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In the face of change, nurses on the admission team at Florida Hospital Altamonte had only one response - embrace the challenge.
 These nine RNs earned the top spot - and a perfect score - as ADVANCE's 2010 Best Nursing Team. It's the first time a team has accomplished that feat in the annual awards program.
Dozens of hospitals from around the state submitted entries that were reviewed by a panel of three independent nursing judges.
Entrants were asked to submit under one of the following categories: initiative, adaptability, expertise and outreach.
"That's phenomenal! I'm not surprised - they're a great team," said Sherba Baine, BSN, RN, assistant director of nursing. "It's amazing to hear they received full marks from all of the judges."
Mobile Team
The hospital was tasked with making the admissions process more efficient, accurate and cost-effective. Patient flow bottlenecked as patients awaited discharge from the ED to inpatient bed, a hospital process improvement study showed.
Baine and her staff replaced the traditional admit/discharge unit with a mobile team.
In the past, patients awaiting admission were placed in a special holding area - or waited in the ED - until an inpatient bed became available.
Nurses on the floor were left to complete the admissions process - a 30- to 60-minute task - once the patient arrived to the unit.
In Motion
Since they couldn't place everything on hold to complete one admission, nurses often stopped to take care of existing patients.
"Any time you stop a process, there's an increased chance of error," Baine said. "The admission team can provide uninterrupted care - the patient has all of that nurse's attention."
The hospital staff closely reviewed each layer of the process - when and where most patients were admitted and what resources were used. Data collected during the performance improvement process showed the majority of patients were admitted to the hospital between noon and midnight.
Consistent Approach
With the new approach, a dedicated team works that 12-hour shift, handling 75 percent of all hospital admissions. Outfitted with mobile computers and wireless phones, these RNs meet patients at the bedside, gather all relevant medical history, reconcile medications and even provide direct care if the floor nurse needs support.
The nurses in the admission team provide support by starting IVs, serving as a resource on computerized charting, obtaining supplies or being an extra pair of hands on a busy unit, Baine said.
Whether it is explaining to patients how they are an integral part in ensuring nurses adhere to hand hygiene, or updating an RN on the hospital's computerized charting system, the admission team nurse takes opportunities to teach.
"I frequently receive praise from physicians regarding the accuracy of the admission medication reconciliations done by the nurses on the admission team," Baine said.
Not only has the process led to increased patient and staff satisfaction, it also can significantly enhance patient safety.
 "Consistency is the key. When the admission process is done repeatedly by the same nurses," Baine noted, "they become exceptionally proficient at it."
Karin Lillis is senior regional editor at ADVANCE.
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