2020 Patient Care Services Annual Report

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e c n e ll e exc

NURSING

Angel Dewey’s Year of Resilience — PAGE 8

COVID-19:

A YEAR IN REVIEW

— PAGE 16

BAYHEALTH PATIENT CARE SERVICES 2020 ANNUAL REPORT


Table of Contents A MESSAGE FROM OUR CHIEF NURSE EXECUTIVE

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LEADERSHIP & PLANNING PATIENT- AND FAMILY-CENTERED MODEL OF CARE

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OUR PATIENT CARE SERVICES LEADERSHIP TEAM

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NURSING 2020–2022 STRATEGIC PLAN

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NURSING 2020–2022 GOALS

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TRANSFORMATIONAL LEADERSHIP ANGEL DEWEY’S YEAR OF RESILIENCE MAGNET REDESIGNATION SOLIDIFIES EXCELLENCE ®

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STRUCTURAL EMPOWERMENT SHARED GOVERNANCE 2020 ACCOMPLISHMENTS

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CULTIVATING PROFESSIONAL DEVELOPMENT

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CLIMBING THE CLINICAL LADDER

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EXEMPLARY PROFESSIONAL PRACTICE PALLIATIVE CARE’S COMPASSIONATE CREATIVITY

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CARE MANAGEMENT ADAPTS TO COVID-19

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NEW KNOWLEDGE & INNOVATIONS HEROES WINNING THE FIGHT AGAINST COVID-19

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EMPIRICAL OUTCOMES MAINTAINING A CULTURE OF SAFETY AND QUALITY

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BAYHEALTH NEWS & RECOGNITIONS TWIAGE TECHNOLOGY IMPROVES EMERGENCY CARE

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NURSE RESIDENCY SCORES TOP DISTINCTION

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GEARING UP FOR PLANETREE GOLD

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STELLAR NURSES CREATE STELLAR YEAR

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IT’S THE YEAR OF THE NURSE & MIDWIFE

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2020 DAISY AWARD WINNERS

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BAYHEALTH TOP NURSES RECOGNIZED

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BAYHEALTH ACHIEVES LEADER STATUS IN LGBTQ HEALTHCARE EQUALITY

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BACK COVER


A message from our Chief Nurse Executive Heading into 2020, who knew a pandemic would create a year of uncertainty? Every day I watched the camaraderie at Bayhealth grow stronger. The perseverance through every sacrifice and obstacle as we focused on providing the best person-centered care was astonishing. Most of us have never lived through a pandemic and had no idea what was ahead of us. I was quite sure the amazing staff at Bayhealth could handle whatever was coming but had no idea it would ever last this long. The first few months of the year were spent planning for a potential surge of patients and prepping for our Magnet redesignation visit. What a contrast considering the excitement to show off our great facilities and dedicated staff and preparing for the unknown disaster ahead of us. Then came the call from the American Nurses Credentialing Center Magnet Recognition Program®, asking if we really wanted to continue with our site visit. After all the hard work put in, we were not going to let something like a pandemic stop us. That is when the Magnet office suggested a site visit using computers. Magnet Appraisers would not come to the hospitals, but they would be on the units, talking with staff via the web. Every individual in the organization rose to the challenge and the week of April 6, 2020, was nothing short of amazing. Staff was able to share their experiences and their feeling of empowerment dealing with a pandemic. The days flew by and we proudly received the approval call from the ANCC Commission on Magnet on May 19, 2020. Even during the height of a pandemic, we were able to celebrate the prestigious honor of Magnet redesignation. Several Bayhealth nurses were recognized by the State of Delaware through the Excellence in Nursing program. Due to COVID-19, Bayhealth held its own safe celebration to recognize the nursing excellence demonstrated by the awardees. The end of the year was much like the beginning as we continued to deal with the pandemic and adjust patient care as needed to make sure our patients received the best and safest care possible. Safety is more important than ever, and we were humbled and honored to have our Bayhealth Hospital, Sussex Campus receive a Top Hospital distinction. The saying that extraordinary times require extraordinary people is very true. During 2020 I have gotten to work beside many astonishing people that make me very proud to be in healthcare. #BayhealthStrong

Brenda Blain, DNP, RN-BC, FACHE, NEA-BC Senior Vice President of Patient Care Services Chief Nurse Executive

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LEADERSHIP & PLANNING

At Bayhealth, our model of care is patient- and family-centered. We embrace Planetree philosophies and believe in treating the whole patient — mind, body and spirit. • Our core values are compassion, accountability, respect, integrity and teamwork.

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• Our work as nurses is grounded in research and evidence-based practice.

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ISS

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STRUCTURAL EMPOWERMENT

TRANSFORMATIONAL LEADERSHIP

• Our goal is to achieve nursing excellence.

IN N URS I NG

EMPIRICAL OUTCOMES

NEW KNOWLEDGE, IMPROVEMENTS

• Our goal is achieved through advocacy, empowerment and collaboration.

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MIND MIIN M ND D

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ATION COLLABOR

MENT T EMPO MPOWERMENT

ADVOCACY

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PATIENTPA PA ATIE EN N NT T AMIL F MILY FA M LYCENTERED CEN NTERED NT D CARE CARE

T BILITY ACCOUNTA IT PIRIT SP S SPIR

N ION P COMPASS

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GRIT

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R E S P EC

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CA RE

EXEMPLARY PROFESSIONAL PRACTICE


Our Patient Care Services Leadership Team Terry M. Murphy, FACHE

Brenda Blain, DNP, RN-BC, FACHE, NEA-BC

President and Chief Executive Officer

Senior Vice President of Patient Care Services Chief Nurse Executive

Cheri Briggs, BS Pharm D., MBA

Angeline Dewey, MSN, RN, APRN, ACNS-BC, CCRN,CNRN

Senior Director of Pharmacy Services

Director of Education

Sharon Urban, MSN, RN-BC, CNML, NE-BC

Faith Colwell-Dorio, MSN, RN, NEA-BC, VHA-CM

Senior Director of Patient Care Services

Senior Director of Peri-Operative Services

Gust Bages, MHA, BSN, RN Senior Director of Emergency and Trauma Services

Cheryl Hewlett, PhD, MBA, MSN, RN, NEA-BC Senior Director of Women’s & Children’s Services

Marianne Foard, MS, RN, NE-BC, PRC Director of Service Excellence Patient Advocacy & Professional Recruitment

Christie Tomaseski, MSN, RN-BC Magnet Program Manager

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Nursing 2020–2022 Strategic Plan Long before 2020 officially began, we were busy working through each of our strategic goals to ensure progress would be made on achieving them. Our mission is to strengthen the health of the community one life at a time. Each of these goals will aid us in living our mission. Our strategic goals correlate with Bayhealth’s strategic plan — organizational excellence, culture, access & growth, and clinical integration. Here are some of the ways we’re making progress on our strategic goals:

ORGANIZATIONAL EXCELLENCE • Emergency Department patient satisfaction scores improved • Bayhealth all-cause inpatient Medicare readmission rate was lowered to 13.9% • Number of serious safety events decreased from 55 in 2019 to 42 in 2020 • Average days between serious safety events improved from 6.6 days in 2019 to 10.7 in 2020 • Planetree education ongoing throughout internal communication channels • NDNQI benchmarks met or exceeded Magnet standards in calendar year 2020

ACCESS & GROWTH

CULTURE • Percent bedside nurses with BSN or higher: 62% • RN turnover rate = 19.7% • RN satisfaction exceeded Magnet peer group benchmarks in all categories per Oct. 2020 NDNQI RN survey • Professional Development Council team members developed action plan to create a streamlined clinical coordinator training plan • Manager’s Council is streamlining nurse manager orientation plan • Clinical Challenges session introduced Graduate Medical Education (GME) program to clinical nurses, emphasizing the importance of positive relationships between physicians, GME residents and nursing • Multiple nursing staff stress level–reducing interventions are being offered: Code Lavender kits for each unit, purchased by the Bayhealth Foundation; CISM support; Virtual Reality research study; and multiple spirit team activities

CLINICAL INTEGRATION • Earned Practice Transition Accreditation Program (PTAP) accreditation with distinction in August 2020

• IRB-approved research involving bedside RNs in progress

• Approved at least 35 new care practice guidelines in line with evidence-based best practices

• Education Department and Bayhealth Medical Group were heavily involved in COVID-19 efforts such as providing education, offering drive-thru testing sites and assisting in COVID-19 vaccination sites in the community

• Emergency Department Telehealth consultations for our behavioral health population grew from 187 in 2019 to 360 in 2020

• Prescription volume in outpatient community pharmacies increased from 39,205 to 41,953 at the Kent Campus, and from 16,911 to 18,552 at the Sussex Campus • Emergency Department distributed naloxone kits to at-risk patients and family members at no cost to recipients 6

• Clinical Classroom in the Education Department scheduled to open Summer 2021 to incorporate more simulation-based training • Nursing Informatics developed an innovative process for early identification of COVID-19 community hot spots • Collaboration between IT, Nursing Informatics and Magnet program to automate NDNQI data reporting of nursing-sensitive indicators


Nursing 2020–2022 Goals ORGANIZATIONAL EXCELLENCE

CULTURE

• Increase overall patient satisfaction to meet or exceed annual organizational targets

• Increase percent of nurses with BSN or higher by 1% annually: 2020 Baseline = 56.7%

• Increase emergency department overall satisfaction to meet or exceed annual organizational targets

• Increase percent of nurses with national specialty certification by 1% annually:

• Reduce hospital-acquired conditions to meet or exceed annual organizational targets

–2 020 Baseline = 51%; 2021 Goal = 52%; 2022 Goal = 53%

• Reduce 30-day readmissions to meet or exceed annual organizational targets

• Decrease RN turnover from 18.3% in 2020 to 17% or less by 2022

• Reduce serious safety events through continued High Reliability practices

• Decrease RN turnover rate within one year of hire to less than 20%

• Achieve Planetree Gold Certification in Patient-Centered Care

• Ensure RN Satisfaction meets or exceeds Magnet peer group benchmarks

• Continually assess unit-level nursing quality indicator data to ensure that Magnet peer group benchmarks are met or exceeded

• Formalize succession planning programs for nursing leadership and emerging leadership roles (Nurse Manager, Clinical Coordinator) to improve onboarding, career development and retention

ACCESS & GROWTH • Increase clinical nurse involvement in nursing research • Increase the number of annual research projects that are completed and disseminated, both internally and externally • Address care transitions across the continuum of care: – Execute key initiatives identified in the Bayhealth Community Needs Assessment Report – Increase education and involvement in the community – Increase annual prescription volume in the outpatient community pharmacies: FY 2020 = Kent baseline 39,205; Sussex baseline = 16,911 • Apply new strategies to address behavioral health • Expand the number of inpatient beds at Kent and Sussex campuses • Increase the number of beds at Sussex Emergency Center • Collaborate with GME program to develop simulation lab

• Collaborate with GME program to introduce the importance of positive physician-nurse relationships in orientation • Build mechanisms to address nursing staff stress levels and burnout

CLINICAL INTEGRATION • Standardize operational and clinical nursing practices to promote efficiency and support a high-reliability culture • Expand telehealth services to assist in improving patient outcomes • Leverage technology to increase accurate, automated actionable data collection and reporting • Standardize format of NDNQI data presentation as it corresponds to Magnet requirements • Streamline Performance Improvement process • Educate staff on LEAN principles for performance improvement initiatives • Collaborate with pharmacy to strengthen the chain of custody of controlled substances 7


TRANSFORMATIONAL LEADERSHIP

Angel Dewey’s Year of Resilience If you ask Bayhealth’s Director of Education Angel Dewey what 2020 was like for her, she’ll look you in the eye with a smile and say, “Quite the journey.” That can be said for most of us. 2020 was filled with uncertainty that left each of us with a story to share. Heading into the year, as the coronavirus emerged, healthcare organizations braced for the unknown. The State of Delaware reported its first presumptive case on March 11, and three days later Bayhealth received its first inpatient positive COVID-19 patient. “We were all very cautious and our natural coping mechanism was to believe that it wasn’t going to be that bad, that it wouldn’t last long,” she said. “I was very concerned, especially when we started having positive cases in our community. Then when New York became the epicenter, I was concerned that we were going to have to ration healthcare. That was my biggest fear.”

It was the beginning of a reality that would set in, but it was one Dewey and those around her could handle. As cases began to rise in Delaware, Dewey partnered with Bayhealth’s Vice President of Ancillary and Clinical Services Brad Kirkes, who led the charge to set up an innovative community drive-thru testing site. The majority of the team members in the Education Department were redeployed to help at the drive-thru clinics. “It gave me an opportunity to get my scrubs back on, because I haven’t thrown them away,” she laughed. She used her expertise to ensure knowledge and compliance with PPE. She stepped into an educator role, teaching team members how to properly wear PPE to avoid any exposures as they swabbed community members who could’ve had COVID-19. “I’m very proud that, during my stint as one of the leaders at the drive-thru clinics from May to July, every single person on the drive-thru team stayed healthy,” said Dewey. “There weren’t any exposures, because we were very strict in our PPE usage.” The testing sites were open during the week and even some weekends. The success of the clinics led to pop-up clinics throughout Delaware such as the Milford State Center and the testing of workers at the local poultry plants. “We became so efficient at it that in one day we tested more than 1,000 workers in a 12-hour workday.”

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All the while Dewey was overseeing the testing site, there was still an Education Department to run and, as with everything else, there were adjustments to be made. Many of the classes and events that are offered to staff, patients and the community remained on hold due to COVID-19, but some resumed with limited capacities or were converted into a virtual format, including the launch of the Safety Refueling Sessions, one of Bayhealth’s High Reliability educational resources. “When August came around and I transitioned from the drive-thru testing back to Education, it took me a few weeks to get adjusted,” she said. “I had to figure out where I was with projects when I left them in March.” For Dewey, 2020 was filled with sacrifices and determination. But her efforts did not go unnoticed. In late November she was awarded Bayhealth’s Nightingale Nurse Leader Nurse of the Year award. In her nomination form, a peer wrote, “She put herself out in the community to do COVID testing and supported many during those difficult times. She put her projects on hold to step up to the plate to educate, swab, and lend a helping hand. She is always going above and beyond.”

“I was there with my team at 5 a.m on December 15. I honestly didn’t know it would be the first one in Delaware; I thought it was going to be the first one at Bayhealth,” she said as she recalled administering the first COVID-19 vaccine in the State of Delaware. “And then in come all these cameras and lights flashing and I still didn’t realize the historic moment I was part of.” For Dewey, it was also a moment of closure. “Having hope that the pandemic will end at some point and being able to do whatever I can to help is what has driven me,” she said. As a Delaware native who has been a nurse for 26 years, she takes pride in giving back to the community that has given so much to her. “I don’t think I stand out from anyone else at Bayhealth during the pandemic because there are so many stories and I’m just one example,” she said. “If anything, I hope to be an inspiration to others because there is always a way that you can help during challenging times.”

The recognition took her by surprise as she’s not very fond of the spotlight. “I was completely shocked, and I just felt like it was part of what I needed to do at the time — to give back when everybody’s world got turned upside-down,” she said. Just a few weeks after receiving the award, as many began to feel a sense of hope, Dewey found herself once again surrounded by flashing cameras. It was a cold and rainy Monday morning on Dec. 14 when Bayhealth’s Kent Campus received the first doses of the COVID-19 vaccine. Bayhealth made history as being the first healthcare system in Delaware to receive and administer the vaccine — and Dewey was a part of it all. Dewey offered her staff to help operate the vaccine open clinics to get team members who were at the highest risk of exposure vaccinated. Bayhealth was on the clock — vaccine administration would begin in 24 hours.

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Magnet Redesignation Solidifies Excellence ®

Earning a second consecutive Magnet® designation bolsters Bayhealth’s reputation for excellence in nursing. However, the path to the distinction wasn’t a walk in the park. Just two weeks before the Magnet appraisers were scheduled to visit in April, in the midst of the COVID-19 pandemic, the nursing staff had a decision to make — cancel the visit or conduct an unprecedented virtual site visit. They accepted the challenge of the virtual site visit. “The virtual tour was truly pulled off by a Magnet organization. It required IT to team up with nursing to figure out how to make sure we didn’t lose reception anywhere because we literally took roving carts through the departments,” said Senior Vice President and Chief Nurse Executive Brenda Blain, DNP, RN-BC, FACHE, NEA-BC. “It felt very similar to the appraisers being here. We still had the same kind of questions, the same kind of meetings; it’s just that they were on a big TV screen instead of here in person. It ran really smoothly,” said Magnet Program Manager Christie Tomaseski, MSN, RN-BC. The virtual survey was positive all the way around. “Staff maintained great attitudes and it was nice for them to remember all of the excellent work they’ve done on behalf of patients. It reinforced for them why they became nurses.”

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The preparation for the Virtual Magnet Redesignation Site Visit consisted of a lot of practice and coordination. The hard work paid off when Bayhealth received the call from ANCC on May 19 that its nursing practice had received redesignation. The appraisers noted that Bayhealth’s nurses are empowered and have a voice in the organization. “The nurses have a questioning attitude and they keep asking questions until they either understand or make it clear that we’re not going in the right direction,” said Blain. “I’ve seen the nurses grow tremendously throughout my time at Bayhealth. The role of the Magnet Champions had an impact on the survey results as well. The group consisted of at least 44 people with someone representing each unit. The Magnet Champions served as liaisons and taught their peers all about Magnet.” The redesignation has helped elevate the culture of Bayhealth in many ways and has its advantages for nurses. “Magnet facilities tend to retain their nurses, which means more longevity and more experience,” said Tomaseski. “You also have the stamp showing you


are above and beyond the national benchmarks for your standards for patient care, so we have fewer infections and mortalities — basically better patient outcomes.” “Throughout our next four years — until the next redesignation period — it will be my responsibility to keep up the culture and make sure nursing excellence is still happening by monitoring our data to drive great outcomes to ensure a culture of professional excellence,” said Tomaseski.

THE LEVEL OF CLINICAL EXCELLENCE AT BAYHEALTH IS UNMATCHED. WE’VE TRULY EARNED OUR MAGNET REDESIGNATION. — B RENDA BLAIN, DNP, RN-BC, FACHE, NEA-BC

Only 8% of U.S. hospitals have achieved Magnet recognition, while Delaware has three Magnet-designated organizations (Bayhealth, Christiana Care Health System and Nemours Children’s Health System). “The redesignation is a rebirth of the excitement of not only being a nurse but being in healthcare,” said Blain. “We’ve really tried to place big emphasis on the fact that, even though this is a nursing designation, nursing can’t do it without the support of everybody else at Bayhealth.”

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STRUCTURAL EMPOWERMENT

Shared Governance 2020 Accomplishments PROFESSIONAL DEVELOPMENT COUNCIL Odasia Bennett Registered Nurse, Surgery Center • Conducted 2020 Nursing Needs Assessment and established action plan to tackle the identified educational needs • Conducted Anatomy of a Lawsuit: Making Safe Patient Care a Priority (role-play court case to address the identified desire to improve knowledge on documentation to prevent litigation according to BH 2020 Nursing Needs Assessment) • 2020 Year of the Nurse promotion in collaboration with Marketing Communications • Bayhealth Nurse of the Year Awards • Coordination of DAISY Awards • Sunshine Award to recognize nursing assistants and surgical techs proposed by Nursing Assistant Destanee Loder and brought to fruition • Conducted annual Shared Governance Retreat

PROFESSIONAL PRACTICE, QUALITY & SAFETY COUNCIL MycKenzie Gillette Registered Nurse, Birthing Center • Improved safety with limb alert identification adjustments • 2020 Safety Retreat with focus of infection prevention, resilience and CEU opportunities • Early identification of opportunities related to CLABSI outcomes; assistance with streamlined CLABSI education

• Collaboration with pharmacy and multiple disciplines (IT, Nursing Informatics) to adapt to updated practice guidelines for titration of vasopressors • Pre-op checklist utilization and education revamped to enhance safety and communication of patient handoff between units • 35 new CPGs approved through subcommittee

RESEARCH & EVIDENCEBASED PRACTICE COUNCIL Holly Dapias Registered Nurse Navigator, Orthopedic Service Line • Increased bedside nurse involvement in conducting research • Increased the number of bedside nurses at Bayhealth with CITI training (required to perform research related to human subjects) • Partnership for virtual reality study related to stress reduction • Reviewed and reduced the required performance improvement audits to allow time for RNs to engage in creating and action-planning improvements leading to better patient outcomes • Provided support and guidance for staff that presented research ideas • Collaborated with the IRB to provide education to the Research Council and facilitate communication between the two groups • Increased nursing knowledge of various aspects of research by involving staff in the research process and offering short educational sessions during the council meetings • Added Medical Librarian as a voting member of the council • Reinstated Journal Club

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MANAGER’S COUNCIL Jennifer Fields Critical Care Nurse Manager

LEADERSHIP COUNCIL Brenda Blain Senior Vice President and Chief Nurse Executive

• Successfully lobbied for Personal Appearance and Dress policy changes

• Organized redeployments to support staff and patients during COVID-19 surges

• Improved accuracy of NDNQI data reporting processes

• Deployed communication techs

• Established retention committee • Team building between nurse managers to increase interdepartmental collaboration

PATIENT CARE CONGRESS Lisa Blake Clinical Coordinator, Birthing Center

• Formed holiday spirit team to bring recognition and positivity to the work environment • Palliative Care grew into community • Improved commitment and engagement levels for relief and per diem staff • NDNQI RN survey participation increased and scores improved • Expanded OBHG coverage on the Kent campus • Instituted Geographic Rounding

• Provided platform for communication between all levels of shared governance, from unit to leadership councils • Influenced availability and variety of food services and employee cafeteria options • Provided goal-formatted education for unit councils (Donabedian Model)

• Obtained approval for Sussex expansion (increase beds) • Provided coverage for Incident Command on the weekends during the most stressful times so there was a constant leadership presence in house for the staff • Drove Planetree and Magnet initiatives • Achieved Leader status for HEI Applications are accepted every October for those interested in joining a Shared Governance council. Visit the Magnet section under the Initiatives tab on BayNet for more information.

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Cultivating Professional Development Bayhealth continues to support the growth of our nurses. From encouraging team members to continue their education to helping them with certifications and providing professional development, we believe in cultivating the talent of our nurses and helping them

grow to become nurse leaders in their own right. Doing so has brought much success to the nursing staff at Bayhealth, as shown through the clinical nurse statistics below.

CLINICAL STATS

713 FULL-TIME NURSES 190 PART-TIME NURSES 1,349 TOTAL LICENSED NURSES 19.7% RN TURNOVER RATE 452 CERTIFIED NURSES 62% WITH BSN OR HIGHER 10% WITH MSN OR HIGHER

Climbing the Clinical Ladder Nursing leadership at Bayhealth is driven to promote clinical expertise. In September, the Clinical Ladder program was introduced to help retain nurses at the bedside, promote employee engagement and, most importantly, improve patient outcomes. Anyone who is a direct bedside registered nurse and not in an advanced clinical role is eligible. This new model will tie in components of nursing excellence standards set forth by Magnet®, meaning all applications must provide examples of transformation leadership, structural empowerment, exemplary practice, and new knowledge and innovation. The Clinical Ladder program offers an opportunity to grow and be rewarded. Bayhealth is committed to driving our nurses to pursue excellence that will allow them to provide the best care possible.

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EXEMPLARY PROFESSIONAL PRACTICE

Palliative Care’s Compassionate Creativity During the height of the coronavirus pandemic, Bayhealth’s Palliative Care team came up with a touching memento for the families of their end-of-life patients. With the consent of the patient and their family members, they took the patient’s thumbprints and put them together to make a heart. The team then placed the heart on a small index card that has “Our Fingerprints Don’t Fade from the Lives We Touch” printed on it. They placed this card into a

small organza bag, along with a test tube containing an EKG strip of the patient’s heartbeat with the date and time of death written on the back of the strip. The bag was then sent to the family members who could not be present at the time of death, or given to those who were at the bedside. “While a small gesture, this is such a beautiful representation of the compassion of our staff as they are serving through such trying times,” said Chaplain Supervisor Rev. Carol Harris, who is part of the Palliative Care team. “The ‘hearts’ of their patients and family members matter so much to them, and while we do this for our Palliative patients, it can be done for all end-of-life patients and their families.”

Care Management Adapts to COVID-19 The Care Management team, which includes social workers and nurse care managers, has played an essential role for our COVID-19 patients and their families. Discharge planning, which may include setting up home healthcare, rehabilitation services, and placement in short-term skilled nursing facilities or nursing homes, and utilization review are two ways they assist all patients and their families. Since the pandemic began, they’ve had to learn new terminology and workflows related to both of these areas.

management and helped develop a plan on how to change our work processes, especially for our patients on the COVID units, in isolation or in rule-out.” In addition, the team says the pandemic has strengthened their relationships and collaboration with physicians and other medical staff.

Having to rely more on telephonic communication has been a challenge. “We had one patient whose wife hadn’t seen him in weeks. Fortunately, we were able to coordinate for her to be outside of the hospital, in her mask of course, to wave to him as he was going into the ambulance for transport,” said Lead Social Worker Debbie Watson, BSAW, MSW, LMSW (left). Care Manager Michelle Devern, RN, BSN, PCCN (right), said keeping up with the ever-changing guidelines and making sure everyone at both campuses was aware of them and advocating for the staff were the most notable adjustments for her. “I talked with 15


NEW KNOWLEDGE & INNOVATIONS

A year of sacrifice, teamwork, resilience and support.

THE FIRST SIGNS OF COVID-19 IN OUR HOSPITAL Heading into the year, as the coronavirus emerged, healthcare organizations braced for the unknown. The State of Delaware reported its first presumptive case on March 11, and three days later Bayhealth received its first inpatient positive COVID-19 patient.

INNOVATIVE DRIVE-THRU Resoundingly successful, the Drive-Thru Clinic hosted by Bayhealth was developed and implemented in less than a week to meet the COVID-19 community need. The first drivethru was held on Wednesday, March 18, with a second one held on Friday, March 20. By day’s end on Friday, Bayhealth’s Coronavirus Management Team (CMT) received more than 750 calls while the drive-thru team tested more than 275 community members. 16


HEROES WINNING THE FIGHT AGAINST COVID-19

REDEPLOYMENT LED TO NEW CONNECTIONS Many Bayhealth team members faced redeployment, or job assignment change, because there was a higher priority to meet the COVID crisis over their current position. Some nurses were redeployed back to the bedside and other team members were sent to the drive-thru testing sites. Many team members formed new connections as they willingly stepped out of their element to lend a hand.

COMMUNICATING THE CONSTANT CHANGES Constant change created a need for more frequent communications. It was important to keep everyone in the know about the latest COVID-19 updates — from town halls with Terry Murphy featuring leaders to daily communications including information regarding PPE supply, COVID-19 cases and more!

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RECOGNIZING HEROES More than ever, healthcare workers played the role of hero as they helped keep our communities safe. Team members were acknowledged in “Be My Hero” campaign. Medical Staff introduced and sponsored COVID Hero Awards to honor deserving team members. In addition, there were many moments of appreciation for staff.

REMAINING RESILIENT A Health & Wellness team was formed to create resources to support the health and well-being of team members during challenging times — from setting up Meal Trains for each campus to putting together “survival kits” and other resources help relieve stress and lift spirits.

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COMMUNITY RALLIED FOR HEROES The outpouring of support from our communities during such an unprecedented time was tremendous. It was encouraging to experience the amount of gratitude we did. Whether it was donating meals or expressing their appreciation of our care, it was a great to know that they cared.

FIRST IN STATE TO ADMINISTER COVID-19 VACCINE Bayhealth was the first healthcare system in Delaware to receive the much-anticipated COVID-19 vaccine. The vaccine has offered a sense of hope to our team members who are dedicated to keeping our staff, patients and visitors safe.

CARING FOR OUR COMMUNITIES Our team members selflessly gave their time to work at the COVID-19 vaccine clinics to help stop the spread of COVID-19. They are driven and committed to keeping our community healthy and safe. 19


EMPIRICAL OUTCOMES

Maintaining a Culture of Safety and Quality For Magnet® Redesignation, we must provide nurse-sensitive indicator (NSI) data for multiple metrics, looking back at the most recent eight quarters, and demonstrate outperformance (51st percentile rank or better) of NDNQI benchmarks. These graphs represent some of the metrics averaged between all campuses for the four quarters of calendar year 2020, which are on track to meet or exceed Magnet standards.

PATIENT SATISFACTION GOAL IS TO BE ABOVE 50TH PERCENTILE RANK BAYHEALTH INPATIENT PATIENT SATISFACTION

top box score percentile rank

TOP BOX PERCENTILE RANK COMPARED TO ALL HOSPITALS (ROLLING 12-MONTH PERIOD: MARCH 1, 2020–FEB. 28, 2021) 90% 80% 70% 60% 50% 40% 30%

■ bayhealth

mean score

20% 10% 0%

■ magnet 50th

comm with nurses

response of hosp staff

comm with hospital doctors environment

comm about medicines

discharge care info transitions

percentile score

BAYHEALTH EMERGENCY DEPARTMENT PATIENT SATISFACTION

top box score percentile rank

TOP BOX PERCENTILE RANK COMPARED TO ALL HOSPITALS (ROLLING 12-MONTH PERIOD: MARCH 1, 2020–FEB. 28, 2021)

20

80% 70% 60% 50% 40% 30%

■ bayhealth

20%

mean score

10% 0%

■ magnet 50th

getting timely care

doctors and nurses comm

comm about medications

comm about follow-up

additional rating quest

percentile score


CLINICAL OUTCOMES GOAL IS TO DEMONSTRATE A VOLUME LOWER THAN THE 50TH PERCENTILE CAUTI PER 1,000 CATHETER DAYS BAYHEALTH PERFORMANCE AGAINST MAGNET HOSPITAL BENCHMARK THROUGHOUT CY 2020 cauti per 1.000 catheter days

0.9

The “0” in quarter 4 represents zero CAUTI for all submitting units.

0.8 0.7 0.6 0.5 0.4 0.3

■ bayhealth

mean score

0.2 0.1 0.0

■ magnet 50th

2020 jan–mar

2020 apr–jun

2020 jul–sep

2020 oct–dec

percentile score

CLABSI PER 1,000 CENTRAL LINE DAYS

clabsi per 1.000 central line days

BAYHEALTH PERFORMANCE AGAINST MAGNET HOSPITAL BENCHMARK THROUGHOUT CY 2020 0.9

The “0” in quarters 1 & 2 represent zero CLABSI for all submitting units.

0.8 0.7 0.6 0.5 0.4 0.3

■ bayhealth

mean score

0.2 0.1 0.0

■ magnet 50th

2020 jan–mar

2020 apr–jun

2020 jul–sep

2020 oct–dec

percentile score

FALLS WITH INJURY PER 1,000 PATIENT DAYS

injury falls per 1.000 patient days

BAYHEALTH PERFORMANCE AGAINST MAGNET HOSPITAL BENCHMARK THROUGHOUT CY 2020 0.6 0.5 0.4 0.3 0.2

■ bayhealth

mean score

0.1 0.0

■ magnet 50th

2020 jan–mar

2020 apr–jun

2020 jul–sep

2020 oct–dec

percentile score

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BAYHEALTH NEWS & RECOGNITIONS

Twiage Technology Improves Emergency Care Bayhealth’s Emergency and Trauma Services in partnership with local Emergency Medical Services (EMS) teams recently started using a secure, HIPAAcompliant communication technology called Twiage. The app, which can be used on smartphones, tablets and computers, replaces the phone and radio calls the teams have historically used for communicating patients’ medical information prior to their arrival to the hospital. “Bayhealth is the first healthcare system in Delaware to use a novel communication technology like Twiage to transform antiquated radio- and phone-based prehospital communication,” said Twiage Co-Founder and CEO John Hui. With Twiage, all Emergency Department (ED) staff members simultaneously receive the patient’s information, such as their name, symptoms, vitals and condition, thereby eliminating the need for multiple radio or phone calls. EKGs, photos and 30-second videos with content to help expedite care before and when the patient arrives at the hospital can also be sent via the app. Once a patient is in the ED, all of their medical information is deleted from Twiage.

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“Using Twiage, we can share critical information with other physicians and specialists, such as neurologists in the case of stroke patients, so they can get to the ED as soon as possible and begin putting together care plans before the patient arrives,” explained Bayhealth Senior Director for Emergency and Trauma Services Gust Bages, BSN, RN. “We’re also utilizing Twiage’s new Isolation module, which allows EMS to let us know if an incoming patient will require isolation before they arrive. This has been particularly helpful during the coronavirus pandemic since we can use the module to triage incoming EMS patients who are showing signs of COVID-19,” said Bages. Bages says one of the other benefits of Twiage is its built-in GPS feature. “Everything is GPS-located, which means ED staff can use the app to track EMS so they know more exactly when they’ll arrive instead of only relying on EMS’s traditional call alerting them they’re five minutes out. This means they can continue to care for other patients who are already in the ED.”


Nurse Residency Scores Top Distinction As nurses at a Magnet®- and Planetree-recognized facility, Bayhealth nurses are driven to achieve nursing excellence and are passionate about the work they do and the care they provide patients. Bayhealth’s Inpatient Nurse Residency Program is now accredited with distinction by the American Nurses Credentialing Center (ANCC) Practice Transition Accreditation Program (PTAP). This makes Bayhealth’s nurse residency program one of only 167 healthcare organizations nationwide that has earned PTAP accreditation with distinction. Bayhealth fully supports equipping new nurses to succeed in the professional setting while promoting

positive patient outcomes. Studies show that accredited transition-to-practice programs promote positive patient outcomes, higher job satisfaction, lower work stress and increased overall job competence, while improving retention in the first year of practice. Visit Bayhealth.org/nursing-recruitment for more information about Bayhealth’s Inpatient Nurse Residency program.

Gearing Up for Planetree Gold Since 2005, Bayhealth has been committed to Planetree’s philosophies of person-centered care. In 2015, Planetree International awarded Bayhealth its Bronze Certification for Meaningful Progress in Person- and Family-Centered Care. In 2018, Bayhealth received Silver Certification for Significant Advancement in Person- and FamilyCentered Care. Bayhealth is one of only seven healthcare organizations internationally with the Silver-level certification since Planetree first introduced the recognition level in 2012, and just one of three healthcare organizations in the U.S. to earn Silver Certification. Earning these certifications was no small feat and Bayhealth is preparing to embark on the journey to attain the Gold Certification.

Planetree education for all staff, improve HCAHPS patient satisfaction scores, implement a care partner program, and cultivate employee and physician engagement, just to name a few.

Bayhealth’s Planetree Gold Steering Team comprises senior leaders across the continuum of care at Bayheath that meet regularly to identify initiatives that will amplify strategic and operational goals, aimed at surpassing the requirements to fulfill the Planetree mission. Areas the team is aiming to improve are to provide

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Stellar Nurses Create Stellar Year The awardees of Bayhealth’s 2020 Nurse of the Year Awards have exemplified Bayhealth’s mission, vision and values through the nursing excellence they consistently demonstrate. These nurses are driven to provide the nation’s best healthcare here at home.

There were six nurses representing six categories: New Registered Nurse Graduate, Med Surg/Acuity Adaptable, Nightingale Nurse Leader, Critical Care, Advanced Practice Registered Nurse and Outpatient/Ambulatory. Congratulations! We appreciate the great work you do!

Pictured: John Starke, Critical Care (top left); Rachel Winston, New Registered Nurse Graduate (top middle); Angel Dewey, Nightingale Nurse Leader (top right); Shariyfa Cedeno, Med Surg/ Acuity Adaptable (bottom left); Janet Messina, Outpatient/Ambulatory (bottom right). Not pictured: Jessica Taylor, Advanced Practice Registered Nurse.

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It’s the Year of the Nurse and the Midwife The World Health Organization (WHO) designated 2020 as the “Year of the Nurse and the Midwife,” in honor of the 200th anniversary of Florence Nightingale’s birth. “One of the goals of the yearlong event was to shine a light on the nursing profession and the important role nurses play in healthcare,” said Gifty Boateng, RN,

Odasia Bennett, MSN, RN, CNOR

Felicia Cruz, MSN, APRN, AGCNS-BC, RN-BC

clinical coordinator, PACU, Kent Campus. “Another goal is to help recruit more people into the profession since there is a nursing shortage. Also, according to a Gallup poll, as of January 2020, nursing was voted as the most trusted profession for 18 years in a row.” Nurses were spotlighted in our publications, social media pages, billboards and other outlets.

Gavin Brown, RN

Tyler Coty, MSN, RN, CCRN

Roland Gillette, MSN, RN, CEN

Kelly Schelts, MSN, RN, CEN

Jane Sweetman, BSN, RN, CEN

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2020 DAISY Award Winners The DAISY Award is given by the DAISY Foundation, which was formed in 2000 by the family of J. Patrick Barnes. The Barnes family wanted to recognize the nurses who cared for Patrick, as well as all the other “unsung heroes” of the nursing profession.

March: Lindsay Karamali, Clinical Decision Unit (pictured on left) April: Elizabeth Cote, Progressive Care Unit May: Will Harvey, Clinical Informatics June: Audrey Aldrich, Hematology/Oncology; now in Nursing Administration July: Derek Sheets, Emergency Department

DAISY Award honorees are chosen by nurses, administrators, peers, physicians, volunteers, patients and families. If you know a Bayhealth nurse who deserves to be nominated, visit Bayhealth.org/Daisy and fill out the nomination form.

August: Erin Slattery, 6A Med Surge IMC

January: Nina Carter, Emergency Department

December: Verna Sellers, 4A Acuity Adaptable, Leadership Award

February: Shelby Schirmer, Progressive Care Unit

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September: Perioperative Services, Team Award October: Sharon Rigney, Emergency Department November: Crystal Shockley, 3A Acuity Adaptable (pictured on right)


Bayhealth Top Nurses Recognized Several Bayhealth nurses were recognized in Delaware Today magazine’s 2020 “Top Nurses” issue published in September. From bedside nurses to clinical educators, these nurses were ranked among the state’s best as voted by their peers.

CASE/UTILIZATION MANAGEMENT AWARD

ADVANCING AND LEADING THE PROFESSION AWARD

Robin Maracle, MSN, APRN, AGCNS-BC

Brenda Blain, DNP, RN-BC, FACHE, NEA-BC

Laura Tolson, APRN, AGAC-NP

Faith Colwell-Dorio, MSN, RN, NEA- BC, VHA-CM

Kevin Wiley, MSN, APRN, ENP-C, FNP-C, RN, CEN

Sharon Urban, MSN, MHA, RN-BC, CNML, NE-BC Marianne Foard, MS, RN, NE-BC, PRC

VOLUNTEERISM AND SERVICE AWARD Dawn Culp, MSN, RN, SANE-A, SANE-P, FNE, DV Melissa Slater, BSN, RN, CMSRN Trina Turner, MSN, RN-BC, LNC

AMBULATORY CARE AWARD Trina Turner, MSN, RN-BC, LNC

NURSING NEWCOMER AWARD Idalis Stamas, BSN, RN Gavin Brown, RN Jacob Lorea, BSN, RN

Barbara Little, MSN, RN, CCM

ADVANCED PRACTICE REGISTERED NURSE AWARD Michele Sturgeon, MSN, APRN, AGCNS-BC, CMSRN

INPATIENT CLINICAL NURSING AWARD Tyler Coty, MSN, RN, CCRN Tanesha Downes, BSN, RN

INFORMATICS William Harvey, MSN, RN, CEN, CPEN, CPHIMS Lindsey Klemash, MSN, RN

CLINICAL EDUCATOR AWARD Brittany Oakey, MSN, RN, CRRN Michelle Thompson, MSN, RN, PCCN

EDUCATION Amy Cunningham, MSN, RN, NPD-BC

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Bayhealth Achieves Leader Status in LGBTQ Healthcare Equality Bayhealth has been awarded Leader status by the Human Rights Campaign (HRC) Foundation in its 2020 Healthcare Equality Index (HEI). The HRC Foundation is the educational arm of America’s largest civil rights organization working to achieve equality for lesbian, gay, bisexual, transgender and queer people. HRC envisions a world where LGBTQ people are embraced as full members of society at home, at work and in every community.

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Bayhealth earned top marks in nondiscrimination and staff training, patient services and support, employee benefits and policies, and patient and community engagement. The HEI 2020 scoring criteria included a higher benchmark, requiring participating facilities to demonstrate that they offered at least one companywide health insurance plan that affirmatively provides transgender-inclusive coverage. These continued recognitions showcase how team members at Bayhealth are driven to continue to work hard to evolve with the dynamic needs our LGBTQ+ patients.