peer review in a union environment jody charles, msn, rn cathy patton, ma, rn chris tarver, ms, rn,...
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Peer Review in a Union Environment
Jody Charles, MSN, RNCathy Patton, MA, RNChris Tarver, MS, RN, CNSJanuary 10, 2013
History of Peer Review
PRN – union over 30 years
Just for RNs, just at ECH
1st Designation Submittal 2005:• Absolute refusal of union to discuss• Documentation submitted included
communication between CNO and President regarding Peer Review
• Surveyors met privately with the union during site visit
2
History (cont).
2nd Designation Submittal 2009:
• On advice of ANCC Consultant, looked at Peer Review in form of direct care nurse feedback
• Submitted in documentation competency check offs and various audits done by direct care nurses on other direct care nurse’s practice
• A bit of a stretch
3
In prep for 3rd Submittal 2014
Our CNO, Diana Russell, wanted to elevate peer review
Presentation by CNO to Union Board• Research on benefits presented• Explanation of peer review in a union setting
• Union strong stance regarding education of all RNs who were going to be asked to give feedback
Agreement reached . . . When leadership committed to educational plan with union input
4
Where to Begin?
• Magnet requirement:
• “Peer Review at all levels”
• The beginning work is focused
on the Direct Care Nurses
5
Start up . . .
Selection Committee Leadership
Manager from each campus asked by the CNO
Nursing Education Manager “Consultant/Facilitator”
Selecting of the Peer Review model/resource
We had relationship with Barb Haag-Heitman
6
Recruiting• Feb 2011: CNO presented to CPC the agreement
with PRN and what Peer Review entails
• Recruiting of direct care nurses• “All RN” flier/email & “In Touch” Message• Message to: Call Nursing Ed Manager for
details
• Presentation to
managers at
Nursing Leader Council
7
First meeting of committee
• Sept 2011 1st meeting• Clinical Ladder process comparison to peer
review (exemplars) – gave the DCN a point of reference from past practice
• Distribution of book: Peer Review in Nursing• Given task to read the book
8
2nd Meeting of Group
• Oct 2011 2nd Meeting• Discussion of pilot unit criteria • Discussion of policies and procedures
• Very important to CNO and union that the nurses developed their process so that they could promote it
• Direct Care Nurses able to say what they wanted and didn’t want in a process
9
3rd Meeting – November 2011
• Barb Haag-Heitman brought in to meet with committee members in full-day session
• Agenda included: • Developed vision and goals• DESC Model • Selected Direct Care Nurse co-chairs
• went around room, and offers made to lead; vote taken
• Met with managers at conclusion
10
ECH Peer Review Committee Vision
“Leading the nursing community in promoting the highest standards of patient care through the peer review processes.”
11
ECH Peer Review Committee Goals
1. Create sustainable peer review process to promote professional nursing practice at ECH.
2. Increase individual and group accountability for positive patient outcomes.
3. Foster a healthy work environment.
4. Create supportive learning relationships.
12
DESC Model (B. Haag-Heitman)
• Describe
• Express
• Suggest
• (Positive) Consequences
Examples . . .
13
Development of Process Details
• Very important to nurses to have peer review not be included in performance appraisal process
• Selected pilot unit at each campus
• Everyone would be expected to participate
• Change in DCN leadership in Feb 2012• one-on-one conversation with manager
facilitator and DCN leader• replaced with DCN leader who was former CPC
chair
14
Spring 2012
• Several meetings on education for Committee about DESC model:• Allowed members to get feedback from
colleagues on the model
• Education plan discussed and developed
15
Summer 2012• Meeting with CNO to review implementation plan in
order for CNO to present to union
• Quarterly plan of a focused competency per quarter• based on nursing strategic plan
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Each Quarterly Cycle
• Early in First month of quarter: competency distributed
• 1st - 2nd month of quarter: complete peer review and turn competency into unit champion; review UPC
• 3rd month of quarter: bring to CPC
17
Accepted Education Plan
• Barb Haag-Heitman returned
• Mandatory for pilot units; open to all DCN
• 2 hour classes; both campuses
• Manager of Nursing Education taught four make up sessions
18
Unit Binders
• DCN leaders wanted to create this Resource for each unit, includes:• Articles on Peer Review• Competency Tools• Barb Haag-Heitman’s Powerpoint• Vision and Goals of Committee
19
First Project
• Med Admin Competency• Related to our Bar Coding Medication
Administration initiative• HCAHPS data on med communication
• Barb Haag-Hietman suggested must have pre and post data to show that peer review made a difference
• Coached us on creating competency with strong focus
20
Lessons Learned
• Selection of Pilot Unit:• data difficult to obtain for first project selected
for pilot units
• Need to assess: Does unit have another major project happening?
• Back up plan for nurses unable to attend mandatory training
21
Questions?
Jody Charles
Jody.Charles@elcaminohospital.org
THANK YOU!!
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