Providence Nursing Institute 2021 Annual Report

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Providence Nursing Institute

2021 Annual Report

Chief Nursing Officer Message Sylvain ‘Syl” Trepanier, DNP, RN, CENP, FAONL, FAAN Colleagues, In some ways, the last year flew by so quickly, and at the same time, it felt like the longest year ever. Yet, COVID-19 managed to keep its grip worldwide and has impacted our practice and industry in ways we could never have imagined. Yet, despite the significant stress that this has caused us, Providence Nurses have demonstrated a steadfast commitment to the best possible care for all. This commitment is the reason the Providence Nursing Institute is unflinching in its pursuit to provide Providence Nurses with the tools and resources they need to deliver world-class care. Our 2021 Providence Nursing Institute Annual Report is dedicated to all the nurses, members of the nursing workforce, and the entire healthcare team who have inspired us to keep going. Providence nurses strive to make every encounter sacred because they see you, take the time to know you, and ease your way. They lead, inspire, and place their patients first, providing world-class whole-person care. I will be forever grateful to all of you for choosing to “show up” despite all the obstacles life has offered us throughout the entire year. This 2021 edition highlights the hard work and dedication the Providence Nursing Institute invests in amplifying Providence’s nurses’ voice. We know that nursing belongs at every table, and that is why we work to advocate for the best tools, resources, training, and everything you need to optimize the care of our patients. May 2022 bring us all Peace, Joy, & Health


Our Nursing Tenents


Providence Nursing Institute Pillars


Professional Practice Model


Nursing by the Numbers


Pandemic Impact

Our Annual Activities 7

You’re Invited: A Shared Leadership Approach


Building A Foundation for Success


Continued Support for the Nurse Caregiver


Celebrating the Nurse Caregiver: Recognitions and Celebrations


Advancing New Knowledge, Innovation, and Improvements


Pursuing the highest level of Nursing Excellence


Operational Stewardship


Staying Engaged

“Nursing is the most trusted profession for a reason. Nurses are skilled practitioners in the science of care and the art of caring. At the Providence Nursing Institute we work to ensure our nurses have what they need to continue that trend. ” - Syl Trepanier, SVP, Chief Nursing Officer

To find more details about the incredible work the Providence Nursing Institute is taking on click the button below.


Our Tenets: The Providence Nurse With every life we touch, we affect more than one individual, strengthening our communities and making the future brighter. Our work creates a better, healthier world for all people, especially those who are poor and vulnerable.

Fellowships and Residencies for All

We believe that all nurses should have access to a residency program when transitioning into practice and to a fellowship program when transitioning into specialty. We offer an accredited evidence-based residency program to all newly graduated nurses who choose to practice at Providence.

Professional Development

As nurses we understand the importance of life-long learning and encourage continuous professional development. We support you in each stage of your career, from residency or practice to specialty or fellowship to management and leadership roles.

Advanced Practice

Advanced practice is vital to our mission of Health for a Better World. At Providence, we value the contributions of advanced practice registered nurses, nurse midwives, certified registered nurse anesthetists, clinical nurse specialists and physician assistants.

Compassionate Care

Providence nurses strive to make every encounter sacred. We approach every interaction with compassion, taking the time to know our patients and easing their way through the healing process.


We believe that all nurses should have an opportunity to influence their practice. We support and promote a shared leadership structure that gives nurses a voice on their practice.

Inclusive Care

We are an inclusive workforce that champions diversity of thought, experience, culture and beliefs. We cherish our core values of compassion, dignity, justice and integrity. For example, bullying is a pervasive issue that has been observed in nursing schools and in practice settings. It is destructive to nurses and organizations. At Providence, we do not tolerate bullying behaviors, condescending attitudes, destructive resentments or backstabbing.


Providence Nursing Institute Pillars Our Values



Sacred Encounters

Our Pillars Clinical Academy: We strive to make Providence a place every new graduate nurse wants to work. The Clinical Academy ensures our family of organizations has a stable nursing workforce and helps fill the gap for our current nursing shortage. Our programs provide reliably prepared nurses for hard-to-fill specialty positions and advanced practice nursing roles, which are essential for Providence’s growth and new care models. Nursing Excellence: We value the continued efforts of our nurses to provide exceptional care in their professional practice environment. We encourage every ministry to pursue excellence designation by certifying organizations as external validation of our commitment to driving quality outcomes through nursing practice and innovation. Academic Advancement and Partnerships: We recognize that nurses are vital to our mission and the pandemic has worsened the nursing shortage. We collaborate with the University of Providence and trusted community partners to help build the professional nurse workforce our future requires. We advocate for flexible learning pathways and financial aid to attract new nurses to the profession and assist current caregivers who seek career advancement. Professional Development: We understand that nurses need continued education to enhance clinical knowledge and skills, obtain specialty certification, and take on new roles in our organization. We deliver education through a variety of platforms and are able to provide credit through our ANNC recognized Continuing Nursing Education Program. Clinical Practice: We understand that working collaboratively to identify best practice and reduce unnecessary variation is vital to move the organization forward. We work collaboratively with clinical teams to evaluate evidence, achieve consensus on best nursing practice, and effectively communicate changes that impact practice to our nursing caregivers. Nursing Research and Innovation: We seek to promote an environment that fosters growth of the nursing profession through research and clinical scholarship. We support nursing caregivers by providing resources, education, and opportunities to engage in scientific inquiry that will improve nursing practice and care delivery.


Providence Nursing Professional Practice Model (PPM) In 2021 the Providence Nursing Institute sponsored the creation of a System Professional Practice Model, a framework designed to support and guide nursing practice delivered in a variety of settings across our system. The Providence Nursing PPM was developed collaboratively by a group of nurse leaders from different regions and disciplines, with input from direct care nurses, and approved by the Nursing Leadership Council. The model is depicted in the form of a circle to signify unit and centered around our aim of striving to make every encounter sacred. The hands provide a visual representation of care and compassion we deliver to all patients.


ONE FOUNDATION: Sacred Encounters



Professional, Evidence-led, Interconnected, Person-Centered, Compassionate


Providence Nurses are: Professional • • • • • •

Accountable for the care provided to our patients Empowered to influence care changes to improve quality Autonomous in designing and implementing nursing care plans Influential over care delivery Life-long learners Equipped with a spirit of inquiry to ask and answer clinical questions

Evidence-Led • • • • •

Committed to providing safe, highly-reliable care Current on the latest evidence and nursing best practices Active in research to lead the field of nursing Innovative in improving care for all patients Motivated to continuously enhance the quality of care provided to our patients

Interconnected • • • •

Person-Centered • Keeping the patient at the center of nursing practice • Focused on caring for the whole person • Inclusive in creating care plans alongside our patients • Culturally-sensitive, meeting people where they are • Honoring the diversity and differences in each person we serve Compassionate • • • •

Focused on our patients’ needs, wants, and desires, holding our patients’ values at the center of our nursing care Present with our patients when others cannot be Supportive of each other, with zero tolerance for bullying Ethical, demonstrating moral courage in all situations

Collaborative and team-based in the care we provide Interdependent upon each other Advocates for our patients Connectors within the care delivery system


Nursing by the Numbers At the Providence Nursing Institute our priority is to ensure that nurses have a powerful voice in decisions that impact their practice and work environment. Now, more than ever the concerns of the nurse must be heard and acted upon to address the rapidly evolving changes in healthcare. We make sure nursing has as seat at the table on system committees and clinical teams to represent the perspective of the 48,000 nurses across our diverse system.












Where We Serve: Telehealth Ambulatory Care Network Physician Enterprises Acute Care Locations





Pandemic Support Nursing has been ranked as the most trusted profession by Gallup’s ethics survey for over a decade. The World Health Organization designated 2020 as the Year of the Nurse in honor of the 200th anniversary of Florence Nightingale’s birth. No one could have predicted that the year would also be marked by a global pandemic, that disrupted every aspect of society and placed nurses on the frontlines of the battle against Covid-19. As the pandemic continued in 2021, the Providence Nursing Institute team was reminded of the value Nightingale placed on teamwork. She led a team of medical doctors, statisticians, and engineers and showed uncompromising commitment to the people she led. We understood the stress repeated surges and workforce shortages placed on our already exhausted caregivers--and reached out to ministries to offer support. Our combined team of 22 caregivers found opportunities to provide both clinical and administrative assistance based on our existing skills and identified needs.

22 Team members

1000+ Clinical Hours Volunteered

15 + Locations

600+ Non-clinical Hours Volunteered

“The ongoing pandemic has had a dramatic impact on the healthcare industry and created significant challenges for our caregivers. We have been privileged to lend our support to system efforts to provide resources to local ministries as they navigate this rapidly changing landscape. ” -Syl Trepanier, SVP, Chief Nursing Officer


You’re Invited: A Shared Leadership Approach While the pandemic has been challenging, it has highlighted the value of working together. The Providence System Nursing Leadership Council (NLC) provided a forum to voice concerns, identify innovative solutions and allocate resources to address needs across our multi-state organization. At the Providence Nursing Institute we lead, participate in, and support many different interprofessional councils, committees, and work-groups to amplify the nurse voice. One voice: One Team.

Magnet Council

Regulatory Education

Pathway to Excellence Nursing

Clinical Education Leadership Council

Professional Practice Model

Clinical Academy Advisory Councils (31)

Nursing Awards Nursing Seminar Series Nurse’s Week Celebration

Resource Management Nursing/ HR People Strategy Council

Clinical Products Clinical & Safety Quality Clinical Informatics

Nursing Research & Scholarship Council Virtual Nursing Journal Club

During 2021

45+ We Lead

System-wide councils, committees, and Work-groups


15+ We Participate

In system-wide councils, committees, and Work-groups

600+ We Engaged Nurse Leaders In the decision-making process

Building A Foundation for Success The Clinical Academy program for new nursing graduates continues to be a valuable springboard to novice and transitioning nurses. Almost 13,000 nurses have participated in the program since 2016, with 3,685 participants in 2021. This year the program was awarded re-designation as a Practice Transition Accreditation Program (PTAP) by the American Nurses Credentialing Center (ANCC). Significant achievements for 2021 include: • Development of the ARNP/APP Transition into Practice Program and APP Preceptor Program, with a scheduled launch in January of 2022. • Implementation of a collaborative pilot with Montana Hospital Association and Providence Alaska to support the delivery of RN Residency in rural locations in those states. • Revision and transition of several curricula to a virtual learning platform to facilitate deliver across ministries. This included deployment of Per-anesthesia (including pre-admission, pre-op, PACU, and extended care), Cardiovascular Lab, Critical Care, Ambulatory, Emergency, and Step-Down Progressive as a virtual courses. An additional 1,927 RN’s participated in Clinical Academy programs (including continuing education, preceptor development, etc.), resulting in over 10,000 course enrollments in Academy curriculum.



1328 559 172





1374 534













Accredited Sites

10,000 Course Enrollments


Life-long Learning: Continued Support for the Nurse Caregiver Eliminating barriers to professional development Providence Nursing Institute understands how important professional development is, that’s why we’ve continued to foster career advancement and leadership growth opportunities for the Providence nurse. In 2021 we standardized the support package for RNs pursuing their BSN at the University of Providence. In addition, we have strengthened our partnership and communications to assist nursing caregivers access a variety of high-quality healthcare degree and certificate programs. As a result of this partnership, 197 nurse caregivers enrolled in RN/BSN, AGNP MSN, MSNE, and PBLSN programs at the University of Providence. All these programs offer schedule flexibility to meet nurses where they are. 2021 also saw the development of numerous programs to support nurses as they transition into leadership, including, a Charge Nurse Program, Nursing Professional Development Specialist Program, Nurse Leadership Fellowship, The Providence Nurse Leader Development Program, and a Nurse Executive Development Program. In addition to creating university partnerships, improving scholarship opportunities and program development, the Providence Nursing Institute hosted a variety of seminars, symposiums, and virtual events for nurses engaging over 1,800 caregivers throughout the system. Our ANNC recognized Continuing Nursing Education Program has also helped Nurse Planners obtain 435 credit hours for more than 390 Providence Nurses. At the Providence Nursing Institute we continue to empower our nurses to achieve their goals by breaking down barriers to professional development.

Elevating Nursing Contribution to Patient Care The Providence Nursing Institute recognizes the need to work collaboratively with interdisciplinary partners to achieve safe, highly reliable, evidencebased practice to improve the quality of care provided to all our patients. Under the guidance of the Nursing Leadership Council various practice initiatives were advanced in 2021. These initiatives


were then translated into clinical practice through the work of the Nursing Clinical Decision Team and the Collaborative Learning and Improvement Communities. This work included standardization and implementation of nursing products, as well as simplification and optimization of the electronic health record (Epic), with the goal of reducing variation in clinical nursing practice while easing our nurses’ way as they deliver care to those we serve.

Improving Communication Key to standardizing and advancing nursing practice is creating a communication pathway to disseminate clinical updates and product changes. The pace of these changes accelerated during the pandemic, making it difficult for front-line caregivers to find the latest information. Providence Nursing Institute collaborated with other stakeholders to create a streamlined process to deliver essential practice information to nurses throughout the system. The Providence Nursing Institute Practice Publication (PNI-PP) was developed to provide a concise summary of changes that directly impact nursing practice, with links to additional resources as needed. 2021 marked the inaugural year of this monthly publication, with 8 editions garnering over 3,700 views. This year the Providence Nursing Institute team authored more than 35 administrative, Epic, product, and practice alerts to inform nursing caregivers about changes impacting clinical practice. We worked to standardize regulatory education by collaborating with accreditation, subject matter experts and educators across the system in the development of 5 HealthStream modules. To ensure reliable access to these resources going forward, we created robust multiple internal and external websites.

Celebrating the Nurse Caregiver: Recognitions and Celebrations The Providence Nursing Institute is dedicated to honoring our nurse caregivers and the amazing work they do every day. In 2021 we were able to celebrate Providence nurses through a virtual event held during National Nurses Week. We issued a call to recognize nurses for their incredible contributions during the COVID-19 pandemic and were thrilled to receive over 500 nominations. Congratulations to each of our 2021 “Nursing Hero of Our Times” Award winners. A total of 15 awards were given, the awaredees are listed below: • • • • • • • • • • • • • • •

Jill Carrington - Acute Care Boyon Yun - Advanced Practice Jennifer Craig - Ambulatory Care Amber Myles - Behavioral/ Mental Health Rose Austria - Case Mgmt./ Care Mgmt. Discharge Planning Gisele Bazan - Education and Professional Development Christian Diance - Emergency & Critical Care Nacole Johnson - Home Health & Infusion Services Priscilla Malagon Bon - Hospice/ Palliative Care/ IHC Allan Komarek - Nursing Admin & Leadership Stephanie Dunkle - Nurse Managers Beth Peterson - Nurse Informatics, Technology, Analytics & Telehealth Rachel Thomas - Rising Star Kira Karinen - SNFs/ Assisted Living/ PACE Affordable Housing Kimberly Malinowski - Support Services

We look forward to honoring our nurse caregivers again during our 2022 event.

“It takes a special kind of person to be a Nurse. A person overflowing with kindness, empathy, and strength. The courage to be there in the darkest of times, and the hopeful optimism to see the bright future ahead.” -Syl Trepanier, Chief Nursing Officer








Advancing New Knowledge, Innovations, and Improvements The Providence Nursing Institute organizes and leads efforts to optimize nursing care through the advancement of research and innovation. Providence Nurses are encouraged to collaborate with nurse scientists, professional development specialists, and practice leaders in scholarly activities that range from unit-based quality improvement projects to multi-site research investigations. The Nursing Research and Clinical Scholarship Council had a busy year and one of significant development. This team partnered with clinical leaders in the research and scholarship space to identify innovative approaches to engage nurse caregivers in the work of advancing knowledge and creating improvements in nursing practice. Significant accomplishments for 2021 include: •

• •

Implementation of a new system-wide nursing research and scholarship journal club, with participation of 53 nurses during the first two sessions Coordination of a “virtual” Nursing Research Conference, attended by 225 Providence caregivers Organization of seven virtual education sessions designed to help nurses build their research skills

In 2021, Providence nurses were able to share their expertise through poster and podium presentations and authoring content for publication.

103 Posters Published


73 Articles Published

23 Podium Presentations

10,018 Downloads by 925 Institutions

Pursuing the highest Nursing Excellence The Providence Nursing Institute encourages ministries to recognize their commitment to excellence in nursing practice and patient outcomes through designation programs accredited by the American Nurses Credentialing Center. In 2021 we are proud to celebrate both initial designation and re-designation awards for excellence as affirmation of our continued efforts to drive clinical outcomes through nursing practice. Magnet Recognition Program The ANCC Magnet Recognition Program recognizes health care organizations for quality patient care, nursing excellence and innovations in professional nursing practice. Providence currently has 13 Magnet designated ministries across 6 states. In 2021, we are proud to recognize achievement of Magnet re-designation for 3 of those ministries: • • •

Providence Little Company of Mary Medical Center – Torrance (2nd Magnet Re-designation) Mission Hospital – Mission Viejo (3rd Magnet Re-designation) Providence Holy Cross Medical Center (4th Magnet Re-designation)

Pathway to Excellence Program The ANCC Pathway to Excellence Program guides the positive transformation of practice environments in multiple settings to build a global community of healthcare organizations committed to nursing workplace excellence. Providence currently has 4 Pathway to Excellence designated ministries. Practice Transition Accreditation Program (PTAP) The ANCC Practice Transition Accreditation Program (PTAP) sets the global standard for residency or fellowship programs that transition registered nurses (RNs) and advanced practice registered nurses (APRNs) into new practice settings. This year the Providence Nursing Institute Clinical Academy Residency Program was successfully re-designated as a PTAP with Distinction and Department of Labor Industry Recognized Apprenticeship program (IRAP) with 23 covered ministries across 6 states, including 8 ministries added in 2021.








Operational Stewardship Productivity and Benchmarking

Productivity and benchmarking tools provide information that can be used to compare operational activity both internally (across our organization) as well as to industry standards. The Providence Nursing Institute has a dedicated team to support reliable productivity and benchmarking definitions, measurements, and reporting to help our leaders meet their strategic goals. In 2021 this team worked collaboratively with the Providence Finance and Labor Efficiency team to roll out a standardized benchmarking tool and process across all regions except California, who will begin implementation in Q4 2022. Refinements were made to the system tool to provide daily in addition to bi-weekly reports. This increased data supports leaders’ efforts to meet budget targets within a pay period.

Centers for Medicare & Medicaid Services (CMS) Reimbursement Program

In 2021 the Providence Nursing Institute coordinated submission of our first application for CMS reimbursement application for Clinical Academy RN Residency program. The initial submission included 13 PTAP accredited hospitals, with plans to expand to 23 hospitals in 2022. This reimbursement process is projected to return significant dollars to the system, since an estimated 29% of expenses are reimbursable for PTAP accredited programs.

Bulk Purchasing

Every year the Providence Nursing Institute maximizes cost savings though bulk purchasing Acute RN educational content. Consolidating these purchases ensures best pricing for all ministries, no matter their size or volume. We expanded this program in 2021 to support clinicians in multiple care settings, increasing the overall savings total to $246,379.

Resident Turnover Savings

A major goal of the Providence Nursing Institute is to reduce turnover of new graduate nurses. In 2021 we were able to meet this goal, with first year turnover for RN participants in the Clinical Academy averaging 50% lower than RN’s who didn’t participate in the programs. This reduction in turnover saved our system an estimated 14.5 million dollars in avoided cost related to turnover.


The Providence Nursing Institute recognizes that financial stewardship is critical to our success in the emerging value-first medical economy. The size and diversity of our system presents both opportunities and challenges to improving operational efficiencies. With so many evolving programs and policies in play, there’s no one-size-fits-all solution. 2021 was a year of embracing new ways to help Providence become better operational stewards.

During 2021 An estimated 14.5 Million in financial savings due to turnover avoidance.

Approximately 29% of expenses reimbursable for PTAP accredited programs. On average 50% lower turnover rate for participating RN’s. Implementation of system benchmarking tool and process at 39 sites across 5 states.

Staying Engaged As we look back and celebrate our past success we know that our work is guided by, and supported through the incredible work of the nurse caregiver. 2022 is going to be a busy an outstanding year for Providence Nursing. Just a few of our activities are outlined below.

Destination Nursing 2025: During this 1-hour event, you will hear System Chief Nursing Officer, Syl Trepanier, review highlights of 2021 and discuss Destination Nursing 2025. He will be joined by Regional CNOs Elizabeth Paxton (AK), Julie Hilsenbeck (CA) and Kristy Carrington (Swedish) as they discuss the exciting opportunities that lie ahead. Let’s build healthier communities together! 2022 Nursing Excellence Awards: The Providence Nursing Institute is honored to pay tribute to its extraordinary nursing community in this year’s 2022 award ceremony. Nursing Professional Development (NPD) Hub: This site was launched in November 2021 to provide Nursing Professional Development Specialists with easy access to educational resources in one centralized location. Here you can learn about upcoming training events, connect with others via the NPD Yammer channel, and find tips and tricks to support your work!

Nursing Research & Innovation: We are excited to work with nurse scientists and clinical partners across our system to provide opportunities to engage in clinical scholarship. You can expand your knowledge by participating in journal clubs, conferences, and other activities offered throughout the year. Professional Nurse Educator Group Conference 2022: Providence Nursing Institute will host the 48th annual conference this year in Anaheim, California. This national conference provides an opportunity for academic and clinical educators to learn from leaders in their field, create collaborative partnerships, and develop a shared vision for preparing the professional nursing workforce our future demands.​​ Providence Nursing Institute News & Events: We are committed to providing our caregivers with numerous opportunities to engage with the Providence Nursing in 2022. Check our News & Events web page frequently to stay in the know about current happenings.



Thank you to those who helped gather data, edit, and create this report.

*All images without proper PPE were taken prior to the COVID-19 pandemic.