Four delivery networks, 7,000 nurses and one goal: excellent patient care

In 2012, Yale New Haven Health System's three chief nursing officers set out to accomplish an ambitious goal: standardize nursing practice across the three system hospitals.

With the system-wide Epic implementation as a catalyst, CNOs Sue Brown, RN, MSN, Greenwich Hospital; Sue Fitzsimons, RN, PhD, Yale New Haven Hospital; and MaryEllen Kosturko, RN, BSN, Bridgeport Hospital, formed the CNO Council to oversee the multi-year project.

On March 9, the CNOs and nurse leaders, clinical nurses and staff from other departments throughout YNHHS celebrated their progress on phase I of the project, which includes:

• Developing a common strategy for staff and patient education, including identifying the competencies all nurses should learn and standardizing nurse orientation across the delivery networks.
• Creating a system-wide program to encourage and support YNHHS nurses' efforts to research and develop evidence-based, best practices.
• Adopting a standard patient- and family-centered care model.
• Implementing strategies to reduce the use of patient sitters.

While these initiatives are ongoing, others have been successfully completed, including creating a nursing professional practice model for YNHHS and standardizing how the delivery networks report quality and safety measures such as falls, hospital-acquired infections and pressure ulcers.

At the March 9 meeting, the CNOs and participants began phase II of the standardization effort, which includes creating system-wide nursing policies and procedures, and exploring a system-wide float pool, YNHHS nursing website and annual report, system shared governance and clinical ladder programs, leadership development programs and a workload measurement tool.

"Thanks to the outstanding work of the team leaders and participants on each of these initiatives, we have made significant progress in our efforts to standardize nursing practice across the system," Fitzsimons said. "When we're done, we will have unified policies, practices and programs that combine each delivery network's strengths, meet the needs of all YNHHS nurses and ultimately enhance the care we provide."

"The energy and pride amongst the nurses has shown how strong we are as one voice governing our practice," Kosturko added. "This has been extremely exciting as we, together, form our future."