Integration of QSEN Competencies and TTP Program Leadership into a System’s Shared Governance Structure

Submitter Information

Author: Maria Cosler, RN, MS
Title: RN Residency Program Manager
Institution: Premier Health
Email: MTCosler@PremierHealth.com
Coauthors: Kim Barton, MSN, BSB/A, RN

Competency Category(s)
Quality Improvement, Teamwork and Collaboration

Learner Level(s)
Continuing Education, New Graduates/Transition to Practice, Staff Development

Learner Setting(s)
Clinical Setting

Strategy Type
General Strategy

Learning Objectives

1. To streamline TTP program communications with the leadership teams and bedside staff to enhance engagement.
2. Build a mechanism in which to share TTP metrics/outcomes with nursing on a monthly and quarterly basis illustrating program success.
3. Have a platform by which to have new graduates present their projects to organization leadership and staff nurses, to raise awareness of their valuable work.
4. Eliminate waste by combining structure and thereby multiple meetings.

Strategy Overview

The practice strategy shared is the integration of our Transition to Practice (TTP) Programs Leadership/Oversight into our existing Shared Governance Structure including the use of QSEN competencies as its structural framework.

Changes to the recommended TTP Leadership Committee structure triggered us to look at our structure and consider integrating program oversight into our current System Shared Governance Model which allowed us to create a platform, which supported our objectives outlined below. (Refer to the Shared Governance Practice model where each subcommittee was built into the shared governance subcommittee.)

– To streamline TTP program communications with the leadership teams and bedside staff to enhance engagement.

Streamline communication with leadership teams and beside staff through each facility’s council structure. We were able to document the shared TTP information in the council meeting minutes and ensured that the chair of the council on the units was sharing this information at staff meetings, we were not able to track the dissemination of information prior to transitioning these meetings together.

– Build a mechanism to share TTP metrics/outcomes with nursing on a monthly and quarterly basis illustrating program success. This was shared by Nurse Residency Manager in Transformational leadership and disseminated throughout the coordinating councils.

When the data is shared during shared governance meetings it is then streamlined into our facility coordinating council each month. Prior to this, that data was shared with leadership only not the direct representative at each coordinating council.

– Created a meaningful platform by which to have new graduates present their projects to organization leadership and staff nurses to raise awareness of their valuable work.

Each cohort would present at the shared governance system meeting following their one-year mark. The PI projects for that cohort were divided into each shared governance subcommittee that the topic was relevant. Each project must illustrate the QSEN domain and any sub-competencies addressed in the project. Prior to this integration, each PI group would present at their own hospital only and only a few nurse leaders and that facility’s CNO.

– Eliminate waste by combining structure and thereby multiple meetings.

Successful integration of a Transition to Practice (TTP) Programs Leadership/Oversight into our existing System Shared Governance Structure

Submitted Materials

281-Practice-2.pdf
281-Practice.pdf
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Additional Materials

Practice Model Infographic_PHP
Shared Governance Council Model_PHP

Evaluation Description

Qualitative and quantitative outcomes have been positive including:

– Reduced meeting time required on council member/TTP Leadership schedules by 2 hours a month per individuals who were attending multiple committees and councils with similar content and topics. The committee had 33 members prior to integration into the system Shared Government.

– Representation from all facilities/councils to communicate back to unit councils’ committees, facilities as relevant. By combining the monthly meetings 792 total hours per year were reduced for the TTP leadership members. In addition, reduction in work for Nurse residency managers by approx. 4 hours a month, preparing for those meetings such as agenda items and meeting minutes.

– Streamlined communication through system shared governance committees (4) and facilities coordinating councils (3). By having the system shared governance model incorporate TTP leadership the communication can now filter down to site coordinating councils. This has also afforded the opportunity for nurses to be together to have a voice and making decisions in a more efficient and timely manner. Before when decisions or votes had to be made, it had to go to each individual shared governance council site first and TTP leadership, then collect the input for a decision to be made. This often delayed moving nursing practice and decisions about program forward and having the current model unifies our institutions nursing.

– Able to successfully recruit additional Supportive Components Coaches for TTP support. By utilizing this platform, we increased our participation of new coaches to 86 active coaches over the past three years. We also could discuss each month when cohorts were starting how many coaches will be needed for that cohort. This method increased the number of new coaches reaching out to us via email on a more regular basis. We also streamlined coaching classes for the coaches and created a flyer to attach to monthly minutes that contained when those classes would be offered.

– Platform for new grad RN resident PI project presentations and champions of the possible unit, facility, and system-wide implementation The audience for the PI project has three committees we filter it thru and this goes to all three coordinating councils which then can be shared in units shared governance council meetings. The new approach reaches every bedside nurse.

– Improved involvement of Executive Leadership and bedside RNs in TTP decision-making. We now facilitate communication and decision making thru Transformational leadership (23 members), which is also communicated to our three sub-committees (70 members), and the three coordinating site councils (260 members). We also have a more open dialogue with our Nurse Executive Council (7 total members, Chief Nurse Officers, and Assistant Chief Nurse Officers at each site) as needed for decision-making on program changes since we have representation each month of an NEC member.