Dartmouth-Hitchcock

Letter from Jane

Dear colleagues:

As I reflect on the year 2010, I am struck by just how many changes nurses at Dartmouth-Hitchcock (D-H) are embracing; how we are transforming health care here in the Upper Valley, in New England, and across the globe. Our annual report will reflect this and highlight several of the D-H nurses who are making a difference here in our region, as well as nationally and in far off areas of the world. This demonstrates the critical role nurses play in helping D-H continuously strive toward our vision to achieve the healthiest population possible. They are but an example of the wonderful staff we attract as a Magnet designated organization and nationally recognized institution for excellence in nursing care. Every nurse makes an impact on their patients, families, neighborhoods, their community and schools. We change, improve and impact those around us. I am often reminded of this when I meet staff nurses who are involved in the Shared Governance process here at D-H; leading and improving our nursing practice with "experience from the bedside."

The mission of D-H Nursing Shared Governance is to develop all nurses as leaders who will create and promote an environment that provides and maintains safe, high-quality, patient- and family-centered care. When I reflect on this statement made two years ago with the redevelopment of our Shared Governance councils, I am proud of the work being done by all nursing staff who are demonstrating what it means to be a nursing leader.

My role as Staff Nurse Executive Chair is a unique one. Not many health care organizations have devoted such time, money and commitment to the Shared Governance process as D-H, and that is exemplified with this designated role. As Spiderman (or Stan Lee actually) so eloquently stated,"With great power there must also come great responsibility." I feel honored to represent staff nurses at the various hospitalwide committees that I am asked to participate in. As well as great responsibility with my role, I feel I have a great opportunity to raise the voice of our staff at the bedside to make real gains in patient quality and improvement outcomes. There is such a benefit to having staff nurse involvement at the local, regional and national level as this report demonstrates. We have fantastic nurses doing inspiring work, as well as the many nursing staff involved in our monthly Shared Governance council meetings.

Here are a few examples:

• Decisions made this year by the Quality and Practice Councils have made drastic improvements in our Nursing Sensitive indicators; Hospital acquired pressure ulcers and blood stream infections took a nose dive!
• Rounding for 4Ps (Pain, Personal Care, Position, Patient Safety) Pilot on eight units, a Shared Governance-led initiative, assisted the units in improving their patient falls, pain reassessment, pressure ulcer, patient satisfaction rates as well as decreased call-light use.
• In the fall, the Nursing Research Council rolled out The Nursing Research Academy, a monthly accredited educational offering highlighting nursing research and use of evidence-based practice by staff nurses, instructed by research leaders from here at D-H.
• The Professional Development Council has been busy planning various celebrations and recognitions for our Certified Nurses to be held during Nurses Week, the newly revised Staff Nurse Achievement Program (SNAP) program, as well as educational opportunities for professional career advancement and organizing the many scholarship programs available to D-H nurses.
• The Management Council revised the on-call policy, nurse educator job brief, worked on a project to improve patient flow through the Access Center, and collaborated on the revised Code of Conduct policy.
• With the implementation of our Shared Governance SharePoint site, a Windows tool that has improved communication and flow of ideas on projects amongst council members, we are striving to improve the work the councils produce as well as maintain an accurate record of meeting minutes and agendas. Council members post comments, new ideas and "discuss"  issues between meetings so that the time together in council has improved outcomes and productivity. I hope in the year 2011-12 we can discuss the possibility of rolling this out to all nurses.

An achievement I am especially happy about this year is working with Volunteer Services to incorporate a patient-family advisor with four of the councils. Their reflections as a patient and family member of D-H have been invaluable to our council meetings and decisions. Their addition to the councils was a goal during our Shared Governance redesign, so to see it carried out successfully is very fulfilling.

I hope you enjoy our new layout of the annual report, saving trees and promoting careful use of resources while highlighting the great work that goes on here by D-H Nurses. As my tenure as Staff Nurse Executive Chair continues this year, I look forward to many staff nurses stepping forward, seeking to be nominated as Chair Elect this fall. Our elections process continues to be participatory; one that I hope sparks great discussion and instills new members with a feeling of pride and shared leadership. As we continue to lay Shared Governance groundwork and collaborate with our health care colleagues, I look forward to reaching out to all nurses and unit-based councils as we work together to improve patient outcomes and reach even higher levels of nursing excellence.

Sincerely,

Jane Taylor, BSN, RN
Staff Nurse Executive Chair