Congress Abstracts 2003

32

PERFORMANCE IMPROVEMENT: STRATEGIES FOR SUCCESS. Kim Maynard, RN, BSN, OCN^®, Georgie Cusack, MS, RN, Ginnie Daine, RN, MBA, CHPQ, and Antoinette Jones-Wells, RN, BSN, National Institutes of Health, Bethesda, MD.

Performance improvement (PI) can be described as a philosophy based upon the continuous improvement of processes leading to improved outcomes and services. At the Clinical Center (CC) of the National Institutes of Health (NIH), PI is viewed as a process approach to problem identification and resolution utilizing systems thinking, data-driven decision-making, and emphasizing a customer/service focus and teamwork. Data is received and incorporated from multiple, sources including process management tools, indicator data, unit/department data, JCAHO preparation, and data from external sources. At the Outpatient Cancer Center (OCC) of the CC of the NIH, a knowledge deficit was identified among nurses regarding the process and implementation of PI. Staff nurses on the units were collecting indicator data at the local level and submitting this data quarterly to the performance improvement committee. Time spent collecting data was not always value-added, as problems pertinent to their units were not always addressed and solved. There was no clear relationship between data collection, use of the occurrence reporting system, and improving patient outcomes and services. To increase PI awareness and involvement at the unit level, and to prepare for a JCAHO audit, an educational approach was developed and implemented by the OCC PI team. Strategies included unit-based education of PI principles, a unit-based audit system, JCAHO “jeopardy” games, and bulletin boards highlighting specific topics. The overall goal was to exert positive influences on clinical practice, research integrity, and cost effectiveness. The program has been highly effective with the level of staff participation quadrupling in the identification and monitoring of performance indicators. JCAHO preparation activities have yielded excellent results reflected in both unit-level mock audits and overall scores received after the JCAHO visit. The implications for clinical practice are that a fun, interactive method to educate staff and increase their investment in the PI process can be developed and operationalized at the unit level. Our PI model promotes staff involvement as well as personal development resulting in increased employee satisfaction. Improving oncology patients’ healthcare outcomes and increasing customer satisfaction are rewards beneficial to all.