At HCA Healthcare, nurses are the cornerstone of patient care and considered the lifeblood of the organization
HCA Healthcare’s Senior Vice President & Chief Nurse Executive, Jane Englebright, Ph.D., RN, CENP, FAAN, says that because nurses are with patients and their families during some of the most important and vulnerable moments in life, it means they have a unique opportunity to make a difference. And they can positively impact both outcomes and the care experience for every patient.
Englebright recently provided her thoughts through an executive Q&A.
Why is it important for nurses to have a voice in their profession?
ENGLEBRIGHT: In the United States, nursing is the largest healthcare profession, with more than 3.8 million registered nurses nationwide. I’m also a nurse. Many of us pursue this profession because we care deeply about improving peoples’ lives. Nurses are insightful, creative and passionate about patient care, and their perspective is invaluable because they spend more time with patients than anyone else in a hospital. As we advocate for patients, our voices influence positive changes for the practice of nursing and, ultimately, that improves patient care. So it’s important for healthcare leaders to create open environments where nurses’ voices are heard and acted upon because it can lead to exciting advancements in patient care.
Listening to nurses through surveys and focus groups helps leadership understand what nurses need to advance their careers as well as to build and maintain a realistic worklife balance to care for their families. Giving a voice to nurses has significant benefits to the organization and its mission to care for and improve human life, but also to the amazing people who deliver that care with compassion and expertise.
How do healthcare organizations benefit when nurses are heard and supported?
ENGLEBRIGHT: Historically, the voices of nurses have led to better patient care. From Florence Nightingale to Clara Barton, we’ve seen that some of the greatest success stories in healthcare occur when nurses are given latitude in guiding decisions that affect patients. That’s the approach we’ve taken at HCA Healthcare for many years now, and it has unlocked possibilities that we and others in care delivery hadn’t yet realized.
For example, 10 years ago, through our CNO Council, nurses asked for a tool to electronically document patients’ vital signs. Documentation was done at that time mostly room-to-room with pen and paper. Automation would create significant time savings for nurses, and would lead to better and safer care for our patients. Companies were asked to present their vital sign solutions to a group of nurses from HCA Healthcare who tested the tools and chose the right technology for them. The tool they selected didn’t exist until these nurses told us what they needed, and that probably wouldn’t have happened if we weren’t actively seeking their perspective.
More recently, we surveyed more than 800 of our nurses for their feedback on advancing nursing practice at our hospitals. Through the survey, we found that a large portion of documentation was neither efficient nor effective. Thanks to our nurses, Evidence-based Clinical Documentation (EBCD) was born.
The EBCD tool helps nurses spend more time with their patients and less time documenting the encounters. The patient-centered focus of EBCD minimizes the time spent inputting data, and at the same time, allows the information that has been entered into the medical record to be extracted in a more meaningful way. As a result, we’ve seen our nurses save at least 30 minutes on documentation, per shift.
Besides the surveys you mentioned previously, what are some additional ways HCA Healthcare ensures nurses’ voices are heard?
ENGLEBRIGHT: We have a number of ongoing vehicles and venues to give voice to our nurses:
- Professional Practice Councils. Every hospital within HCA Healthcare has these councils, which exist to proactively identify issues and opportunities to improve care. They are venues for bringing forth new ideas and for testing innovations in care delivery. The councils systematically raise the bar on nursing performance.
- Advisory Councils. These specialty councils govern how best practices are shared across the health system and include nursing representatives from each division and various clinical roles, including direct care nursing staff and nurse leaders.
- Nurses at every level of our organization. While nurses are best known for being on the front lines of care, they are stepping beyond nurse director and CNO titles and into positions such as CEO and COO. Nurses in C-suite roles are helping to shape business and operational decisions across the enterprise.
- Vital Voices. Through this program, which utilizes a continuous listening approach, colleagues actively seek conversations to solve problems and generate ideas. This allows nurses to provide real-time feedback and see real-time improvement.
- Inspire App. The app is an easy way for nurses to recognize excellence, chart professional growth, and connect with mentors and peers.