Culpeper Medical Center

Nursing summary report:Haymarket Medical Center and Prince William Medical Center

This is us

2018-2019

Ifeelveryprivilegedtoserveasyourchiefnursingofficer.Aswebeginanewyearand

anewdecade,itisawonderfultimetoreflectonalltheaccomplishments

ofnursing.

2020hasbeendesignatedasthe“YearoftheNurse”inhonorofthe200thanniversary

ofFlorenceNightingale’sbirth.Sheprovidedanannualletteroraddresstothe

nurseswhowereintrainingandthosewhohadgraduated.Inher1872address,

Nightingalewrote:

“For us who nurse, our nursing is a thing, which, unless in it

we are making progress every year, every month, every week,

take my word for it we are going back.”

TheNovantHealthUVAHealthSystemPrinceWilliamMedicalCenterandHaymarket

MedicalCenter2018-2019NursingSummaryReportisatestimonialtotheprogress

thathasbeenaccomplishedbyallwhohaveacceptedthecallingtonotonlycarebut

becaringtothosewhocometousforcomfortandhealing.

Thankyouforallyoudoforourpatients,theirfamilies,ourcommunityandtheteam

memberswearehonoredtosharethiscallingwith.

Novant Health UVA Health SystemPrince William Medical CenterHaymarket Medical Center

Message from the chief nursing offi cer:

KathyCampbell,MSN,MPA,RN

chiefnursingofficer

MissionNovant Health UVA Health

System exists to improve the

health of communities one

person at a time.

VisionWe, the Novant Health UVA

Health System team, will

deliver the most remarkable

patient experience in every

dimension, every time.

• Authentic personalized relationships

• Affordability

• Quality

• Voice and choice

• Safety

• Easy for me

Values

Our peopleWe are an inclusive team

of purpose-driven people

inspired and united by our

passion to care for each

other, our patients and our

communities.

Our promiseWe are making your

healthcare experience

remarkable. We will bring you

world-class clinicians, care

and technology — when and

where you need them. We are

reinventing the healthcare

experience to be simpler,

more convenient, and more

affordable, so that you can

focus on getting better and

staying healthy.

• Diversity and Inclusion

• Teamwork

• Personal excellence

• Courage

• Compassion

• NovantHealthUVAHealthSystem

CancerCenter

• NovantHealthUVAHealthSystem

CatonMerchantHouse

• NovantHealthUVAHealthSystem

CulpeperMedicalCenter

• NovantHealthUVAHealthSystem

HaymarketMedicalCenter

• NovantHealthUVAHealthSystem

PrinceWilliamMedicalCenter

• NovantHealthUVAHealthSystem

MedicalGroup

• Qualitycarewhenandwhereyouneedit

• Easy-to-accessphysiciansandavariety

ofoptionsofcare

• Highlyskilledspecialists,advanced

treatmentsoptionsandaccessto

clinicaltrials

• Accesstoacademicmedicalcenter

expertise,subspecialtycareand

potentialbreakthroughtreatments

• Workingtogethertoimplementbest

practices,advanceourpopulationhealth

strategyandlowerhealthcarecosts

Novant Health UVA Health System locations:

Connecting you to care

Care by the numbers

5

ER visits

Providers

Babies bornHospital beds

Team members

Operatingrooms

ER treatment rooms

Surgeriesperformed

Medical group locations

104,433

925

260

2,453

13

78912

11,772

30

2,479

Databasedon2019statisticsprovidedbyNovantHealthUVAHealthSystem

Care by the numbers

Volunteers

Northern Virginia Market in 2019

734,279

Total population

Household income<$15k

$15-25k

$25-50k

$50-75k

$75-100k

$100-200k

<$200k

0% 5% 10% 15% 20% 25% 30% 35%

Education

Lessthanhighschool

Somehighschool

Highschooldegree

Somecollege/associatedegree

Bachelor’sdegreeorgreater

6%6%

36%

28%

24%

The community we serve

7

Age groups

Percentagesmaynottotal100%duetorounding.Source:Sg22019populationestimates

Language16%

72%

12%

Spanishathome

Otherlanguagesathome

OnlyEnglishathome

26%

9%

13% 14% 14%12%

8%

4%

0-17 18-24 25-34 35-44 45-54 55-64 65-74 75

30%

25%

20%

15%

10%

5%

0

Ethnicity/race

White

Hispanic/Latino

Black/AfricanAmerican

AsianandPacificIslander

Other

9%4%

15%

21%

51%

The community we serve

Nursing by the numbers

Student Nurse Apprentice Program

TheStudentNurseApprenticeProgram(SNAP)isa10-weeksummerprogramto

enhanceskillscompletedbyrisingseniornursingstudents.ManySNAPsreturnas

registerednurseresidentsand/orremainonaspart-timeorshort-termtechnical

assistantsastheyfinishtheirnursingprogram.From2018to2019,20SNAPswere

hiredthroughthisprogram.

New Grad Residency ProgramTheNewGradResidencyProgram

forregisterednurseskickedoffin

VirginiainJuly2017.This12-month

programisdesignedtotransitionthe

newnurseintoprofessionalpractice

throughscheduled,interactivelearning

sessions,aguidedpreceptorshipand

socializationopportunities.In2018,

therewasa69percentretentionrate

afteroneyear.In2019,thatretention

rateincreasedto95percent.In2020,

thisprogramwillbecoordinatedby

MagnetProgramManagerKathy

Garrisonincollaborationwith

departmentnursemanagers.

8

6

4

2

0Behavioral

healthCritical

care unitEmergency department

Medical services

unit

Operating room/post-anesthesia

care unit

Women’s services

New Grad Residency Program, by specialty

2018 2019

Highest nursing education degreesD

egre

es

2018

Hay

mar

ket

Pri

nce

Will

iam 2018

2019

2019

39

113

127

67

Diploma/associate degree

70

208

210

60

Bachelor’s degree

11

26

35

8

Master’s degree

1

2

1

—

Doctorate

—

2

2

—

Advanced Practice Registered Nurse

9

Acute Care Nursing Clinical LadderAnew,system-wideAcuteCareNursingClinicalLadderprogramlaunchedinJanuary

2017torecognizetheexpertiseoftheacute-carenurseswhopracticeatthebedside.

Thesenursesprovideclinicalleadershipandtakeontasksandprojectsthatenhance

patientcareandqualityoutcomesthroughouttheorganization.

Nursing by the numbers

Clinical Ladder statistics Haymarket 2018

Haymarket 2019

Prince William

2018

Prince William

2019

ReceivedLevel3 18 9 26 33

ReceivedLevel4 4 7 32 36

ReceivedLevel5 5 6 9 26

Total number of successful Clinical Ladder applications

27 22 67 95

Turnover rates

Thenursingdepartmentturnoverrate

droppedsignificantlyatPrinceWilliam

MedicalCenterin2019.Vacancieswere

filledandnewpositionswereaddedat

bothHaymarketMedicalCenterand

PrinceWilliamMedicalCentertomeet

theneedsofareapatients.

Hay

mar

ket

31%

31%

Pri

nce

Will

iam

25%

9%

2018 2019

National Certifi cation Day

Certifiednurseswerecelebratedin

Marchwithacontinentalbreakfast

atbothHaymarketMedicalCenter

(26registerednurses)andPrinceWilliam

MedicalCenter(83registerednurses).

2018

27

71

2019

26

83

Haymarket Prince William

The implementation of the in-person safety huddle has led to:

• Improvedinterdepartmentalcooperation

• Efficientuseoftimeforsharingsafety-eventreportsfromthelast24hoursand

plannedactionstoaddressthoseconcerns

• Assignedaccountabilityandresponsibilityforactionsandfollow-upreportsina

timelymanner:

– Individual(s)assignedtoeachconcern

– In-personconversationsinrealtime

– Specificdatemutuallyestablishedforstatusupdates/resolution

– Whiteboardsutilizedtotrackprogressoneachsafetyandqualityconcern

Patient safety and quality huddlesInJanuary2019,theconceptof“AlwaysPatientReady”wasintroducedasPrince

WilliamMedicalCenterpreparedforitsTriannualJointCommission(TJC)survey.Using

thesefiveseparatetoolschangedthecultureofsafetyacrosstheorganizationand

helpedsecureasuccessfulTJCsurveywithoutanyconditionalfindingsinJuly2019.

Toolsinclude:

• Scavengerhunts

• Leaderrounding

• “FocusoftheDay”publications

• Dailydepartmentchecklists

• In-personsafetyhuddles

Patient safety

11

Manycouncilshadnewchairsandfacilitatorsin2019,makingitayearoftransition.

Aspecialcouncilfortechnicalassistantswasalsopilotedattherequestof

teammembers.

Coordinating CouncilTheCoordinatingCouncilcollaborateswiththechiefnursingofficerandthechairs/

facilitatorsofallcouncilstoeffectchanges.

Partners’ CouncilThePartners’Councilcoordinatedseveralcommunity-support,wellnessand

nursing-recognitionevents(includingthequarterlyDAISYAward)in2018-2019:

• Afull-daysymposiumwithJoanne

Duffyaskeynotespeaker(February)

• NationalDrugTakeBackDay

(AprilandOctober)

• RelayforLife(May)

• Nurses’Weekbasketsandactivities

(May)

• Schoolsuppliesdrive(September)

• Annualfooddrive(November)

• Coatdrive(NovemberandDecember)

• Employeegivingtree(December)

• RemarkableYOUcommunityscreenings(ongoing)

Research Council TheResearchCouncilpromotesevidence-basedpractice,performanceimprovement

andnursingresearchthrougheducationalactivitiesandsupportfromNovantHealth

NurseScientistGloriaWalters.Activitiesfor2019included:

• Fourlocalresearchprojectswere

invariousstagesofdevelopment

andcompletionatPrinceWilliam

MedicalCenterandHaymarketMedicalCenter

• Completionofmanyperformance

improvementprojects

• ResearchBootCamp

• AnnualNovantHealth

ResearchSymposium

Shared governancePatient safety

Professional Practice and Development Council

TheProfessionalPracticeandDevelopmentCouncilpromotesprofessionalgrowth

andeducationattheunitanddepartmentlevel.Thecouncilalsoisresponsiblefor

promoting,developingandreviewingpoliciesthatinteractwithnursing.In2019,

thecouncil:

Safety and Quality Council

TheSafetyandQualityCouncilsupportsthebedsidenursebypromoting

compliancewithbestpracticesandevidence-basedcaretoensurebest

patientqualityoutcomes.

Activities for 2018-2019:

• Reviewedscorecardsandqualitydataonamonthlybasis

• CollaboratedwithTheProfessionalPracticeandDevelopmentand

Researchcouncilsonprojectstoimprovesafetyandqualitymeasures

• Collaboratedwithinfection-preventionandpharmacydepartmentstoimprove

safetyandqualityofcare

– Loweredhealthcare-associatedInfectionrateswithcatheter-associated

urinarytractinfections(primaryfocusfor2018-2019)

– StandardizedtheCodeCartlockingandrestockingprocesses

• EstablishedPyxisMedStationkits.Thesekitsimproveefficiencyanddecrease

medicationerrors

– Supportedpressurepreventionandquarterlywoundrounds

– Evaluatedfallrateswithineachfacilitylookingfortrendsandensuring

fall-preventioninterventionsareproperlyimplemented

• Supportednursingspecialty

certifications,tuition

reimbursementprocessesand

recognitionincludingNational

CertificationDay

• Supportedacute-careClinical

Ladderprogramapplicants

andNovantHealthUVA

HealthSystemchairpersons

ontheClinicalLadder

programreviewteam

• Reviewedandsubmitted

commentsonanynewand

under-reviewnursingpolicies

toreflectpracticerequirements

intheNovantHealthUVA

HealthSystem

• Collaboratedwithclinical

educationandothershared

governancecouncilsinsupportof

educationalinitiativesincluding

thein-housenursingsymposiums

Supportedacute-careClinical

Ladderprogramapplicants

HealthSystemchairpersons

Researchcouncilsonprojectstoimprovesafetyandqualitymeasures

Collaboratedwithinfection-preventionandpharmacydepartmentstoimprove

Loweredhealthcare-associatedInfectionrateswithcatheter-associated

ontheClinicalLadder

Thepatientandfamilyareatthecenterofnursingpractice,reflectingourongoing

commitmenttoremarkablenursingcare.

13

Professional Practice Model

NovantHealthUVAHealthSystem’sProfessionalPracticeModeldepictshow

thenursingdepartmentpractices,collaborates,communicatesanddevelopsasa

professiontoprovidethehighestlevelofqualitycare:

commitmenttoremarkablenursingcare.

Gentleandcaringnursinghands

supportthepatientandfamilyto

representtherelationship-based

carenursesprovide,andtheDuffy’s

QualityCaringModelisincluded

becauseitprovidesthebasefor

allnursingpractice.

Thesharedgovernancecouncils

surroundthecenterofthe

circletoshowhowtheyprovide

thestructure,collaboration,

developmentandcommunication

fornursingpractice.

Theoutercircleshowsthe

organizationalsupportfornursing

andthealignmentofournursing

practicetothecorporatevaluesandthe

NovantHealthUVAHealthSystemvision

ofaremarkablepatientexperience,inevery

dimension,everytime.

Nursing symposiums

• Opioid Crisis Across the Continuum of Healthcare(April6):Morethan

70attendeesincludingnursesandnursingstudentsfromoutsideofthe

NovantHealthUVAHealthSystem

• The Art & Science of Nursing “Breaking Out the Leader in YOU”(Sept.13):

Morethan50registerednursesusedZOOMtechnologytoattendvirtually

2019 nursing accomplishments and awards

• Glucommander(Summer2018)

• ZOOMVideoConferencingand

MobileChatincreasingaccessto

remoteevents(September2018)

• Insupportofthecorevalue

ofdiversityandinclusion,

gender-identitydocumentation

wasenhancedinDimensionsto

allowlegalsex,genderidentity

andsexassignedatbirthasthree

separateentities

• VirtualInstructor-LedTraining

(VILT)initiatedaseducation

modalityforsomecourses

(August2019)

• InteroperabilityofIVinfusionpumps

(January2018)

• Dimensionsupgrades:e-cigarettes

wereaddedtopatient-history

admissionassessmentsaftera

suggestionfromPrinceWilliam

MedicalCenteremergencyroom

nurse(April2019)

• Addedanavatarfordocumentation

oflocationsforlines,drainsand

airwaysinDimensions

• Roverwithbarcodescanningto

includemedications,specimen

collectionsandbloodproducts

(Spring2018)

Innovations and technology (2018-2019)

15

2019 nursing accomplishments and awards

Washington Regional Transplant Community recognition

• PrinceWilliamMedicalCenterreceivedtheLeslieEbertAwardattheSynergy

SymposiumonNov.1.Theawardrecognizessmallerhospitalsthatsupport

organ,eyeandtissuedonationandafacility’sdisplayofacultureofdonation

throughvariousinitiatives.HaymarketMedicalCenterwasarunnerupforthis

sameaward.

• AlishaGreen,aregisterednurseinPrinceWilliamMedicalCenter’s

emergencydepartment,wasrecognizedasaChampionofReferralsand

receivedabest-practiceawardforherworkusingclinicaltriggerstoidentify

potentialdonors.

Preceptor appreciation

• Recognizedmorethan115preceptorsinOctober2019withasmallgift

deliveredtothemontheunitsbyleaders

• Startedformalpreceptorprogramfornursingtechnicalassistants

• Beganannualpreceptorupdatetoreinforceconsistencyintraining

New care units

• InJune2019,PrinceWilliamMedicalCenteropeneditsobstetricemergency

department(OBED)withinthelaboranddeliveryunit.Alloutpatients

arrivingtolaboranddeliverywillbeevaluatedintheOBEDandpregnant

patientswhoenterthroughtheemergencydepartmentwillbetriagedto

OBEDasappropriate.

Nursing Annual Validations (NAV)

• Overthecourseof3.5daysinNovember,650nursingteammembers

completedNursingAnnualValidations(NAV).Manystationsusedgamingto

assessknowledgeandskills.

17

DAISY Awards

PrinceWilliamMedicalCenterandHaymarket

MedicalCenterjoinedtheDAISYorganization

inthethirdquarter.

• PrinceWilliamMedicalCentercreatedaspecialcareunit(SCU)inJuly2019.

TheSCUservesasflexspaceaccommodatingthreelevelsofcare:Intensive

caretoadultandgeriatricpatientswithafocusonsingle-organsystemfailure,

intermediate-levelcriticalcareand/ormedical-surgicalpatients.

• AsurgicalwellnesscenterservingbothPrinceWilliamMedicalCenterand

HaymarketMedicalCenteropenedinSeptember2019.Thesurgicalwellness

centerprovidespre-operativehealthscreeningsandtestingforpatients

inasinglelocationatasingletimeandisstaffedwithanadvancepractice

registerednurseandperioperativeregisterednurses.

Prince William Medical Center

honorees:

Mariane Gomez|registerednurse

orthopedics/oncology(Quarter3)

John Wilson|licensedpracticalnurse

behavioralhealthinpatientunit(Quarter4)

Haymarket Medical Center honorees:

Brooke Travers |registerednurse

Kirsty Steyn |registerednurse

medical–surgicalunit(Quarter3)

Ethan Newham|registerednurse

emergencydepartment(Quarter4)

Clinical Nurse Educators(November2019)

Michelle Curran|registerednurse

women’sandchildren’sservices

Sue Mahle |registerednurse

medical/surgical/behavioralhealth

Tori Martin|registerednurse

emergencydepartmentandcriticalcare

Cassi Moxley|registerednurse

surgicalservices

Team Award:

Emergency department

• Left-without-treatmentratesdecreasedtolessthan2percentbecauseofan

initiativetoimprovepatientflow.

• Initiateddischargefollow-upphonecalls.

Behavioral health department

• Addedadvancepracticeregisterednursestothelistofprovidersforinpatients.

• Completedrenovationstotheunittominimizeligaturerisks.

• Sustained100percentcomplianceforQ15minutesafetyroundingaftera

process-improvementinterventionthatwassuggestedbyteammembers.

• Decreasedincidenceofcontrabandfoundonunitincollaborationwiththe

publicsafetydepartment.

• Beganpilotprogramtotrainregisterednursestoperformface-to-face

evaluationsforviolent-restraintepisodesintheabsenceofaprovider.

Critical care unit

• Replacedcontinuousrenalreplacementtherapymachines.

• AddedArticSuntemperaturemanagementsystem.

• Addednon-invasivecardiacoutputmonitoring.

• IncreasedscopeofpracticetoincludecareofImpellapatients.

Outpatient wound center

• ReceivedHealogic’sPresident’sCircleAwardinMay2018forexceedingclinicalandoperationalqualityresultsfortwoconsecutiveyears.

2019 service line accomplishments and awards

19

Orthopedics/oncology

• Increasedthenumberofbedsableto

beflexedinhigh-volumesituations

fromeighttoelevenatPrinceWilliam

MedicalCenter.

• Expandedorthopedicproceduresat

HaymarketMedicalCenter.

Medical/surgical

• PrinceWilliamMedicalCenterwasnamedatier-oneunitforteamengagement

byPressGaney.

• HaymarketMedicalCenterreceiveditsmetabolicandbariatricsurgery

accreditationandqualityimprovementprogramcertification.

• Initiateddischargefollow-upphonecalls.

Surgical services

Prince William Medical Center:

• ImplementedMakoRobotic-ArmAssistedTotalKneereplacementprogram.

• Hiredfirstregisterednurseresident.

• UpdateditscomputerinthesterilecoretostreamlineCensiTracforSterile

ProcessingDepartment.

• Increasedoperatingroomvolumeby232casesin2019.

Haymarket Medical Center:

• Addedsixnewsurgeons:twobariatric,twocolorectalandtwo

generalsurgicalists.

• Increasedoperatingroomvolumeby411casesin2019.

2019 service line accomplishments and awardsCardiac catheterization lab

• InitiatedImpellaprogram.

• Implementedsame-daydischargeprogram.

• Startedconstructiononthesecondcathlab(openedFebruary2020).

Implemented post-surgery patient phone calls

This is us

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