A Step Above

ADVANCE for Nurses' second annual Readers' Choice survey unveils nurses' picks for top hospitals

Trish O'Keefe, MSN, RN, NE-BC, chief nursing officer at Morristown Memorial Hospital, an Atlantic Health facility in Morristown, NJ, best described the nursing philosophy shared by the 14 hospitals recognized in ADVANCE for Nurses' Readers' Choice survey.

"We've focused a good deal on an empowered environment for our staff within a shared governance framework," she said. "Our nursing staff makes decisions regarding their practice, which is a priority in our Magnet culture."

Empowering nurses pays off big time, according to Linda Geisler, MEd, RN, NEA-BC, vice president of patient services at CentraState Healthcare System, Freehold, NJ. "Our Press Ganey results show patient satisfaction ratings of 99 percent in the [emergency department] and 96 on the inpatient units," she said.

Margaret Cusumano, MSN, RN, vice president for patient care services/chief nursing officer at Vassar Brothers Medical Center, Poughkeepsie, NY, emphasized the importance of encouraging staff to disclose issues openly without punitive action.

"We have a very transparent culture where mistakes are acknowledged, with full disclosure both clinically and administratively," she said.

Change is also in the air at Montefiore Medical Center, Bronx, NY.

"Nursing is truly on the move at Montefiore; that's our new mantra!" said Joanne Ritter-Teitel, PhD, RN, NEA-BC, vice president of clinical services/chief nursing executive at Montefiore.

"Our new leadership team is seeking to create momentum for continuous change, with a strategic plan that continues to keep us among the top academic medical centers in the country."

Room for Improvement

"Listening is a cultural competency issue here," explained MaryPat Sullivan, MSN, RN, CNS, chief nursing officer at Overlook Hospital, Summit, NJ, an Atlantic Health facility. "How do you best hear your staff and improve the working environment for them so they can provide the very best possible patient care?"

When patient volume went up by 20 percent in 1 year, each Overlook board member adopted one or more nursing units to mentor, rounding regularly to encourage two-way communication.

Many of the hospitals on the Honor Roll use open forums to make sure everyone hears the same message.

"You can never over-communicate; there's always room for improvement," emphasized Elizabeth McCormick, MSN, RN, executive director/chair of nursing at Memorial Sloan-Kettering Cancer Center, New York, NY.

"Whenever we have important issues to communicate, we hold town hall meetings, and I regularly host advisory breakfasts with front-line staff," she said.

Champions for Quality

When hospital leaders consistently communicate their commitment to quality care, everyone wins.

"Our CEO Daniel Aronzon, MD, and our entire leadership team have continued to be champions for quality and safety in patient care, and advocates for whatever investments are necessary to promote a quality environment for the staff that provides that care," Cusumano said. "We don't do things in a vacuum within the corporate suite; it all translates back to the bedside so the nurses are hearing it, seeing it and experiencing it every day."

Maria Brennan, MSN, RN, CPHQ, vice president for patient services/chief nursing officer at St. Joseph's Regional Medical Center, Paterson, NJ, emphasized teamwork is critical.

"We've created effective multidisciplinary approaches to improve our compliance with core measures, brought in more advanced practice nurses, and organized a nursing quality council and an organizational performance improvement committee that deal with performance-improvement issues," she said. "I'm glad we were so proactive with our quality of care around core measures and our nursing involvement because it certainly puts us in a great position to deal with Medicare reimbursement changes around surgical infections, [ventilator-associated pneumonia], pressure ulcers, falls and other complications."

Many of the Readers' Choice facilities participate in the National Database for Nursing Quality Indicators [NDNQI] and emphasize evidence-based practice.

"We compare ourselves nationally to hundreds of hospitals regarding nursing-sensitive indicators," O'Keefe said. "We have programs around each of the indicators, including medication management and wound care. We've been recognized by the Institute for Healthcare Improvement for wound care, and chosen as one of the wound care mentor hospitals nationally."

Susan Bowar-Ferres, PhD, RN, NEA-BC, senior vice president/chief nursing officer at NYU Langone Medical Center, New York, NY, noted that grassroots involvement in quality initiatives has yielded tremendous benefits.

"Our quality and practice councils are at the most logical level they can be, and they identify, measure and report what's important within their specific area of practice," she said.