NewsAnnouncements : Nursing Staff On Journey To ‘Pathway to Excellence’

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Nursing Staff On Journey To ‘Pathway to Excellence’


By Bernard S. Little

WRNMMC Command Communications

Walter Reed National Military Medical Center’s Directorate of Nursing is well on its journey to Pathway to Excellence (P2E) designation, said officials from the American Nurses Credentialing Center during a briefing July 17 at WRNMMC.
P2E designation by the ANCC recognizes health-care organizations that promote and sustain a safe, positive and healthy work environment for nurses, which leads to better outcomes for patients. To earn P2E status, an organization must integrate specific P2E standards into its operating policies, procedures, and management practices. The ANCC grants P2E designation for four years, which is earned through a comprehensive review process.
During the July 17 meeting at WRNMMC, ANCC officials Jeff Doucette and Patience Harris briefed the WRNMMC nursing team on how to achieve P2E designation. They explained WRNMMC’s pillars and P2E standards are aligned, as well as P2E facilities are characterized by a health-care team in which nursing leadership is strong; policies reflect nursing input; and where a healthy environment calls for the best nursing practices.
 “We have been on our journey since September 2016,” said Navy Cmdr. Bridgette Ferguson, special assistant for P2E in the WRNMMC nursing directorate, which has adopted the theme “P2E, the Journey Begins with Me.”  She explained WRNMMC’s nursing directorate has established teams focused on P2E standards, which include shared decision-making, well-being, professional development, quality, safety, and leadership, all surrounding a positive practice environment. The groups have taken steps to actualize the P2E standards to ensure nurses are a respected part of the interprofessional team and strengthen the roles of nurses at WRNMMC.
The WRNMMC pillars of quality, research, readiness and education, surround its priority of the patient being at the center of everything the medical center does.
Of the approximate 5,000 hospitals in the United States, the ANCC has designated approximately 150 as P2E organizations, said Doucette, vice president of Magnet Recognition and Pathway to Excellence Program for the ANCC. P2E has its genesis in the Nurse-Friendly hospital program, established in 2003 by the Texas Nurses Association to improve the workplace and positively impact nurse retention. The ANCC was able to expand the Texas Nurse-Friendly program into a national program, acquiring it in 2007 and renaming it Pathway to Excellence.
Doucette, a nurse for more than 25 years, served as regional vice president of clinical service and chief nurse executive for Bon Secours Hampton Roads Health System prior to assuming his current position with the ANCC. He explained, “Pathway to Excellence guides the positive transformation of practice environments in multiple settings to build a global community of health-care organizations committed to nursing workplace excellence.
“It’s really about building a great workforce,” he continued. The P2E framework includes: fostering interprofessional collaboration; giving the frontline staff a voice; making staff feel valued and empowered; fostering frontline caregivers to be the drivers of quality initiatives; and creating a culture of sustained excellence.
“When [the ANCC] visits organizations, we like to look at what your current structure is, or how you expect your organization to perform,” Doucette said. He explained WRNMMC’s pillars (readiness, quality, research and education) have significantly help put the nursing team on its journey to P2E designation because of the pillars’ similarities with P2E standards.   
Harris, senior registered nurse specialist for the ANCC, further explained the P2E standards and what organizations seeking P2E designation are expected to achieve.
She said shared decision-making allows nursing staff shared governance and interprofessional collaboration to influence care delivery, workflow, hiring, product evaluation, as well as engages staff, builds teamwork and strengthens culture.
Effective leadership fosters collaboration and a shared governance environment, Harris continued. “Leaders actively engage staff for input and serve as advocates for their patients and staff,” she added.
Safety encompasses the well-being of patients and staff, Harris said, adding that a safe environment prevents unnecessary accidents and violent incidents.
Quality initiatives develop and promote interprofessional collaboration, evidence-based research, improved outcomes and internal and external benchmarking, Harris explained.
Well-being emphasizes the importance of staff taking care of themselves so they are better able to care of their patients, she stated, adding it’s important that the nursing staff is actively involved in planning those efforts that promote work-life balance and effectiveness. This includes encouragement and recognition of achievements, contributions to improving population health and flexible scheduling. Well-being programs help organizations prevent exhaustion, cynicism and inefficacy among staff, thereby reducing burnout and promoting vigor, dedication and absorption for staff engagement, she continued.
Professional development includes “comprehensive orientation support and guidance of mentors and preceptors focused on staff members’ individualized learning needs, clinical experience and ongoing education,” Harris said.
She added that the overall benefits of adhering to P2E standards include: nurses feel valued and have a voice; there’s an environment that supports quality nursing practice; and nurses become central to interprofessional collaboration.
“The best benefit of all is saving lives,” Harris said.
She pointed out that the Cleveland Clinic Marymount Hospital, which has put into practice P2E standards, has witnessed a 46 percent reduction in hospital-wide patient falls, and 78 percent reduction in hospital acquired pressure injuries, an 85 percent reduction in specimen labeling errors and a 60 percent reduction in catheter associated urinary tract infections during the period covering 2012 to 2016.
On its journey to P2E designation, Ferguson explained the WRNMMC nursing staff has participated in a number of well-being initiatives including hospital-wide resiliency and wellness fairs, as well as fitness challenges for nursing team members.
She added the directorate also is practicing shared decision-making, with nurses sitting on boards for hiring actions in their units, as well as participating on other policy and procedure establishing groups within the medical center. In addition, team members participate in daily nursing huddles and interprofessional meetings.  Members of the team have also produced a comprehensive book to inform staff of educational offerings at WRNMMC the P2E safety team also hosted a two-day event in May focused on pediatric and geriatric safety, and in the realm of leadership, Director of Nursing Services at WRNMMC, Navy Capt. Valerie Morrison, regularly hosts lunches to encourage the sharing of ideas for best practices and recognize the achievements of nursing team members. The directorate also recognizes its members monthly with the DAISY Award for Extraordinary Nurses.
For more information concerning WRNMMC’s P2E efforts, contact Cmdr. Bridgette Ferguson at 301-400-0566.