2016 Nursing Outcomes Annual Report

2016

NURSING OUTCOMES ANNUAL REPORT

Nursing

WHAT’S INSIDE STRATEGIC AIM #1 | Advance Nursing Practice Excellence and Transformation Breast Milk and Blood Transfusion Administration Preventing Readmission Through Risk Assessment and Coordinated Care Patient Care STAR ratings (Home Care) Patient Satisfaction: HCAHPS 2016 Fine Award Central Line Associated Bacteremia Prevention Infection Control Practitioner Workflow Optimization

STRATEGIC AIM #2 | Intensify Evidence Based Practice and Translational Research Skin to Skin Evidence-Based Practice Forum Stroke Certification Evidence-Based Clinical Decision Support Tool Caring for High-Risk Patients Receiving IV Opiod Medication

STRATEGIC AIM #3 | Promote Leadership, Excellence and Career Development Legislative Day 2016 Friends of Nursing Excela Health Nurses, Taking the Lead 2016 Professional Presentations and Publications Certifications CRNA AND CRNP 2016

STRATEGIC AIM #4 | Foster Financial Stewardship and Workforce Management STAR Teams Structured Interprofessional Beside Rounds (SIBR) Nurse Resident Orientation EHMG: Using LEAN to Standardize Workflows NDNQI Clinical Indicators

STRATEGIC AIM #5 | Enhance Nursing Image and Community Partnership Healing Gardens Care Team Volunteer Program Walk a Mile in her Shoes Graffiti Wall Exploring Program Pancreatic Awareness

AWARDS AND RECOGNITION 1

Vice President, Helen K. Burns, PhD, RN, FAAN Senior Chief Nursing Officer Well done!! It is my privilege to acknowledge and celebrate Excela nurses - and the entire nursing care team, for the outstanding care provided, the professional work accomplished and the outcomes reached.

Let me set the stage: The ambulance doors open and within minutes you save the life of a patient, and with the touch of your hand you bring hope; You gently place a baby in the arms of a new family and smile, sharing the joy of life; After your patient’s hip surgery, you collaborate with her rehabilitation team to manage her pain so she can participate in therapy, gain strength, and be active again; You sit with the family of a patient who has just suffered a stroke and explain in simple terms the medical care and treatment that he will experience to regain his health and his “self”; You create the “bedside” in a patient’s home, ambulatory clinic, or primary care office; As a case manager or nurse navigator, you compassionately guide patients through their journey, relieving their suffering through coordination of care, explanation of treatments and technology, and being there to listen, comfort, and alleviate fear; You preserve the dignity, and seek comfort for a dying patient, while supporting the family in saying goodbye; These are just a few examples of the extraordinary care that our care teams provide for patients each and every day. But there is more! You lead and manage … Many things!

You educate staff to assure competency and proficiency; You guide us to use technology – to improve patient care and enhance our practice environment; You are putting wellness - the balance of mind, body and spirit - into motion and becoming role models and advocates for health, and demonstrating your commitment to developing and promoting a safe and healthy work environment. These are but several more examples of the extraordinary nature of Excela Nurses. I want to thank all of you for your commitment to our patients, to our profession, and, to one another.

With sincere gratitude and great pride,

WHO WE SERVE

Tfoear the

Soul

Nursing

FRAMEWORK FOR SUCCESS

STAFF CHAIRS Rina Piper • Kathy Radocaj Cathy Choby • Jenna Vennum Not pictured: Marcie Slivka, Jamie Donahue, John Wheelus, Christine Jefferson, Gretchen Peske, Rebecca Breegle

THE SHARED GOVERNANCE MODEL The Shared Governance model at Excela Health provides clinical professional nurses a voice in decision making that creates a positive impact on the quality of patient and family care.

Shared leadership is actualized through a formalized structure of councils, committees and work groups. Clinical professional nurses have the ability to facilitate recommendations and make decisions that pertain to clinical care, quality improvement, and professional nursing practice. Under this model of shared responsibility, Excela Health’s clinical professional nurses assume full responsibility for nursing practice while participating in strong collegial relationships with other disciplines in the planning and delivery of patient care.

LEADERSHIP COUNCIL AND UNIT BASED PRACTICE COUNCIL The Leadership Council and Unit Based Practice Councils are at the core of the Shared Governance model. The Leadership Council provides a mechanism for the communication, integration and coordination of the four functions of the Excela Health Shared Governance structure. The Leadership Council works within the Shared Governance structure to provide vision, direction and planning for the nursing organization in matters of patient care and professional development. The Unit Based Practice Councils (UBPC), provide a voice for clinical nursing in decision making at the unit level. The UBPC is accountable for unit operations, communication and compliance with nursing care standards for specific populations. Each unit systemwide has a UBPC. The Nursing Professional Practice Evaluation (NPPE) Committee, Shared Governance Committee, Staffing Committee and Nurse Executive Committee are part of Leadership Council.

PROFESSIONAL DEVELOPMENT COUNCIL The role of the Professional Development Council is to oversee the development, implementation and evaluation of professional career development programs, grounded in evidence-based practice and nationally recognized standards of nursing practice.

The Professional Advancement Committee and the Professional Image and Community Partnership Committee is overseen by this council.

STRENGTHENING THE VO 5

MANAGEMENT COUNCIL The role of the Management Council is to oversee the human, fiscal, material (space/ equipment/supplies), and support resources/services within and affecting the continued operations of the Department of Nursing and that support safe, cost-effective, quality care.

The role of the manager moves from controlling and directing to facilitating and integrating the function s of the unit. This council will address the accountabilities of management in shared governance. Recommendations on matters relating to the allocation, distribution, and assignment of resources to the individual units and the Nursing Department as a whole, shall be determined, defined, and proposed to the Nursing Excellence Council. The Recruitment Committee and the Retention and Recognition Committees are also a division of this council.

PRACTICE EXCELLENCE COUNCIL The role of the Practice Excellence Council is to define, implement and maintain the highest standards of nursing practice that are evidence based, meet regulatory requirements and are consistent with professional practice standards as defined by state and national nursing organizations. The Innovation, Technology and Informatics Committee and Evidence Based Practice Committee is a subset of this council.

ADVANCED PRACTICE PROVIDER COUNCIL The Advanced Practice Nursing Staff implements the standards of practice as defined by the American Nurses Association, other specialty certifying nursing organizations, Pennsylvania State Law, their specialty organization and practice/discipline specific guidelines. They work collaboratively with the physician and other members of the health care team and within the boundaries of their specialty scope of practice privileges and approved protocols.

OICE OF EXCELA NURSES 6

STRATEGIC AIM

1

#

ADVANCE NURSING PRACTICE EXCELLENCE TRANSFORMATION AND

TAMMY VOGEL, MSN, RN Director, Nursing Services/Quality Excela Health seeks to establish a culture that empowers nurses, encourages autonomy, and promotes innovation through shared leadership, interprofessional collaboration, and a Profession Practice Model that creates a new standard in nursing excellence and results in better outcomes for the patients we serve.

BREAST MILK AND BLOOD TRANSFUSION ADMINISTRATION The ever expanding efforts to ensure patient safety were strengthened with the implementation of Cerner Bridge Blood Transfusion and Breast Milk Administration at Westmoreland Hospital. The initiative facilitates positive patient identification at the bedside providing for additional patient safety and tracking.

Prior to implementation, human error leading to potential or actual mistakes in blood or breast milk administration could occur at any step in the process. The Bridge product saves nursing time and increases accuracy, ensuring the patient receives the appropriate breast milk/blood component.

Cerner Bridge was instituted on April 27, 2016, at the Westmoreland campus with great success. During initial implementation, as issues were identified, the support team investigated and quickly resolved these issues. Bridge Blood Module compliance was monitored and an 80% compliance was achieved within the first week of use for blood product administration. The compliance rate quickly escalated to 100% as staff realized the benefits for the both the patient and the nurse with this initiative. Overall Bridge Breast Milk Compliance steadily increased to 100% after only a few months of implementation. Random audits completed after implementation reflected a continued compliance of greater than 98%.

Ensuring the “right” patient gets the “right” blood transfusion or breast milk safeguards the process and lends itself to a decrease in errors.

Bridge Breast Milk use compliance was 98% for the first month of usage.

PREVENTING READMISSION THROUGH RISK ASSESSMENT AND COORDINATED CARE In March 2016 an evidence-based documentation program that uses an interdisciplinary approach to recognize and identify those patients who are at high risk for readmission was implemented. An interprofessional Readmission Team was developed to prepare for this event. The predictive model implemented searches the documentation in the electronic health record for approximately 60 readmission risk factors and determines a readmission risk score.

The nursing staff, clinical resource management staff, providers, and other health care team members have access to this score when reviewing and documenting in the health record.

The Readmission Risk Score guides nursing care that focuses on education, discharge planning, follow up appointments, when to call the doctor, as well as other specific interventions.

Interdisciplinary Plans of Care (IPOCs) are suggested for those patients at high risk for readmission and who have been identified as having ineffective home medication management. Nursing can then concentrate their education and interventions to meeting the specific identified needs of the patient.

The Structured Interdisciplinary Bedside Rounds implementation has leant itself well to the goal of reducing readmissions as discussion of the Readmission Risk Score has been incorporated into this process. A Collaborative Care Rounding page in the electronic record enables the interdisciplinary team to view patient information from a single page and allows the staff to document a rounding note, anticipated discharge disposition/date, and patient/family goals.

The three and five month Health Checks have shown steady improvement in target encounters with a transition care management assessment completed and in target encounters with discharge documentation completed. The need for further optimizations in target encounters readmitted to the hospital within 30 days of discharge has been identified in the Health Checks. We continually review data and educate staff on the tools available to decrease Excela Health readmission rates.

TEAM

Gena Bertes, Systems Analyst Michele Curcio, MSN, RN John Dolan, MBA, BSN, RN Valerie Dusack, Manager, Quality Systems and Clinical Analytics

Karen Edmunds, MSN, RN-BC Ann Esachina, BSN, RN Tosha Gornall, LSW Rosanne Maticko, BSN, RN Edith Spinneweber, BSN, RN, CCM

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30 DAY READMISSION PREVENTION - APRIL | JUNE | AUGUST COMPARISONS 2016 Readmission Prevention Metrics % of target encounters with a transition care management assessment completed prior to discharge

Month 1 4/14/30

Month 3 6/1-6/30

Month 5 8/1-8/31

Result Indication

48.3% N: 111 D: 230

48.8% q N: 160 D: 328

54.8% q N: 182 D: 223

Demonstrates whether a structured process is being followed on the targeted population of patients.

% of target encounters with discharge documentation completed

97% N: 223 D: 230

98.2% q N: 322 D: 328

% of target encounters readmitted to the hospital within 30 days of discharge

10.4% N: 24 D: 230

8.5% N: 28 D: 328

q

**High Risk Population**

98.5% q N: 327 D: 332

14.5% q N: 48 D: 332

Demonstrates a valueadd approach to assess at-risk patientes and ensures a structured process to address high-risk patient needs.

Reflection of planned discharge effectiveness.

Root-cause analysis will indicate future resourcespecific adjustments that mat be needed.

PATIENT CARE STAR RATINGS Excela Health Home Care and Hospice (EHHC) has always been highly recommended in the community for transitioning patients from hospital to home, providing end-of-life care, providing increased monitoring to prevent hospitalizations, and educating and managing new disease processes. In 2015, when the Centers for Medicare and Medicaid Services (CMS) began publishing their STAR ratings, EHHC fell short despite the excellent reputation for patient care. To understand why community reputation and CMS STAR ratings were not aligned, EHHC first had to understand the Scorecard system. This system assesses nine core measures and rates them on a scale from 1-5 based on Outcome and Assessment Information Set (OASIS) data and Claims data for Medicare patients only. OASIS is the comprehensive assessment tool that is utilized nationwide throughout Home Health agencies for all Medicare/ Medicaid patient. This tool is the national standard for initial data collection on patients to determine skilled needs and care level. In other words, CMS rates all Home Health Agencies based on how they are answering the questions provided on the OASIS. Upon further assessment, areas of deficiency were identified and some immediate improvements were made.

Understanding the STAR ratings allowed EHHC to identify opportunities for optimizations. In 2016, EHHC pinpointed three specific core measures on which to focus. Flu Vaccines, Timely Initiation of Care, and Drug Education were the three key 11

core measures. Several initiatives to improve the agency's score in these three areas were implemented. The most effective initiative was the purchase of Strategic Healthcare Program (SHP) software. SHP sends clinicians alerts to notify them of existing conflicts in data and OASIS responses. An example of this would be the OASIS question regarding Flu vaccinations. The question asks clinicians if services were provided during the months of October through April in the form of a YES or NO response. If the question is answered with a YES response, the clinician is then prompted to answer another question to address who, how, and when the patient received the Flu vaccine. If the NO response is selected, the OASIS skips this subset and the clinician is redirected to the next question. Often times, this question was misread and clinicians were answering this question as if it were asking if the patient received the Flu Vaccine. They would answer NO if the patient declined the vaccine and would be directed as described above. Prior to initiation of SHP, the No response would be counted against the STAR rating as an incorrect answer. With the SHP alerts, the software would indicate a discrepancy between the date and the NO response to the question. This allowed EHHC to go back and correct the mistake and answer the question correctly, lending to better scores in this specific measure.

Another approach that EHHC utilized to improve STAR ratings was improved protocols and education during Team Meetings. This method addressed the measure for Timely Initiation of Care. A standardized protocol was developed to ensure compliance with CMS guidelines for initiating care within 48 hours of discharge from an inpatient facility. This information is also tracked daily and reported monthly. If a case is determined to be out of compliance, it is investigated to identify the cause and education is then provided to clinicians regarding a process to avoid this in the future.

Like the hospital systems, EHHC also increases awareness to remind staff to discuss medication management and side effects with patients on a regular basis.

As a result of the multiple efforts of administration and staff, the Scorecard published in December 2016 along with the projected Scorecard data based on the SHP software reflected improvement in all three categories. EHHC plans to look at Readmission, Pain, and Ambulation in 2017.

WORKGROUP Patricia Lebin, BSN, COC-C, Quality Analyst Sue Kezmarsky, BSN, Manager Education and Quality Christine King, BSEd, BSN, Manager Home Health Julia Shroyer, RN Tish Humes, RN, Home Care Supervisor Jackie Peterson, RN, COS-C, Home Care Supervisor Denise Kemp, RN, Home Care Supervisor Cheryl Johnson, RN, COS-C, Home Care Supervisor

Amy Pernelli, OTR-L, Rehab Supervisor Joe Pasquino, DC, PT, CCSP, Supervisor of Rehab Services Jenn Faris, BSN, RN, COS-C, Nursing Supervisor Laura Davis, RN, Home Care Supervisor Maryellen Davin, BSN, RN, Palliative Care and Hospice Supervisor Matt Klimchok, BSN, RN, Home Care Supervisor Dave Litzinger, BSA, Senior System Analyst Erica Shaffer, BS, Executive Director

PATIENT SATISFACTION: HCAHPS 2016 Excela Health considers patient satisfaction a key indicator of organizational success. Excela measures a patientâ&#x20AC;&#x2122;s perception of care using the Hospital Consumer Assessment of Healthcare Providers and Systems or HCAHPS survey issued by the Centers for Medicare and Medicaid Services. Nursing has many opportunities to impact the survey domains positively. Based on the many initiatives advanced over the past few years, it is clear Excela Nursing is trending upward on key survey questions.

FINE AWARD: Central Line Associated The Fine Award is a prestigious award that honors those that exemplify innovation, patient safety, and quality improvement through professional collaboration and measurable improved outcomes. In 2016, the Infection Prevention and Control (IPC) team along with the Excela Health Education Team and Administration team worked together to decrease Central Line Associated Bacteremiaâ&#x20AC;&#x2122;s (CLAB) system wide. The Fine Award Committee recognized the team's efforts to decrease infection rates through education and awareness and awarded Excela Health with the Fine Award for their efforts and commitment to providing quality care and patient safety.

In 2011 through 2013, The Excela Heath Hospital System had identified a peak in CLAB infection at approximately 3.0 per 1,000 central line days. This data was much higher than the national benchmark for the previously stated years. It was clear that this was a problem that needed to be addressed and the IPC team were up to the task. Two questions were asked: What is causing the increase in infection and How can they be prevented? After careful consideration and an in depth gap analysis, it was determined that the compliance recommendations of the Healthcare Infection Control Practices Advisory Committee of the Centers for Disease and Prevention (HICPAC) were being followed. Implementation and education seemed to be the area that needed the most improvement.

The IPC team, in collaboration with the Excela Education department, then went to work devising a plan to disseminate the information and create a culture of best work practices in regard to central line care. Using the Failure Mode Effects Analysis (FMEA) method, the team was able to identify where the breakdown was and create new work practices and standard work flow processes to correct the issues and in turn, result in better outcomes for the patients. The team also looked at the products staff were using with central lines and moved toward purchasing products that were known to reduce the rate of infection.

The team then designated CLAB champions from each unit that were responsible for completing competencies and education for each staff nurse from that unit. The CLAB champions will be tasked with ongoing education as evidence based practice and technology evolves.

As a result of the research and time committed to this effort, we were able to decrease central line days and cut CLAB infection rates by half in 2015. Although a slight increase was noted in 2016 for CLAB infection rates, the Infection Prevention and Control team, Education Department, CLAB Champions, and Administrative staff continue to monitor and brainstorm initiatives to decrease rates and to provide outstanding care to those we serve.

Kathleen Rosatti, BSN, RN, Director of Medical Outcomes Kim Beck, BSN, RN, LEAN Facilitator Mary Jo Bellush, MSN, RN, CIC Allison Thomas, RN 17

Melanie Fritz, RN Beverly Smith, M Lisa Hayden, Pro Carol Fox, MD, C

Bacteremia (CLAB) Prevention

N MBA, BSN, RN CCRN ocurement Contract Manager Chief Medical Officer

TEAM

Nik Asher, MD, Intensivist Unit Specific Registered Nurse CLAB Champions 18

INFECTION CONTROL PRACTITIONER WORKFLOW OPTIMIZATION Eliminating duplication, accessing and documenting in multiple systems, and ensuring regulatory agency notification when appropriate led to review of standard work flow processes for the Infection Control Practitioners (ICP’s). In order to consolidate information and provide a more universal approach to data collection and documentation the Excela Health Infection Control department decided to investigate and select one documentation system.

The Cerner product for Infection Control allowed the ICP’s to consolidate documentation and eliminate the need to document in multiple systems. The Infection Control module also ensured real time notification to the ICP’s of culture results, isolation order changes, and reportable conditions. This notification appears directly on the work list, without the need to run a report. Another key feature allows the ICP’s to do more electronic submission of data to National Healthcare Safety Network versus hand mining all the data and then entering to the appropriate reporting agency.

In order to initiate the Cerner Infection Control Module, changes in documentation took place for nursing and respiratory therapy. These changes were taught, implemented, and monitored to ensure the needs of the ICP’s would be met.

In preparation for the implementation of this module, Discrete Microbiology was needed to allow the culture reports to cross the interfaces correctly. Discrete Microbiology is a structured result verses a free text result. Having a result that is discrete will allow the information to flow to the work list for the ICP’s and it is much more useful for tracking and trending.

The kickoff for the project occured in October 2015 and implementation took place in December 2016. The Clinical Informatics staff and Information Technology staff continue to work with the ICP’s to identify optimization opportunities.

TEAM

Kate Rosatti, BSN, RN Michele Curcio, MSN, RN Kennette Grohal, MSN, RN Mary Jo Bellush, MSN, RN, CIC Debbie Schotting, MSN, RN Joan Grote, BS, MT (ASCP)

Suzanne Mamrose-Hunt, MPH, MT (ASCP) Mary Hagy, MS, MLS (ASCP) SM Jeff Lehman, BS, ASCP Joanne Golden, BS MT(ASCP) BB Deb Schell, System Analyst Implementation 19

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STRATEGIC AIM

INTENSIFY EVIDENCE BASED PRACTICE AND

TRANSLATIONAL RESEARCH APPROACH

Vice President, TRACI FICK, MSN, RN, NEA-BC Patient Care Services, Frick Hospital Utilizing Evidence Based Practice research in the clinical setting facilitates autonomy, aids in structuring policy, and gives staff confidence that the care they are providing has proven results.

SKIN-TO-SKIN Excela Health’s mission is “Improving the Health and Well-Being of Every Life We Touch.” This mission starts at the moment of birth to impact the smallest and youngest patients. The health care staff of the Family Additions Maternity Unit recognizes the positive impact that skin-to-skin has on the stabilization of newborn from intrauterine life to extrauterine living.

Skin-to-skin, sometimes called Kangaroo care, is the immediate placement of the baby from the womb to the skin of the mother’s belly or chest. The baby is dried and stimulated while on the mother. The immediate skin-to-skin experience fosters the stabilization of the newborn’s temperature as well as blood sugars. The mother’s warm skin decreases the baby’s stress of birth and in turn allows the natural instinct to seek the breast. The baby moves his/her way to the mother’s breast via scent of his/her mother’s milk. The movement of the baby to the breast is often referred to as “the breast crawl.”

The baby is skin-to-skin for the first hour of life. This is a “Golden Hour” for bonding.

The tasks of the nurse are delayed while the family experiences this once-in-a lifetime moment that can never be recreated. Tracey 21

Downs, BSN, RN, IBCLC states that “The warmth and heartbeat of the mom, the voice and touch of the mom, all contribute to decreasing the stress of a birth for both the baby and the mother.”

The implementation of immediate skin-toskin occurred February 2016. The exclusive breastfeeding rates have increased since the implementation of the immediate skin-toskin project. Prior to the start of the project, the exclusive breastfeeding rate was 34.1%.

The Best Practice recommendation of Joint Commission PC-05 is 70%. By the end of the calendar year 2016, the exclusive breastfeeding rate on the unit climbed to 51.2%.

The health and well-being of every life we touch occurs at the moment of birth at Westmoreland Hospital.

Exclusive Breastfeeding Rates 2016 Feb. (Pre) | July (Mid) | Dec. (Post)

Breastfeeding rates comparisons Pre and Post Implementation of Skin to Skin Care

“ “ “ “

One of the keynote speakers, Dr. Linda Siminerio, provided a compelling discussion of education and care delivery methods for the diabetic population. Her presentation has sparked an exploration of our current process and strategies for improvement across the health system. Breakout sessions included research presentations on breast cancer and cognition, breast milk immunity and donor milk banking, EBP projects exploring EBP survey results and the education plan for Excela Health, and restraint reduction in Behavioral Health.

The two research speakers energized the audience as they discussed their projects, and the excitement was contagious!

Several attendees commented that they would be glad to participate in a research project and had no idea that research could be so fascinating!

The closing keynote addressed a significant yet little known threat to our youth: human trafficking. Dr. Amber Edyud provided background information and statistics on the scope of the problems, particularly here in Western Pa. She has worked with the FBI to develop strategies to identify potential victims and appropriate interventions.

Attendees included nursing staff, nursing managers and leadership, ancillary departments such as Nutrition and Case Management, and students and faculty from affiliating schools. Staff nurses, managers, Case Management staff, Physicians and Dietitians participated in the 16 poster displays and covered a wide variety of topics.

The committee has begun work on the 3rd Annual Forum for 2017!

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EVIDENCE

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Nursing staff had a fantastic opportunity to showcase their Evidence Based Practice (EBP) projects at the 2nd Annual Dissemination of Nursing Quality Improvement, Evidence, and Research Forum: Nursing Implications for At Risk P atients. This all-day forum, sponsored by the Evidence-Based Practice Committee, was targeted to the staff nurse. Goals for the forum included highlighting multidisciplinary approaches to clinical issues and problems as identified and worked on by the staff nurse at the unit level, and identifying strategies to improve patient care. Chaired by Karen Scanlan, MSN, RN, CCRN, the committee played a key role in the program’s success!

BASED PRACTICE FORUM

Speakers very knowledgeable/ learned a lot.

Looking forward to the third annual!

Very interesting and motivational.

Makes me want to participate in research.

First time I attended and found it to be a very positive experience.

STROKE CERTIFICATION Ensuring patients receive timely and evidence based care when experiencing signs and symptoms of Stroke is a top priority for Excela Health. In May 2016 all three acute care hospitals achieved designation by The Joint Commission as Primary Stroke Centers and were recognized by the Pennsylvania Department of Health for exceeding national standards for quality patient care. The stroke team met regularly to build a framework for program structure to achieve clinical excellence leading to certification.

The journey began with a cohesive interdisciplinary Stroke Team that met to collect, analyze, and use standard performance measure data to continually improve treatment plans, address opportunities to reduce delays in care, and provide ongoing education to staff providing care to patients. All employees were given a badge for quick reference that reminded staff â&#x20AC;&#x153;Minutes Save Brainâ&#x20AC;? and outlined the four most common symptoms of a Stroke. FAST (face, arm, speech, and time) became the basis for systemwide education.

At Excela Health promoting recognition of signs and symptoms of heart attack and stroke and the importance of seeking medical care within the Golden Hour window of time reflects the greatest opportunity for a good outcome.

STROKE STEERING COMMITTEE Denise Addis, MSN, RN, CPHQ, Director Value Based Quality Melissa Anderson, MSN, RN, Frick CCU, Clinical Nurse Coordinator Tina Baker, RN, Westmoreland 3AB Jennifer Barrick, MSN, RN, Westmoreland 2AB, 2D, 2E, IV Team Nurse Manager Kelly Bedner, MSNEd, BSN, RN, CEN, Clinical Education Specialist, Emergency Department Shirley Brandon, MSN. RN, Coordinator Clinical Informatics Louis Catalano, MD, Neurology Ricki Chew, BSN, RN, Latrobe PCU Clinical Nursing Coordinator Kathryn Crovak, MSN, RN, Latrobe EPIC Rehabilitation, 4Surgical, Jointworks Nurse Manager Barbara Day, MT (ASCP) SBB, Director, Laboratory Cheryl Destefano, M.A., C.C.C./SLP, Manager, Inpatient Rehabilitation Services John Dolan, MBA, BSN, RN, Director, Clinical Resource Management Diane Dunn, MSN, RN, Latrobe Nursing Supervisor and Stroke Coordinator Tara Elkin, BSNMT, MBA, Frick Supervisor, Imaging Services Sheila Farina, MSN, RN, Nurse Educator Traci Fick, MSN, RN, NEA-BC, Frick Vice President, Patient Care Services Carol Fox, MD, FAAFP, Senior Vice President and Chief Medical Officer Sherry Gaston, Vice President, Ambulatory and Diagnostic Services Brandy Gratzinger, RN, Westmoreland 2D Brandi Hall, MSN, RN, Frick Nurse Manager, Patient Care Services Scott Harter MD, Latrobe Stroke Medical Director Emergency Medicine Marti Haykin, MD, Neurology Ashley Hensell, BSN, RN, Westmoreland 2E Jill Hostetler, MS, RN, Westmoreland 3AB, 3D, 3E Nurse Manager Gina Hrach, MSN, RN, MBA, Latrobe Critical Care, 2 East, 3 North Nurse Manager James Jellison Sr., RN, Latrobe ED Vickie Jellison, MSN, RN, Latrobe ED, PCU, 2 West, 3 South Nurse Manager William Jenkins MD, Frick Stroke Medical Director Emergency Medicine Tami Judy, CRNP, Neurology

Nicole Komenda, BSN, Frick ED Clinical Nursing Coordinator Monica Krinock, BSN, RN, Latrobe PCU Clinical Nursing Coordinator Michael Mazowiecki, MD, Neurologist Debbie Medley Jenkins, MSN, RN-BC, CCRN, Nurse Educator Courtney Milsom, RN, Westmoreland ED Kaitlyn Nawrocki, RN, Westmoreland ED Kelly Neubauer, MSN, RN, Westmoreland ED Nurse Manager Megan Nicholson, MSN, RN, Westmoreland 1D,1E Nurse Manager Susan Orange, RN, BA, Frick and Latrobe Manager, Imaging Services Lonna Paterline, MSN, RN, Westmoreland Vice President, Patient Care Services Mark Persin. DO, Westmoreland Stroke Medical Director Emergency Medicine Jill Piccolo PA-C, Neurology Kathy Radocaj, MSN, RN, CCRN, Westmoreland ICU/CCU Nurse Manager Judith Raishart, BS, RTR(R) Director, Imaging Services Martin Rock, BS, PMP, Frick Supervisor, Laboratory Amy Sailor, MS, CCC/SLP, MLLS, Director, Rehabilitation Services Karen Scanlan, BSN, RN, CCRN, Westmoreland ICU Clinical Nursing Coordinator Anne Marie Scekeres, MSN, RN, CPHQ, Manager, Quality Analytics and VBP Aaron Schatz, BS, Westmoreland Manager Laboratory Maryann Singley, MSN, RN, Latrobe Vice President, Patient Care Services Barbara Six, BS, RT (R), Westmoreland Manager Imaging Services Jessica Spiker, MSN, RN, Quality Analyst System Stroke Coordinator Shelly Trout, MT (ASCP), Latrobe Interim Manager Laboratory Michael Utz, MD, Neuro Radiology Tammy Vogel, MSN, RN, Latrobe Director, Nursing Services and Quality Wasil Waleski PA-C, Neurology Barbara Wang MD, Internal Medicine W. Mike Widmann, MSN, RN-BC, CCRN, Coordinator, Clinical Informatics

EXCELA HEALTH NURSES LEAD THE WAY TO IMPLEMENTING AN EVIDENCE BASED CLINICAL DECISION SUPPORT TOOL Starting in 2012, the patient care team at Excela Health started looking for ways to improve outcomes in our patients suffering from sepsis. Severe Sepsis and Septic Shock are major health care problems affecting millions of people around the world each year.

Mortality from sepsis is greater than breast cancer, lung cancer and colon cancer combined. It was recognized that early detection and standardized care were key to improving these outcomes. An interprofessional team met and created a manual screening tool to help with early detection. The team also implemented standard bundles of care to be utilized when sepsis is identified.

Our sepsis journey to excellence has continued to move forward since 2012. In May of 2016, the Excela Health team implemented the St. John Sepsis Agent and the Interdisciplinary Sepsis Advisor. The St. John Sepsis Agent replaces the manual screening tool built in 2012.

It looks for many of the same criteria that were in the manual tool; however, the process is now automatic. As vital signs and lab values are documented, the system analyzes the results and generates alerts for Systemic Inflammatory Response Syndrome (SIRS) and Severe Sepsis when the appropriate criteria are met. The Interdisciplinary Sepsis Advisor adheres to the philosophy of bundled care started in 2012 (and supported by the Surviving Sepsis Campaign) and offers the added benefit of clinical decision support to aid the clinician in choosing the right antibiotic for the source of infection and the right dose for the patientâ&#x20AC;&#x2122;s condition.

The planning for this project was focused on integrating Quality and Patient Safety.

The first order of business was to identify the project leadership team. This included individuals from the Value Based Quality Department, Information Technology, Quality

25

Analytics and Clinical Informatics. A larger team was then created to help with design decisions and implementation. This team consisted of Nursing representation from all three facilities (Emergency Department, CCU/ICU, MedSurg, and PCU), a Sepsis Nurse Lead, a Reporting Team, Pharmacy, Education, Physician champions and the Hospitalist Management Team.

Several tools and strategies were utilized to ensure a successful implementation. Folders with education materials were distributed.

Videos were assigned using our internal education tool, Net Learning. A Command Center and Rounding Schedule were Left to right: Denise Addis, MSN, RN, CPHQ; Miche developed for MSN, RN; W. Michael Widmann, MSN, RN-BC, CCR Anne Marie Scekeres, MSN, RN, CPHQ elbow support.

Hints and Tips handouts were developed and distributed.

Real time reports were used to determine areas for improvement and directed education.

Since implementation, we have been able to demonstrate an improvement in our mortality related to sepsis as well as the number of patients that have received perfect patient care. Post implementation monthly meetings are held to review compliance and discuss opportunities for improvement.

Because of how successful we were with our implementation, the team had the opportunity to present our story at the Cerner Health Conference. This conference is host to an international community of health care professionals. The team received positive feedback about their presentation.

SEPSIS MORTALITY

SEVERE SEPSIS AND SEPTIC SHOCK 10/1/2015 - 1/31/2017 Discharges

ele Curcio, RN-CSC;

Michele Curcio, MSN, RN, Senior System Analyst Sally Backus, MSN, RN, Coordinator, Clinical Informatics W. Michael Widmann, MSN, RN-BC, CCRN, Coordinator, Clinical Informatics Bonnie Barnhart, RN, BSE, MBA, CPHFQ, Quality Analyst Regulation and Accreditation AnneMarie Scekeres, MSN, RN, CPHQ, Manager Quality Analytics and VBP Carrie Horner, MSN, RN, Quality Analyst, Regulation and Accreditation Walt McGuire, R.Ph., Pharmacy Manager Dane Lewis, R.Ph., Pharmacy Manager

Amy Kriss, R.Ph., Pharmacy Manager Dr. Rich, MD, FAAP, Chief Medical Information Officer Denise Addis, MSN, RN, CPHQ, Director Value Based Quality Gena Bertres, System Analyst Val Dusack, Manager Quality Systems and Clinical Analytics Liz White, BSN, RN Anita Mastrorocco, Senior System Analyst Jessica Spiker, MSN, RN, Quality Analyst System, Stroke Coordinator Nik Asher, MD, Intensivist Debbie Schell, System Analyst

TEAM

CARING FOR

HIGH-RISK PATIENTS RECEIVING

IV OPIOD MEDICATION Excela Health System adopts a proactive approach to health care in the inpatient and outpatient setting alike. This commitment to prevention is apparent in the recent initiatives in identifying high risk patients receiving IV opioid medications. Led by Denise Addis, MSN, RN, CPHQ and Staci Orbell, MSN, RN, CPAN, an interdisciplinary team was tasked with identifying risk factors, evaluating and executing IV opioid administration policy, and decreasing incidents involved with the use of these medications.

This team implemented several new processes to reduce the risk to the patient.

Through identification of risk, increased monitoring, policy changes, and staff education, Excela expects to see fewer events associated with the use of intravenous opioid medication. In 2016, Excela developed a prescreening tool to identify patients that have predisposition factors. Additional vitals sign machines were purchased to allow for increased monitoring of patients, specifically respiratory status and blood pressure.

The team also adjusted policy to include IV 27

Morphine and IV Dilaudid in the high risk assessment pain management. The Education department then utilized multiple methods such as Net Learning modules, face-to face, and the HERO newsletter to ensure that the program would be a success.

Pre and Post-Surgical assessments were also developed to identify the at risk patient.

Other areas of focus for the workgroup were documentation and assessment components. The Clinical Informatics department worked with the committee to include these assessments in our Electronic Medical Record for improved communication of risk systemwide. This would ensure that all disciplines would be able to easily identify patients as high risk and take the appropriate precautions.

Since implementation of these procedures in September of 2016, the workgroup continues to audit and improve the success of this program. The current data indicates that the changes made will lead to better outcomes for the patients we serve.

IV OPIOD MEDICATION RISK TEAM Denise Addis, MSN, RN, CPHQ, Director Value Based Quality Staci Orbell, MSN, RN, CPAN, Nurse Educator Perioperative Services Amy Acie, CRNA, MHS, Anesthesia Amy Kriss, PharmD, Manager, Westmoreland Pharmacy Joe Mikeska, Director, Bio-medical Engineering Jeff Oliver, RRT/RPFT, System Manager, Respiratory Care Jill Helfferich, BSN, RN, Nurse Manager Jessica Stack, MSN, RN, Nurse Manager, Perioperative Services Rob McCoy, MBA, BSN, RN, Director, Perioperative Services Michelle Lewis, MSN, RN, Nurse Manager Sheri Walker, MSN, RN, Nurse Educator W. Michael Widmann, MSN, RN, CCRN-CSC, Clinical Informatics Sue Tokarski, MSN, RN, Nurse Manager Carrie Horner, MSN, RN, Nurse Manager Katie Crovak, MSN, RN, Nurse Manager Brian Berry, CRNA, MBA, MS, Chief Nurse Anesthetist Robert Stough, MD

3 STRATEGIC AIM

#

PROMOTE LEADERSHIP, EXCELLENCE AND

CAREER DEVELOPMENT

Vice President, MARYANN SINGLEY, MSN, RN Patient Care Services, Latrobe Hospital The Excela Health System encourages the professional development and leadership in all levels of nursing. Through programs such as Tuition Reimbursement, the Nurse Residency Program, and multiple committees systemwide, Excela supports opportunities for growth and excellence.

LEGISLATIVE DAYHarrisburg, 2016PA Nursing advocacy can be a complex process performed in many settings for a variety of causes. Nursing advocacy is constant throughout the health care arena and is invaluable to leading improvements in the health and well-being of our patients.

Political activism and commitment to policy are key strategies to positively influence decisions in health care. Helen Burns, PhD, RN, FAAN, Senior Vice President and Chief Nursing Officer for Excela Health, recognizes the value of Excela nurses having information on the political climate and the effect the current debated topics will have on our patients and our staff. Dr. Burns supports Excela nurses sharing their voice at the local, state and national levels. On April 11, 2016, Dr. Burns and Ronald Ott, Senior Vice President of Community and Government Relations for Excela Health, traveled with a group of Excela nurses to Harrisburg, PA, to participate in the Pennsylvania State Nurses Association sponsored Pennsylvania CODE BLUE day – nursing emergency. The purpose of the day was to provide a forum for Pennsylvania nurses to advocate for patient safety by sharing how nurses can

work with hospital leadership to establish staffing committees tasked with the development of individual staffing plans.

Dr. Burns, Cynthia Allison, BSN, RN, Traci Fick, MSN, RN, NEA-BC; Brandi Hall, MSN, RN; Deborah Jablonsky, MSN, RN, and Marci Slivka, BSN, RN, met with Senator Kim Ward, Representatives Eli Evankovich (of the 54th district), George Dunbar (56th district), Eric Nelson (57th district), and Michael Reese (59th district). Each representative listened intently as the nurses from across Excela Health explained the campaign to maintain current level of autonomy within the clinical unit staff when making staffing decisions. Excela nurses also campaigned for advanced practice nurses to be able to practice without the oversight a physician after a certain number of supervised worked hours. Senator Ward recognized the Excela nurses for visiting the Capitol and wrote on her social media page “… they were here to talk about the staffing /ratio issue because they care about taking good care of their patients. They are in the trenches and know what they are talking about so I’m in with their suggestions.”

Left to right: Tracy Fick, MSN, RN, NEA-BC; Senator Kim Ward; Brandi Hall, MSN, RN; Marci Slivka, BSN, RN; Deborah Jablonsky, MSN, RN; Cynthia Allison, BSN, RN; Helen Burns, PhD, RN, FAAN; Ronald Ott

SN Excela Health’s Department of Nursing has created a model for philanthropic support of nursing initiatives within our health system.

This fund, “Friends of Nursing,” enables Excela Nursing to promote recognition for and excellence in nursing practice, encourages lifelong learning and inspires innovation.

Established in 2015, Friends of Nursing creates a vehicle for grateful patients, their families, other community members, and health care professionals to support nursing at Excela Health. Last year, Friends of Nursing enabled Excela Health’s Nursing Department to hold its first Evidence-Based Practice and Research Forum, open to all Excela Health nursing staff, with nationally-recognized speakers. Thanks to Friends of Nursing, Excela was represented at the American Nurses Association Annual Nursing Quality Conference and a team of Excela nurses also attended a national conference for institutions working toward Magnet designation – a national designation that recognizes the highest level of excellence in nursing practice.

Contributions for Friends of Nursing at Excela Health are very much appreciated and can be made to Latrobe Area Hospital Charitable Foundation, with the designation “Friends of Nursing Fund.”

EXCELA HEALTH NURSES, TAKING THE LEAD Brandon, Shirley, MSN, RN-BC, Clinical Informatics, Board Member, Western Pa Chapter Healthcare Information and Management Systems Society (HIMSS) Burns, Helen, Ph.D. RN, FAAN, Chief Nursing Officer, Secretary, Board of Directors Pennsylvania Organization of Nurse Leaders (PONL); Expert Panel, Building Health Care System Excellence American Academy of Nursing; Board Member, Pennsylvania Action Coalition Advisory Board; Committee Member, Clinical Steering Committee, Vizient, Inc. Edmunds, Karen, MSN, RN-BC, Clinical Informatics, President, Western PA Chapter American Nursing Informatics Association (ANIA) Fick, Traci, MSN, RN, NEA-BC, Frick Hospital, VP Nursing Patient Care, Committee Member, Legislative Committee, Pennsylvania Organization of Nurse Leaders (PONL) Kaltenbaugh, Le Ann, MSN, RN, Latrobe Hospital, Operating Room, Bylaws Chair Person, Association periOperative Registered Nurse (AORN) Kapolka, Megan, BSN, RN, COHN, Employee Health, President, Southwest PA Chapter, Association of Occupational Health Professionals (AOHP) Singley, Maryann, MSN, RN, Latrobe Hospital, VP Nursing Patient Care, Executive Team, Southwestern PA Region Executive Team - PA Coalition Widmann, W. Michael, MSN, RN-BC, CCRN, Clinical Informatics, Secretary, Western PA Chapter, American Nursing Informatics Association (ANIA) 32

2016 PROFESSIONAL PRESENTATIONS

Publications

Jenkins, D. (2016, March/April). Enhancing nurses' pain assessment to improve patient satisfaction.

Orthopaedic Nursing, 35(2), 108-117.

Orbell, S. (2016, May/June). Frequently asked questions, clinical practice hot topic: Initiating inpatient orders in the PACU. Breathline, 36(3), 10.

Orbell, S. (2016, July/August). Clinical practice hot topic: Minimize your risk for liability in the PACU. Breathline, 36(4), 15.

Splendore, R., Burns, H.K., Choby, C. (2016). Dress for respect: A shared governance approach. Nursing Management, 47(4), 51-53.

Burns, H.K. (2016, April). Are lean and safety synergistic partners? The proof is in the outcomes. Roundtable presentation at American Organization of Nurse Executives Annual Conference, Fort Worth, TX.

Presentations

Cratty, P.; Chabak, B. (2016, October). Use of a tidal model informed program to improve patient satisfaction and decrease chemical restraints on an adult inpatient psychiatric unit at a community hospital. Podium presentation at the American Psychiatric Nurses Association Conference, Hartford, CT. Burns, H.K. (2016, October). Implementing an evidence-based approach to practice â&#x20AC;&#x201C; It takes strategy.

Podium presentation at the Pennsylvania Organization of Nurse Leaders Annual Leadership Conference, Gettysburg, PA. Widmann, W.M.; Addis, D.; Scekeres, A.; Curcio, M. (2016, November). Sepsis/VTE advisors: Collaborating to implement evidence-based medicine tools. Podium presentation at the Cerner Health Conference, Kansas City, MO.

33

S AND PUBLICATIONS Eysler, K.; Farina, S.; Noonan, L.; Burns, H.K. (2016, March). Excela STAR: Shared team approach for quality results. Poster session presented at the Sigma Theta Tau International Scholars Night, Pittsburgh, PA. Jenkins, D., Noonan, L.; Burns, H.K. (2016, March). Organizational culture and readiness for evidence-based practice in a community hospital system. Poster session presented at the Sigma Theta Tau International Scholars Night, Pittsburgh, PA. Burns, H.K.; Bernardo, L. (2016, March). The nursing research consultant: A cost-effective approach for strategic planning. Poster session presented at the American Organization of Nurse Executives Annual Conference, Fort Worth, TX. Burns, H.K.; Sarkisian, S.; Burns, H.U. (2016, April). Accountable care units improve patient satisfaction.

Poster session presented at the American Association of Physician Leadership, Washington, D.C. Backus, S. (2016, April). Increasing safety with bar coded medication administration. Poster session presented at the American Nursing Informatics Association National Conference, San Francisco, CA. Vogel, T.; Reidmiller, C.; Krinock, M.; Cutrell, M. (2016, September). PM care rounding – “Hands on; Lights out”. Poster session presented at the Southwestern Pennsylvania Organization of Nurse Leaders Annual Conference, Farmington, PA. Bedner, K. (2016, September). Use of the ED BKAT 2 for emergency department orientation. Poster session presented at the Southwestern Pennsylvania Organization of Nurse Leaders Annual Conference, Farmington, PA. Jenkins, D.; Scanlan, K.; Noonan, L.; Burns, H.K. (2016, September). Facilitating unit-based EBP education in a community hospital system. Poster session presented at the Southwestern Pennsylvania Organization of Nurse Leaders Annual Conference, Farmington, PA. Jenkins, D.; Noonan, L.; Burns, H.K. (2016, September). The relationship between implementing evidencebased practice and nursing demographics in a community hospital system. Poster session presented at the Southwestern Pennsylvania Organization of Nurse Leaders Annual Conference, Farmington, PA.

Poster Recognition

Rosatti, K., Hartman, S.; Wentzel, C.; Burns, H.K. (2016, October). From idea to implementation: Development of a nursing professional practice evaluation model. Poster session presented at the Pennsylvania Organization of Nurse Leaders Annual Leadership Conference, Gettysburg, PA. Anderson, M. (2016, December). Taking preventative action in the community. Poster session presented at the Pennsylvania State Nurses Association "Nurses Matter" Conference, Poconos, PA.

34

Acute Critical Care Knowledge Professional (Adult) Beverly J. Smith

CERTIFICATIONS ** Represents multiple certifications

Acute/Critical Care Nursing Andrah A. Bates (Palmer) Pam Caruso Jamie L. Culley Carol J. Emanuel Barbara Grote Deborah B. Jenkins** Chelsea A. Long Brittany L. Lubinsky Erica Palmer (Lingenfield) Danielle L. Pavlik Kathleen A. Radocaj Bridget M. Rafferty-Himler Glenn M. Repko Karen K. Scanlan Beverly J. Smith** Christen M. Stercho Sarah L. Stewart Chad T. Toth Robin D. Weyandt W. Michael Widmann**

Certified Clinical Documentation Specialist Rebecca J. Fello

Certified Diabetes Educator Michele L. Axelson Kathyrn Feret Deb Siwula Marcella Stoner

Erin Prettiman**

Rebecca S. Herroscheck Eileen M. Kantorik

Certified Ostomy Care Nurse Patricia Hutchinson**

Certified Emergency Nurse

Certified Post Anesthesia Nurse

Kelly J. Bedner Laurie G. Dearmitt Nicole M. Komenda Amanda L. Vesely

Staci L. Orbell

Certified Hospice and Palliative Nurse

Denise D. Addis Bonnie E. Barnhart AnneMarie Scekeres

Certified Professional in Healthcare Quality

Gretchen W. Peske

Certified in Infection Control Adult Health Clinical Nurse Specialist

Certified Occupational Health Nurse, Case Management

Mary J. Bellush Deborah M. Schotting

Certified Professional in Patient Safety Jennifer M. Gregory

Certified Ambulatory Perianesthesia Nurse

Certified Medical-Surgical Registered Nurse

Eloise R. Cary

Kortnee M. McGinnis Erin Prettiman** Susan Tokarski Cindy L. Glod

Certified Breast Patient Navigator â&#x20AC;&#x201C; Cancer

Patricia Hutchinson** Susan Poklembo Kimberly L. Strashensky Amy B. Phillips

Kelly L. Long

Certified Nurse Operating Room Certified Case Manager Joyce A. Hodczak Susette J. Lasher Rosanne R. Maticko Eugenia G. Ochap Ronald Slater Edith K. Spinneweber

Certified Wound Ostomy Nurse Abby E. Johnston Sue E. Zezzo

Victoria Harmon Leann Kaltenbaugh

Certified Occupational Health Nurse Megan B. Kapolka

Certified Wound, Ostomy, Continence Nurse Sandralee Hartman Sarah M. Vanderelli Lori E. Crawford

Certified Childbirth Educator Susan K. Patula** Roseann Rudy**

Certified Wound Care Nurse

Cardiovascular Surgery Certification W. Michael Widmann** 35

Gerontological Nursing Certification Dawn M. Henry Amy Phillips

Nurse Executive, Advanced (Certified Nurse Administration - CNAA,BC prior to 2008) Traci M. Fick

Informatics Nurse

Nursing Professional Development

Sally E. Backus Karen M. Edmunds William M. Widmann**

Deborah B. Jenkins** Sheri Walker

Inpatient Obstetric Nursing Barbara A. Alexander Darla J. Klein Susette J. Lasher** Beverly J. Leidy Susan K. Patula** Waynette C. Reynolds

Progressive Care Nursing (Adult) Erin Prettiman** Elizabeth A. Stefano

Registered Cardiovascular Invasive Specialist Elizabeth A. Dell

International Board Certified Lactation Consultant Tracey M. Downs Ann Kremer Cynthia A. Morris Roseann Rudy Ann Kremer Cynthia A. Morris Roseann Rudy

RN EDUCATION

BY LEVEL 2016

0.81%

12.42%

36.28%

15.42%

35.06%

CERTIFIED REGISTERED NURSE ANESTHETISTS Amy Acie Staci Alexander William Antonucci Michele Bailey Terri Baker Melissa Barras Robin Bell Gabrielle Beltz Lisa Berdar Brian Berry Richard Burkey Danielle Cooley Linette Copelli Melissa Cunningham Carol Curry

Joseph Herman Deborah Hill Jillian Hodczak-Coffey Elizabeth Hollar Brian Holt Todd Hrtyanski Julie Hutchinson Mark Kantola Christopher Kolowitz Rae Kozinko Patricia Kuster Leslie McClarren Stephen Miller Beverly Nickelson Tammy Nuzzo

Michael DeBroeck Ann DeLattre Ruth DiLello Cynthia Donatelli Joseph Dorazio Lori Droschak Patricia Eisner Jennifer Ellena Diane Fair Cynthia Gladora Amy Graham Danielle Gray Lisa Groft David Guidry Cara Haines

Theodore Oshie William Pileggi Donna Ross Joelle Sabatine Victor Sansing Heather Scanlon Kristen Schnauber Stacy Smith-Carei Rebecca Sullivan Stephen Taylor Susan Tranchine Vicki Vecchiolla Lisa Vittone Renee Wilson

CERTIFIED REGISTERED NURSE PRACTITIONERS Mary Augustine Susan Barbarossa Ashley Batsa Vicki Beal Brittany Brown Kathleen Campbell Laurie Christner Sally Cline Amanda Connors Michele Culler Erin Dieter

Maryann Dowling Jeanine Doyle Kathleen Eisensmith Kayla Ellis Karen Ewing MaryBeth FarinaMazur David Geiger Mallory Gergely Kari Halaut

Marian Hazy Rebecca Heinle Tami Judy Mary Kish Merry Kruger Lauren Love Victoria McIlnay Janine Meneghini Mandee Mikeska Diane Navarre Regina O'Leary

37

Jennifer Penrose Cathy Piper Megan Reed Dawn Repak Shawna Rutkowsky Rene' Smail Jerod Smith Kristina Smouse Kelly Snively Anna South

Judith Svidron Emily Tetil Chantal Trice Paula Urban Randolph Wadsworth Leanne Wiltrout

4 STRATEGIC AIM

#

FOSTER FINANCIAL STEWARDSHIP WORKFORCE MANAGEMENT AND

LONNA PATERLINE, MSN, RN

Vice President, Patient Care Services and Behavioral Health, Westmoreland Hospital

To maintain growth as a company, Excela uses a LEAN approach to health care management that focuses on cost saving, efficient planning of allocated resources. It also depends on having a highly qualified, diverse staff and utilizing them to the fullest extent of their licenses. This ensures that we will continue to be successful in our endeavors.

Unit-B ased C h

In January 2016, Excela Health convened a work group to look at evidence based strategies to improve nurse sensitive indicators such as patient outcomes and staff satisfaction. A team approach was utilized to have unit based collaboration involving key stakeholders.

Excela Health STAR teams consist of the Unit Based Council Chairperson (who relays information on pertinent issues occurring at the unit level), the Nurse Manager (who is responsible for identifying the data relevant to the current unit processes), and the Nurse Educator (who is responsible for facilitating and organizing the meeting while coaching and mentoring staff nurses in problem solving approaches).

airper so

n

EXCELA HEALTH STARS

Nur se

Ma nag er

Nur se E d uc

ato r

have everyone in the loop, and meeting on a regular basis helps to bring issues, ideas, and concerns to light.â&#x20AC;?

STAR teams were created as a tool to improve autonomy, communication, and collaboration among the unit based council chairs while providing a voice for frontline nursing staff. STAR teams review unit-level data and identify solutions for issues related to clinical alarms, workforce metrics, and patient satisfaction as well as healthy work environment issues.

STAR teams were established systemwide and meet monthly on each unit to prioritize issues and develop strategies for improvement. Carly Gruss, RN, a unit based council chair and member of Westmoreland Hospital 3D/E STAR Team, said â&#x20AC;&#x153;The STAR team has given our floor the opportunity to bring up current issues and

39

Excela Health STAR teams drive quality improvement; support a collaborative approach for both nursing leadership and clinical nurses to bring about unit-level changes that positively affect clinical nurses and care outcomes, and provide a format for both nursing leadership and clinical nurses to discuss and solve problems related to improving care outcomes.

STRUCTURED INTERPROFESSIONAL BEDSIDE ROUNDS (SIBR) At Excela Health our mission is to improve the health and well being of every life we touch. Nursing significantly impacts this mission in everyday care of the patient. One key area identified by the nursing staff for improvement involved bedside rounds.

Bedside rounds is an opportunity for the Provider, Nurse, case management, pharmacy, and other interprofessional team members to discuss the treatment and discharge plans for the patient. Several key problems were identified in the current practice such as variations in the rounding process regarding who was present, a lack of timely communication between the interprofessional team regarding the discussions during rounding, and multiple providers rounding at the same time thus making it difficult for appropriate staff to be present for the rounding.

A multidisciplinary team met for a two day LEAN project to discuss the standard workflow. The goal of the LEAN project was to establish standard workflow for Structured Interprofessional Bedside Rounds (SIBR), define clear roles and responsibilities for team members, and develop evaluation metrics.

Prior to the team coming together, a team from Continuous Improvement collected data on various days at each campuses, tracking 100 patients during rounding. To validate what Continuous Improvement staff saw, a survey was sent out to physicians, nurses, case managers and pharmacists which validated the inconsistencies of components of the rounding process, 93 individuals participated in the survey. It was discovered that when staff rated the overall success of collaborative rounding process, 58% felt we had achieved a moderate success, and only 21% rated the program as highly successful.

At that point, the team took a closer look at who all the members of the collaborative care team were within the patient stay, and what each of the team members would be doing throughout the stay. The team then mapped the ideal state and utilized stars to indicate where they felt ideally SIBR would occur. Realizing limitations of resources in various hospitals and on various days, the team agreed the minimal members for SIBR would be the Patient, Physician and Primary Nurse. The Core team is the physician and the primary nurse, but ideally has Case Management and Pharmacy present when available. The team has clarified roles and responsibilities for the rounding to be successful.

SIBR was implemented with the hospitalist group being the primary physician focus group. Every day, every patient is to be rounded on with the core team of patient and family, primary nurse and physician participating giving clear communication, roles, and expectations. To evaluate this process, an electronic audit was created through Qualaris that enabled the observer to answer yes/no questions if the desired expectation was completed during rounding.

NURSE RESIDENT ORIENTATION Clinical orientation for a newly hired registered nurse is key to ensure a smooth transition to the new role.

Regardless of the medical surgical unit, a consistent and standardized orientation is needed. The Education department determined that an analysis of current clinical curriculum and orientation processes was needed.

The results of that analysis reflected several key areas for improvement.

Educator and preceptor evaluation processes were inconsistent and orientation checklists and progress documentation forms were outdated.

A lack of standard work was noted regarding new nurse orientation to IV Therapy skills, i.e. venipuncture and wound care. Inconsistencies were also noted in guaranteeing the nurse had a clear understanding of the roles of the interdisciplinary team, i.e. clinical resource management.

LEAN methodology was utilized and the team decided upon four key solutions.

Biweekly meetings with the nurse resident, preceptor, nurse manager and educator were to be implemented. A standard orientation length of eight weeks would be established.

In addition, during the eight-week orientation Nurse The Nurse Residency Resident Program at Excela Health orientation was an excellent way to start would my nursing career: through wonderful include experiences, a plethora of learning opportunities, and the ease of time with transitioning from a student to a the IV Team, full-fledged RN. Wound Care, - Nurse Resident, and Clinical Anthony Speeney, BSN, RN Resource Management.

â&#x20AC;&#x153;

â&#x20AC;&#x153;

Barnhart, Celesta R. Blasko, Leann M. Clair, Courtney L. Coles, Brittany S. Cope, Emily E. Crail, Brittany A. Dalrymple, Angela J. Dodson, Katlyn A. Fabi, Alyssa Marielle B. Hensler, Kristin L. Hensler, Megan M. Horner, Julie D. Kendall, Elizabeth M. Kern, Stephanie M. King, Lynn L. Klaum, Sarah L. Klimchock, Kacie S. Knupp, Amanda L. Kopper, Melinda L. Mansour, Samuel J. Mendillo, Matthew D. Milavec, Jodi M. Obstarczyk, Allison L. Parquette, Julia R. Petty, Tiffany K. Ricco, Rebecca L. Ridgway, Hiedi E. Sadecky, Karla Santamaria, Kaci B. Schroyer, Sierra J. Shadron, Cheyanne L. Shankle, Stacey L. Shaw, Megan N. Simpson, Beth A. Small, Staci A. Speeney, Anthony M. Vamosi, Erin Wagner, Maria A. Weaver, Christina D. Wilkins, Alissa M. Zehner, Catherine J. Zieglemeier, Alicia N.

Med/Surg 3 North, LH Progressive Cardiac Unit, LH Med/Surg 3D, WH PCU 2E, WH BH-Inpatient Unit 2, WH Nursing Administration, FH PCU 2D, WH Progressive Cardiac Unit, LH Progressive Cardiac Unit, LH HH-Skilled Nursing, WH Emergency Department, FH 3 South, LH Labor & Delivery, WH Critical Care, LH Emergency Department, FH HH-Skilled Nursing, WH Step Down Unit, WH Operating Room, WH 2 East, LH BH-Inpatient Unit 2, WH Critical Care, LH Critical Care, LH Emergency Department, LH Med/Surg 4AB, WH Med/Surg 2AB, WH Step Down Unit, WH Nursing Pool, LH Nursing Pool, LH Emergency Department, WH Step Down Unit, WH Med/Surg 3D, WH Labor & Delivery, WH Step Down Unit, LH OB Gyne 5D, LH Progressive Cardiac Unit, WH 2 East, LH PCU 2D, WH Progressive Cardiac Unit, LH Emergency Department, WH Med/Surg 3 North, LH Progressive Cardiac Unit, LH Med/Surg 2AB, WH

EHMG: USING LEAN TO STANDARDIZE WORKFLOWS Excela strives for excellence and communication is vital to providing excellent innovative and quality care. The members of Excela Health Medical Group (EHMG) Primary Care Division worked diligently this year to establish an infrastructure plan to improve and develop standard work flows, evidence based practices, rapid cycle improvement, and quality measures that would impact the way the multiple outpatient centers communicate not only with each other but also with the inpatient facilities to transition care more efficiently.

A forum was established consisting of frontline staff members that met regularly to discuss issues that impacted their daily practice to begin to identify possible solutions and strategies using a LEAN approach. The key concepts in LEAN are providing care in a timely, productive, quality, and cost efficient manner. The group used chart reviews, claims-based data, root cause analysis, and process mapping to determine initiatives that would lead to quality primary care experiences, improve the overall health of our patients, better communicate information systemwide, and

facilitate a patient-centered approach that could be transitioned to home.

Barriers to this project included the availability of time for meetings, as this required the presence of multiple disciplines; discrepancies among different avenues of data sources, and physician engagement, however, with the support of Excela Health Administration, the Board of Trustees, the Medical Director for outpatient services, and other resources the work group was able to implement programs to improve in each area identified successfully.

The group continues to work toward its goal of implementing the best practices to achieve the best possible outcomes for the patients we serve. EHMG is committed to generating new ideas and examining old practices for improvement.

Nancy Gould, RN, Practice Manager Stephanie Glass, Lead Patient Information Coordinator Colleen Peretto, LPN Amy Gallaher, Medical Assistant Chrsity Goswick, RN Nicole Zerone, Office Supervisor Vicki Whipkey, Office Supervisor Kathy Phillips, RN Michele Hull, Lead Patient Information Coordinator Debbie Wall, Practice Manager Dawn Allen, Quality Coordinator Joni Anderson, Practice Manager Wendy Ross, Lead Biller Cindy Uncapher, Practice Manager Kelly Shriver, Quality Coordinator Carrie Brant, Practice Manager Lea Anderson, Transcriptionist Kris McCracken, RN Debbie Brannaka, Office Supervisor Cynthia Martin, Medical Assistant Sheryl Stercho, LPN

Dawn Katsolis, Office Supervisor Mark Pencak, Medical Assistant Jamie Griffith, Manager, Physician Billing Lisa Stefancic, Ovvice Supervisor Cindy Scarpa, Office Supervisor Arianne Rowland, Medical Assistant Laura Wallace, LPN Stacey Bush, RN Supervisor Brenda Pennesi, Senior Patient Information Coordinator Drusilla Emanuel, Quality Analyst Dustine Antonucci, RN Health Coach Rebecca Plummer, RN Brittany Mercinko, Quality Coordinator Laura Nemeth, LPN Jennifer Master, Office Supervisor Lisa Fodor, Practice Manager Megan Parry, MA Tina Hahn, Practice Administrator Nancy Friedline, RN Supervisor

NDNQI CLINICAL INDICATORS

!

!

!

5 STRATEGIC AIM

#

ENHANCE NURSING IMAGE COMMUNITY PARTNERSHIP AND

RANAE SPLENDORE, MS, BSN, RN

Director, Professional Development/ Nursing Informatics

As an organization, Excela Health works within the community to identify opportunities for partnerships between nurses and patients to form relationships that improve visibility and instill trust and confidence in our team.

THE HEALING GARDEN â&#x20AC;&#x153; I go to nature to be soothed and healed, and to have my senses put in order.â&#x20AC;?

- John Burroughs Each Excela Health hospital has a Healing Garden where patients and family can go to find peace in an otherwise busy, overwhelming, and clinical environment. The garden provides patients and family members with a green space to relax and get fresh air. These healing gardens are also associated with improved health outcomes.

The Healing Garden is an area with plenty of greenery, shade, comfortable seating, and murals. These areas are meant to give the patient the perception of being in nature in an exotic location where their problems are a million miles away.

These spaces have been shown to decrease blood pressure, improve respiration rate, and improve brain activity in even a few minutes. As a system that is constantly seeking to improve care to our patients and achieve the best possible outcomes for those we treat, this is the perfect marriage of health and wellness.

Healing Gardens are also a great place for family and friends to visit with patients in a private and quaint environment that helps patients to forget, if even momentarily, that they are sick and enjoy the company of others. This allows patients to truly relax and relaxation promotes healing.

These areas are also utilized by caregivers and staff to relax and regain their bearings. Caring for others can be stressful and these areas allow caregivers to take a moment to refocus and refresh. All in all, this is a great place for everyone and a great place to visit if you in need of a break from it all.

CARE TEAM VOLUNTEER PROGRAM The Care Team Program is a partnership between Nursing and Volunteer Services across the health system. It is designed to enhance patient comfort and satisfaction while providing support to nursing. Communication with a patient and family is established with the volunteer visiting each patient room to introduce herself and offer whatever support may be necessary. Should there be a concern, the volunteer notes the concern and shares it with the Nurse Manager on the unit.

Strategic objectives include (1) To support the Excela mission: To improve the health and well-being of every life we touch, and (2) To aid in the improvement of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) performance scores.

Care Team volunteers visit patients with a focus on: • Patient Comfort • Quality Care • Discussion of and orientation to the Communication Board • Effective communication among staff, volunteers and families • Room cleanliness and orderliness • Patient Safety with an emphasis on fall risk protocols • Provision of amenities that include reading materials, puzzles and refreshments as permitted 46

Last year, the Excela Nurse Recognition and Retention Committee was invited to become actively involved in the Blackburn Center’s community event titled “Walk a Mile in her Shoes”. This event is held annually in downtown Greensburg.

The event is to raise our voice (as we move our feet!) in speaking out against the social norms that perpetuate domestic and sexual violence. The Professional Image Committee had set a goal for getting at least 12 participants to walk as a team representing Excela Health. We named our team the Excela Healers, T-shirts were purchased by the Vice Presidents, Patient Care Services and our marketing department had them printed. We ended up with 30 Excela walkers that included staff, friends and family.

Excela Health Healers will be participating in the future as this walk challenges us to help to change somebody’s life in a positive way. By working together we can decrease gender violence in our community. Many victims rely on the Blackburn Center’s services to heal and restore hope. The Walk serves as a dual purpose for the agency, it generates much needed funding to sustain the agency’s services (there is a $5.00 registration fee for each participant) and it brings awareness to the community in speaking out about domestic and sexual violence.

WALK A MILE IN

HER SHOES

GRATITUDE GRAFFITI WALL What are you grateful for?

November 2016, Excela Health employees, patients and visitors had the opportunity to express their thanks on our Gratitude Graffiti Wall. The project, sponsored by the Excela Health Nurse Recognition and Retention Committee, benefited from the designs of Seton Hill University art therapy students.

The Gratitude Graffiti Project was a 30-day (month of November) practice of purposeful appreciation of one’s life through interactive art.

The project engaged employees, patients and visitors to contemplate a source of gratitude in their lives and provided an outlet to express that thought of thankfulness in a public setting.

When they participated they were no longer “spectators” of art, they became fully engaged in creating art that expressed their gratitude.

Washable paint markers were available close to the interactive art displays at Frick, Latrobe, and Westmoreland Hospitals on glass window corridors. These accessible outlets acted as reminders or Gratitude Stops, where a person walking by could mentally note, something they are grateful for or to take it a step further and write on the wall what they are grateful for that day. The sentiments were so heartfelt and moving over the 30 day period, we didn’t want to wash the windows.

PARTNERING WITH BOY SCOUTS OF AMERICA THE EXPLORING PROGRAM Excela Health has partnered with the Westmoreland-Fayette Council of the Boys Scouts of America to be part of the Exploring Program. Exploring introduces youth ages 14 through 20 to various careers in the health care arena. The programâ&#x20AC;&#x2122;s first session was held October 5, 2016 and continued through the end of the school year. Excela sponsors the program at each of its three hospital campuses (Westmoreland, Latrobe, and Frick) along with Excela Square at Norwin the first Wednesday of the month from 6:00 PM to 7:30 PM. Fifty eight youth registered for the Exploring Program at Excela from various school districts in Westmoreland County. The school districts included were Greater Latrobe, Ligonier Valley, Derry Area, Yough, Mount Pleasant, Greensburg Salem, Hempfield Area, Penn Trafford, and Norwin. Students were asked to identify topics of interest for discussion.

The monthly program includes discussion concerning educational requirements of the particular health care profession, day-to-day job functions, and hands-on activities such as simulation labs for the students. Monthly presentations explore the professional roles of radiology, anesthesia, laboratory, physical/occupational therapy, and respiratory therapy. Future topics include nursing, exercise physiology, various physician specialties, physician assistants, emergency medicine, certified nurse practitioners, social workers, and clinical dietitians. In the coming school years, it is hoped for participation from more schools in Westmoreland and Southern Fayette County.

Staff members participating in the Exploring Program include: John Dolan, MBA, BSN, RN; Kennette Grohal, MSN, RN-BC; Traci Fick, MSN, RN, NEA-BC; Tammy Vogel, MSN, RN; Jeff Siegel, BSN, RN, PHRN; Lonna Paterline MSN, RN; Michelle Lewis, MSN, RN; Kate Eysler, MSN, RN; Becky Breegle, BSN, RN; Amy Harvey, BSN, RN; Jamie Donahue, BSN, RN; Katie Ulrich, BSN, RN, and Kate Smartnick, RN.

Latrob

e Hospit

al

Westmoreland Hospital

PROGRAM Frick Hospital

PANCREATIC AWARENESS NURSING SPOTLIGHT Employee of the Month is an achievement that recognizes employees that go above and beyond in their service to our patients and the community that we serve. Karen Adamoski, BSN, RN, was among those honored this year in this capacity for her work to raise awareness for pancreatic cancer awareness and her contribution to the early diagnosis of a patient in her care. Thanks to Karen's vast knowledge and excellent assessment skills, she was able to recognize the early signs and symptoms in a patient that was being worked up for gastrointestinal disorders. She took action and recommended that the patient be seen by a specialist and pursue further testing for pancreatic cancer. It was this suggestion that led to the early diagnosis and treatment for this patient.

Karen's expertise and experience with pancreatic cancer resulted in a great outcome for this patient; unfortunately it was born out personal tragedy. Karen lost both her father and her brother to pancreatic cancer making this affliction close to her heart and a cause that she champions. Karen states, “Raising money for research is important to raise awareness and find a cure.” According to the American Cancer Society, in 2017, approximately 53,500 people will be diagnosed with pancreatic cancer in the Unites States alone and roughly 43,000 will die this year from this disease. Pancreatic Cancer accounts for seven percent of all cancer deaths in the United States. For this reason, Excela Health supports Karen for her work to help fight this illness and recognizes her efforts to identify early interventions.

Karen is involved in several projects that raise funds for pancreatic cancer throughout the year including silent auctions, jewelry sales, and the PurpleStride walk. This will be Karen's 5th year anniversary of her Jewelry Sales event that she hosts along with Dr. Shelly Johns, who also has lost a loved one to pancreatic cancer and shares Karen’s dedication to finding a cure. This event started as a quaint fund-raiser and has evolved into a Jewelry Fair with more than vendors, food, raffles, and prizes raising $10,000 last year for Pancreatic Cancer Research. Karen is anticipating this year's event to be in July ahead of the September PurpleStride walk.

The PurpleStride Walk is an annual nationwide 5K to end Pancreatic Cancer. Karen will walk in the 2017 PurpleStride on the Pancreatic Cancer Destroyers team, a team named by Karen's niece, and in memory of her late brother and father.

Thank you for making a difference in the lives and communities of those we serve.

AWARDS AND RECOGNITION

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The Cameos of Caring® Program & Awards honor exceptional bedside nurses who work at acute care hospitals. The program was established in 1999 in keeping with the University of Pittsburgh School of Nursing’s commitment to the advancement and promotion of the nursing profession.

Excela Health through its member hospitals has been a proud participant in the program for more than 15 years.

Excela Health Nursing recognizes that caring for patients is a team effort. Outstanding Care Team Members.

• Demonstrate putting patients first through teamwork and respect toward others; • Display a compassionate approach to patients and families through acts of kindness; • Demonstrate a commitment to personal and professional development; • Demonstrate a positive attitude; • Communicate effectively with all members of the health care team; • Provide mentoring to colleagues; • And demonstrate passion for the work they do.

The Friend of Nursing Award recognizes a non-nurse member of Excela Health who has demonstrated leadership that has significantly impacted nursing practice, nursing education, nursing administration and/or patient safety and quality.

Criteria: • Significantly enhances the image of nursing.

• Publically advocates for nurses and/or the nursing profession.

• Works collaboratively with nursing to create/ establish patient focused processes.

Excela Health recognizes nurses and nursing teams who create an exceptional patient care experience by participating in the DAISY Foundation’s awards program. Honorees are selected from nominations submitted by patients, visitors and health system staff and judged for their compassionate care, kindness, teamwork, clinical expertise and professional collaboration. The award was created in memory of Patrick J. Barnes to recognize extraordinary nursing care everywhere.

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BERNADETTE WALLACE, BSN, RN Excela Health Latrobe Hospital

TAMMIE K. HOKE, RN Excela Health Home Care and Hospice

Advance Practice Honoree Clinical Focus 2016

RAY P. PARONISH, MSN, RN, CRNP Excela Health Inpatient Palliative Care

OUTSTANDING CARE TEAM MEMBERS 2016 Susie Melenia, Escort, Westmoreland Hospital Janet Errett, LPN, Westmoreland Hospital Dennis Scrabot, ACLS Tech, Frick Hospital Tracey Shaffer, Unit Clerk, Westmoreland Hospital

OUTSTANDING NURSE RESIDENT AWARD 2016 Jessica Fordyce, RN, Westmoreland Hospital

FRIEND OF NURSING AWARD 2016 Marilyn Daniels, Manager, Library Services 53

2016 DAISY AWARD Individual

Team

Sheilah Reskovac, BSN, RN

Clinical Informatics Department Sally Backus, MSN, RN Shirley Brandon, MSN, RN Karen Edmunds, MSN, RN Kennette Grohal, MSN, RN W. Michael Widmann, MSN, RN-BC, CCRN

Amy Medved, CRNP Ann Highlands, BSN, RN

2016 Daisy Honoree Sheilah Reskovac Nomination Letter: My Mom had Pulmonary Fibrous. She was not a smoker; she was a seamstress and got the disease from the dust, dyes and chemicals from the fabrics she sewed over the years.

Once Mom entered the hospital it seemed her health issues began to pile up. She had blood clots, then pneumonia and then we heard about the hole in her heart and the list goes on. I spend 5 nights in the hospital with Mom. They were hard nights. On the last night Mom was truly struggling to breathe. Mom had a terrible time breathing and passed out on me as I tried to get her up to go to the bathroom.

Things happened fast but when I called for help, I swear I got everyone on the floor coming to our aid. I looked at all of these very young kids. I am 54 and I swear not one of these kids was over 15. I wanted to say ‘anyone of you over 15 raise your hand’.

I looked at their faces and I thought for a moment I may be the one in charge.

Then a young lady, Sheilah Reskovac, who I thought was so young, stepped up and said we have a plan and here is exactly what we are going to do. She not only had the attention of everyone in the room, she had my respect. Her strength and training

kicked in and she was in charge giving directions and giving them tasks. She was professional and showed true leadership.

In the middle of a cold snowy January night she was a rock. More than that as we were laying my mom down and getting her back into the bed I glanced up at her young face and one single tear rolled down her face.

She had compassion for my dying mom.

We all knew we were coming to the end.

Sheilah Reskovac demonstrated strength and compassion beyond her years. Be proud of that young lady. Not only did I see the compassion in her, my three younger sisters told me she came to each of them and hugged them just before they took my mom to the Hospice floor as we waited for the end.

My sisters and I talked and each of us wanted to see her nominated for this special DAISY Award. She deserves it. We saw compassion and knowledge in formulating a plan and most of all a role model for others. My Mom was a special person and before she passed away each of us girls got a special lecture. The lecture she gave me was, ‘be kind’. Always be kind. Sheilah certainly was that to my Mom.

EXCELA EXCELS WHEN IT COMES TO

ORGAN DONATION Excela Health participated in the 2016 Pennsylvania Donate Life Hospital Challenge that encourages Pennsylvania Hospitals to increase organ donation awareness and designations within their hospital and community.

The activities are captured on a scorecard and point totals are used to designate titanium, platinum, gold, silver, or bronze level. Scorecard activities include inservicing on organ donation process, attending donation/transplantation programming offered by the Hospital Association of Pennsylvania (HAP), presenting Grand Rounds education at your hospital for nursing, providers, hospital leaders, and other innovative ways to promote and educate. Other activities include flag raising and donor awareness events. The more activities you conduct the more points you receive.

Staff representatives from each campus played a key role in the accomplishments of the health system.

Cindy Allison, BSN, RN was â&#x20AC;&#x153;proud and excitedâ&#x20AC;? when she learned all her hard work and time paid off as Excela Latrobe was awarded Platinum designation. Karen Scanlon, MSN, RN, CCRN played a key role in ensuring Gold designation for Excela Westmoreland and Traci Fick, MSN, RN, NEA-BC represented Excela Frick as we obtained Silver designation there.

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THANK YOU FOR YOUR SERVICE NURSING TEAM MEMBERS Kathleen Boyer, RN, Frick Hospital Ruth Burns, Unit Clerk, Latrobe Hospital Jill Como, MSN, RN, Westmoreland Hospital Marsha Dovyak, RN, Excela Health Cindy Glod, RN, Westmoreland Hospital Katherine Goldberg, RN, Latrobe Hospital Barbara Grote, MSN, RN, Westmoreland Hospital Rebecca Hill, Unit Clerk, Latrobe Hospital Deborah Hudzema, RN, Westmoreland Hospital Melanie Jones, RN, Westmoreland Hospital Denise Kemp, MSN, RN, Home Care and Hospice Kathryn Kepple, BSN, RN, Westmoreland Hospital Wendy Kish, BSN, RN, Westmoreland Hospital Mary Luczki, Health Unit Clerk, Frick Hospital Patricia Lukon, RN, Latrobe Hospital Barbara Mcindoe, RN, Frick Hospital Susan Melenia, Patient Transporter, Westmoreland Hospital Rosemarie Moffa, RN, Westmoreland Hospital Cynthia Riedman, Unit Clerk, Westmoreland Hospital Roseann Rudy, RN, Latrobe Hospital Karen Sansing, RN, Westmoreland Hospital Dennis Scrabot, ALS Technician, Frick Hospital Loretta Shearer, RN, Latrobe Hospital Ranae Splendore, MS, RN, Westmoreland Hospital Joan Steiner, RN, Frick Hospital Judith Svidron, CRNP, Latrobe Hospital Bernadette Wallace, BSN, RN, Latrobe Hospital Randi Wichrowski, RN, Westmoreland Hospital

40+ Years

ENGAGING AND RECOGNIZING STAFF ACROSS EXCELA HEALTH MARCH OF DIMES

MAGNET

PAYING IT FORWARD Frick

PAYING IT FORWARD Westmoreland

COLOR EXCELA HAPPY NURSE WEEK 2016 57

“PASSION creates

“

MOTIVATION, which leads to

innovation.

Craig Groeschel

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