks for other surgeries.
The Nursing Professional Practice Council (NPPC), with members from each division, was officially established in March 2020 when the Nurse Executive Council approved its initial charter. The mission of the NPPC is to support professional nursing practice; align clinical practice to evidence; and provide oversight, direction and governance for professional nursing practice across the system. This ensures quality, safety and excellence in care for all patients and their families. The NPPC work is aligned to our strategic pillars: People, Excellence, and Future. Major work of the council has been implementation of the Nursing Core Standards of Practice. These standards are based upon the 3rd edition of the American Nurses Association (ANA) Scope and Standards of Practice. Applied in conjunction with CommonSpirit facility policies and procedures and licensed independent practitioner (LIP) orders, they reduce variation in practice across our organization by conforming to current evidence. We accomplish this by leveraging the nursing and respiratory care procedures found in Elsevier Clinical Skills, our source of truth for evidence-based nursing procedures. As evidence has evolved, Elsevier has researched and made beneficial substantive changes to these procedures because of change requests made by CommonSpirit nursing staff.
FY22 Annual Report 67
PracticeProfessional
AssistantExecutiveSeniorPickett,toDr.
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The NPPC structure now includes a Joint Practice-Education subcommittee and a Joint Practice-EHR sub-committee, both established in 2021. These committees have extended the reach and capacity of the NPPC by leveraging subject matter expertise of our committee members, who provide content review and recommendations to the council. The efforts of Council members have led to systemic changes throughout CommonSpirit that benefit both our patients and our nurses. •
A ThanksSpecial Linda
Kathy Sanford, CommonSpirit CNO, is a steady partner behind the scenes, helping make CommonSpirit nursing run smoothly. Her dedicated efforts, bright smile and friendly demeanor are key in making our ongoing nursing communications efforts successful.
68 CommonSpirit Nursing
“ “ You are the hands of healing, the face of comfort and compassion, the professional,ultimate the special presence that makes the difference to our —patients.SisterBarbaraHagedorn,
SC, Member of the CommonSpirit Board of Stewardship Trustees
