Other Titles

Clinical Session: Leaders creating healthy work environments

Abstract

Session presented on Saturday, April 13, 2013:

Nurses are aligned to drive frontline policy in quality improvement. Yet studies often lack rigor and sample sizes large enough to be definitive. While smaller studies show that frontline operational failures occur every hour of every shift and threaten patient safety, multi-setting studies are requisite in order to craft effective microsystems interventions. Such interventions will foster learning organization climates through decreasing workarounds and making system corrections. Aims: Using a new research network for healthcare improvement, conduct a landmark national study to explain first-order operational failures in medical-surgical units in context of work environment and quality outcomes. Methods: To broaden generalizability, a local pilot study of microsystem operational failures was expanded to 52 medical-surgical units through a new national improvement research network. Network members formed a virtual research collaborative, supported by the network coordinating center and virtual laboratory. Team science principles were employed to create a common goal around a rigorous study and strong team relations. The virtual collaboratory venue provided central databases, assured fidelity of the protocol through a specialized implementation kit and site monitoring, and supported research capacity-building. Results: Within 9 months, the 14-hospital research team was formed, research protocol deployed, fidelity maintained, and 24,014 data points collected and analyzed. Results of the survey of virtual collaboration readiness were positive and team satisfaction was high. Conclusions: Research network concepts were successfully applied in a national network to investigate healthcare delivery improvement. The cyberinfrastructure, networking processes, and approaches achieved research capable of producing evidence sufficient to drive policy.

Author Details

Kathleen R. Stevens, RN, MS, EdD; Frank Puga, PhD; Robert Ferrer, MD, MPH; Darpan I. Patel, PhD

Sigma Membership

Delta Alpha at-Large

Lead Author Affiliation

The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA

Type

Presentation

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Operational Failures, Frontline Nursing, Improvement Science

Conference Name

Creating Healthy Work Environments 2013

Conference Host

Sigma Theta Tau International

Conference Location

Indianapolis, Indiana, USA

Conference Year

2013

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Additional Files

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National network study of operational failures in frontline nursing: Scaling up for policy

Indianapolis, Indiana, USA

Session presented on Saturday, April 13, 2013:

Nurses are aligned to drive frontline policy in quality improvement. Yet studies often lack rigor and sample sizes large enough to be definitive. While smaller studies show that frontline operational failures occur every hour of every shift and threaten patient safety, multi-setting studies are requisite in order to craft effective microsystems interventions. Such interventions will foster learning organization climates through decreasing workarounds and making system corrections. Aims: Using a new research network for healthcare improvement, conduct a landmark national study to explain first-order operational failures in medical-surgical units in context of work environment and quality outcomes. Methods: To broaden generalizability, a local pilot study of microsystem operational failures was expanded to 52 medical-surgical units through a new national improvement research network. Network members formed a virtual research collaborative, supported by the network coordinating center and virtual laboratory. Team science principles were employed to create a common goal around a rigorous study and strong team relations. The virtual collaboratory venue provided central databases, assured fidelity of the protocol through a specialized implementation kit and site monitoring, and supported research capacity-building. Results: Within 9 months, the 14-hospital research team was formed, research protocol deployed, fidelity maintained, and 24,014 data points collected and analyzed. Results of the survey of virtual collaboration readiness were positive and team satisfaction was high. Conclusions: Research network concepts were successfully applied in a national network to investigate healthcare delivery improvement. The cyberinfrastructure, networking processes, and approaches achieved research capable of producing evidence sufficient to drive policy.