With inpatient, outpatient, home health and palliative care services, Mercy Health Youngstown is the largest employer in the Mahoning Valley region of Ohio. Investments in employee development, therefore, have a positive impact on both the health system and on the community at large, making this a top priority for senior leadership.
Mercy Health Youngstown has expanded access to skills and leadership training for entry-level workers with education programs, college tuition reimbursement and opportunities for career advancement. Entry-level employees with leadership potential, for example, are encouraged to enroll in School At Work (SAW), a training and career development program created by Catalyst Learning Company.
SAW participants complete a series of modules led by a Learning Coach in the Culture and Learning Department at Mercy Health Youngstown. The Principles of Patient Satisfaction and Safety module has proved to be especially valuable.
“We found the Patient Satisfaction course very useful because entry-level employees didn’t realize how the little things they do affect patients and patient satisfaction. Sometimes patients arrive at the hospital frustrated and hard to please, so this particular course made a big difference,” said Learning Coach Georgette Peters. “This course also showed entry-level employees the importance of their work and its impact on HCAHPS reimbursements.”
To demonstrate program value and return on investment, Mercy Health measures impact and tracks aggregate success among SAW participants. Of the 35 students who graduated from SAW last year (20 from Mercy Health Youngstown and 15 from Mercy Health Cincinnati), nine are now enrolled in higher education and pursuing further training to move up within the organization.
SAW graduate Janet Johnson found similar success. She started in an entry-level position at a Mercy affiliate hospital in 2009. With a grant from the Robert Woods Johnson Foundation, she trained to be an entry-level healthcare associate. This resulted in a promotion to Environmental Services, where managers recognized her leadership potential and recommended Janet for SAW. She completed SAW and is now enrolled at Penn State, pursuing a career as an occupational medicine assistant at Mercy Health Youngstown.
Mercy Health is proud to see employees like Janet advance.
“When speaking with our employees who complete the SAW program, I always thank them for bringing me along on their journey. I hope to assist in lighting the flame, and I hope the students keep it burning,” said Peters.
Mercy Health Youngstown plans to continue offering SAW courses and hopes to expand the curriculum to smaller regional partner facilities. Additionally, senior leaders hope that by offering upfront college tuition reimbursement, they can help employees overcome barriers to advancing their education, particularly those who earn the lowest wages.
The health system aims to enroll up to 45 percent of their employees in skills training programs and help more employees pursue advanced educational opportunities. As employees succeed and move up within the organization, senior leaders are seeing morale and retention rates improve, resulting in better patient care. Mercy Health Youngstown believes that employees are their most valuable resource, and by investing in them they hope to make lives better and the community stronger.
Saint Anthony Hospital staff worked hard to improve its Leapfrog Hospital Safety Grade from a D in 2014 to an A in October 2016. The nonprofit, community teaching hospital in Chicago found one key to success came in providing front-line nurse leadership with increased confidence and management tools that would help improve hospital standards and quality of care.
Finding the Right Curriculum
Saint Anthony’s development team was searching for a structured, in-depth learning program that would empower their nurses to take leadership to the next level. What they found was Catalyst Learning Company’s NCharge® Nurses Learning to Lead program. NCharge provided the detailed content and knowledge assessments they were looking for, with results that are measurable. By focusing on relevant leadership scenarios within the hospital, participants were able to easily relate and apply techniques to their everyday environment.
“Like most healthcare organizations, we are growing and changing. We were also in the process of reorganization. It was about sweeping clean on old ideas and looking for ways to be more efficient. Illinois is also tightening on funds and as a nonprofit hospital, we had to look at ways to be more efficient in how we were working and make our staff feel as if they have a way to advancement,” stated Jaqueline Napier, Manager of Talent and Development at Saint Anthony.
Leading with More Confidence
One important outcome noted by Saint Anthony management is the overall improved confidence among nursing leadership. Creating a more autonomous team has positively impacted the hospital environment and proven an effective influence regarding quality of care.
Sonia Haro, an ICU Staff Nurse and NCharge participant, committed her time to the NCharge series with specific objectives in mind. “I was looking for ways to communicate more effectively, especially when setting expectations for the team. Sometimes, not everyone feels like being a team player. I wanted to find a way to encourage my team but stay firm and reach expectations,” explained Haro. This was the type of leadership training that most staff nurses don't get with shadowing or clinical training. Haro was pleased with NCharge, which provided her with a better understanding of communication styles and techniques to handle a variety of situations confidently in the unit.
Haro wasn’t the only person who noticed a need for better communication and confidence from front-line nursing leaders. When Catalyst Learning surveyed nurse managers at Saint Anthony before the NCharge courses were implemented, less than 20% strongly agreed that the Charge Nurses in their departments displayed confidence when leading their teams. In addition, less than 30% agreed that Charge Nurses were cognizant of the key drivers of a positive patient experience. A few months after the training was held, the same nurse managers were surveyed and reported dramatic improvement with over 65% saying Charge Nurses were more confident and over 70% recognized key drivers in positive patient experience.
Cultivating Team Dynamics
A more efficient, collaborative environment was formed as a result of the NCharge leadership training. The team who completed training worked stronger and smarter together when handling obstacles. “I really wanted to work with others in the hospital in the same position. It’s nice to have others to lean on and run questions by, and share experiences with. Networking with my own colleagues was a great bonus,” stated Haro.
Elizabeth Negrete, Director of Perinatal and Pediatric Services, had staff who completed NCharge training. Staffing in OB, having the right number of staff and the right combination, had been a continuous issue. NCharge class participants looked at staffing and created plans to put the right skills and experience in the best combinations. “Now the staff are the ones doing the schedule, entering it in to the system and balancing. When the census goes down, they adjust appropriately based on the patient grid. This shows how they have been working more autonomously and are able to make important decisions with less guidance,” explained Negrete. “The Charge Nurses are working more in collaboration with the house managers. Before, staff managers were just telling them what the need was, but now the Charge Nurses are more empowered to speak up about needs.”
Haro reported that the rounding process has also gone through changes, giving the NCharge participants an opportunity to observe with fresh eyes what happens within the unit when everyone is not on board with a change. “It takes some buy-in from everyone, and there were days when we were just being run ragged. You could easily see that on days when the new process wasn’t being used, feelings and tensions were high,” conveyed Haro.
By equipping front-line leaders with the skills to embrace change, NCharge prepares staff for reaction from team members and how to move forward as a unit. This can be vitally important and impactful when trying to deal with the constant updates within hospitals. “There is always more trust from staff when changes come from Charge Nurses. There is more peer influence and impact. The staff has more of a buy-in because they know the Charge Nurses truly understand what the impact will be since they are on the frontline with them,” described Negrete.
Made evident in the impressive move of their Leapfrog Safety grade from a D in 2014 to an A in October 2016, the hospital seems to have found the key to success in increasing quality standards. Napier credits the NCharge series with being a factor in that improvement after implementation in early 2016.
The combination of increased confidence, more efficient staffing and adaptability to change have helped Saint Anthony become a more progressive, efficient hospital when it comes to patient care and standards. “The nurses are more cohesive as a team and moving towards a group environment where the charge nurses really stand out as leaders. They are really keeping their team members engaged. All of that correlates to the patient experience and how everyone is measured,” stated Napier. “Our people were skilled but now they have more confidence in those skills and their ability to engage the nurses on their team. They now understand how this all comes together to enhance the patient experience.” By giving front-line leaders new techniques to handle their day-to-day situations and changes, an environment of new ideas and proactive enthusiasm has been cultivated.
By investing in the front-line nursing leadership at Saint Anthony, stronger teams were built and the confidence instilled in the newly trained charge nurses was of great value. The return on investment for the Chicago hospital is shown through the recognition of receiving its first A rating from Leapfrog Hospital Safety Grade and becoming a top-rated hospital.