2019 NURSING YEAR IN REVIEW

Kaiser Permanente Southern California

Region

2019 NURSING YEAR IN REVIEW

Extraordinary Nursing Care. Every Patient.

Every Time.


TABLE OF CONTENTS

Welcome

Foundations of Kaiser Permanente Nursing Practice

Transformational Leadership

Structural Empowerment

Exemplary Professional Practice

New Knowledge, Innovation & Improvement

Recognitions

2

3

5

8

9

14

22

23


TABLE OF CONTENTS

It is an honor to share with you the 2019 Kaiser Permanente Southern California Annual Nursing

Report highlighting our nurses’ remarkable accomplishments. For 19 years running, nursing has

been named the most trusted profession in America according to Gallup. This annual poll rates

professions on their ethical standards and honesty. In addition to high ethical standards and hon-

esty, this trust is based on several other factors including competence, professionalism, compas-

sion, drive for innovation, ability to inspire hope, patient advocacy, and serving as valued mem-

bers of our patients’ health care team.

Competence, trust, and the potential for making significant contributions to improve healthcare

outcomes are the reasons nurses must play key roles in redesigning health care in the United

States. Nurses are significant contributors to health care transformation by helping to create a

work environment that promotes the opportunities for nurses to practice to the full extent of

their education and training. This includes encouraging and supporting nurses to achieve higher

levels of professional education and training through an improved education system that pro-

motes seamless academic advancement.

Kaiser Permanente’s integrated system has expansive pockets of excellence because of the inno-

vative work of our nurses. Our mission is to deliver high-quality, affordable health care through

Extraordinary Nursing Care - Every Patient, Every Time. To achieve this, we need to provide an

excellent care experience everywhere, every time—and develop and spread successful practices

that improve access, quality, safety, and affordability.

Jerry Spicer, DNP, RN Regional Chief Nurse Executive & Vice President Clinical Effectiveness - Southern California Kaiser Permanente Foundation Hospitals

Message from the Regional

Chief Nurse Executive

WELCOME

3


It is an honor to share with

you the 2019 Kaiser Perma-

nente Southern California

Annual Nursing Report high-

lighting our nurses’ remarka-

ble accomplishments. For 18

years running, nursing has

been named the most trust-

ed profession in America ac-

cording to Gallup. This annu-

al poll rates professions on

their ethical standards and honesty. In addition to high ethical standards and honesty, this trust is based

Nursing Values Professionalism Excellence Patient and Family Centric Teamwork Integrity Compassion

Kaiser Permanente’s Mission Our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve.

Nursing Vision As leaders, clinicians, researchers, innovators and scientists, Kaiser Permanente nurses are advancing the delivery of excel-lent, compassionate care for our members across the continu-um, and boldly transforming care to improve the health of our communities and nation.

Nursing

Professional

Practice Model

4


It is an honor to share with you the 2019 Kaiser Permanente

FOUNDATIONS OF KAISER PERMANENTE NURSING PRACTICE

Integration and Alignment at KP

234 Medical Offices/Clinics

26,585 Registered Nurses

4.6 Million Members Served

KP SCAL Report: Dec 2019

Alignment: Kaiser Permanente is committed to helping shape the future of

health care. We are recognized as one of America’s leading

health care providers and not-for-profit health plans. Founded

in 1945, Kaiser Permanente has a mission to provide high-

quality, affordable health care services and to improve the

health of our members and the communities we serve. Kaiser

Permanente is dedicated to care innovations, clinical research,

health education and the support of community health.

5


15 Southern California Organizations

Anaheim Medical Center

Baldwin Park Medical Center

Moreno Valley Medical Center

Los Angeles Medical Center

Woodland Hills Medical Center

Irvine Medical Center

Zion Medical Center

Riverside Medical Center

Panorama City Medical Center

Downey Medical Center

Fontana Medical Center

South Bay Medical Center

Ontario Medical Center

San Diego Medical Center

West Los Angeles Medical Center

DEMOGRAPHICS

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TRANSFORMATIONAL LEADERSHIP

Linda J Knodel, MHA, MSN, NE-BC, CPHQ,

FACHE, FAAN Senior Vice President/Chief Nurse Executive

Kaiser Permanente

Julie Miller-Phipps President Southern

California Region

Patti Harvey, RN, MPH, CPHQ

Senior Vice President Quality, Regulatory, Clinical

Ops Support Southern California Region

Jaime Reiter, RN, BSN,

MBA, SPHQ

Executive Director Regional Patient Care Services

Southern California Region

SOUTHERN CALIFORNIA “REGIONAL CORNER”

Kaiser Permanente Southern California Regional Patient Care Services (PCS) Department supports and collaborates with our 15 Medical Centers in the region. The Regional PCS team utilizes research and evidence-based practices to develop new knowledge and innovation in the nursing profession. Regional PCS Directors include:

Staci Harrison, DNP, RN Director, Medical Surgical-Critical Care

Linda Fahey, RN, NP, MSN Director, Care Experience & Patient and Family Centered Care

Juli McGinnis, RN, MSN, NEA-BC Director, Professional Nursing Practice

Aaron Bero Director, Strategic Project Implementation

Leilani Unite, RN, BSN, MSN, CNML Director of Strategic Workforce Effectiveness

Cecilia Crawford, DNP, RN Director of Evidence-Based Nursing Practice

Jennifer Schwartz, MSN, BSN, RN, CNOR, CSSM Director, Perioperative Services

Marianna Volodarskiy, RN, MSN Director, Maternal-Child Health

June L. Rondinelli, PhD, RN, CNS | Nurse Scientist Director, Regional Nursing Research Program

Ghada Dunbar, DNP, RN, MHA, CENP, CNML Director, Professional Development & Education

Noemi Valenzuela Yi, MSN, RN Practice Leader, Clinical Systems and Operations Integration

Ambulatory & Continuing Care

Jan Dorman Vice President Regional Continuing Care & Outside Medical

Sylvia Everroad, MSN, RN Regional Chief Administrative Officer, SCPMG

Aileen Oh, MSN, RN Chief Nursing Officer, SCPMG

Annie Russell Chief Operating Officer, Regional Medical Group

Hazel Torres, MN, RN Director; Professional Development & Research

Angel Vargas, FACHE Executive Director: Home Health Services

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STRUCTURAL EMPOWERMENT

PATIENT CARE SERVICES/ STRATEGIC WORKFORCE EFFICIENCY By: Leilani Unite, RN, BSN, MSN, CNML Director of Strategic Workforce Effectiveness

Focus: Nurse Staffing Office Initiative aim is to improve patient care and nurse satisfaction by having the right nurses, in the right place, at the right time.

Intervention/Strategy: Through interviews and obser-vations, the four areas identified in standardizing pro-cesses throughout all 15 SCAL Medical Centers are 1) Weekly Advance Planning 2) Near-Term Schedule Change Requests (TORTS) 3) Daily Staffing Huddles and 4) Daily Lookback Meetings. The development of the Daily Staffing Tool (DST) measures the processes on a daily and bi-weekly basis. On a monthly basis, the DST is collected from all Southern California Medical Centers and presented in form of an “Operational Dashboard” shared with all local and regional leaders. Outcome: Initial improvements demonstrated by a de-crease in Variable Hours per Patient Days (HPPD), To-tal Productive HPPD, Overtime and Paid FTE/ADC.

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Implemented Staffing Office Optimization’s four pillars at all Southern California Medical Centers

RN FTE Mix (Full Time, Part Time, and Per Diem)

Focus: Decrease full time employees; increase part time and per diem employees through attrition of full time; moving towards flexibility in staffing as census changes and seasonal fluctuations occur.

Intervention/Strategy: With the use of the “RN Staff-ing Mix Planning Tool” collected on a bi-annual basis from each Medical Center, their progress is reviewed based on the Medical Centers’ current full-time employ-ee (FTE) mix, preferred FTE mix, and proposed FTE mix. The tool also provides an estimated average pay-roll cost and headcount (span of control) for each cate-gory. Which, in turn, provides guidance to local and re-gional leaders regarding the Optimal FTE mix for a nursing unit. Outcome: SCAL-Nursing Staffing Mix trend shows a reduction in Full Time with an increase in Part Time and Per Diem from 2015 to 2019. Data also reflects a decrease of overtime.

"Alone we can do

so little;

together we can do so much."

– Helen Keller


PATIENT CARE SERVICES/ STRATEGIC WORKFORCE EFFICIENCY By: Leilani Unite, RN, BSN, MSN, CNML Director of Strategic Workforce Effectiveness

10

Standardized Guidelines for 2020 Staffing Matrices

Focus: A Staffing Matrix serves to provide a plan for how to appropriately staff a nursing unit to meet the care needs of patients while ensuring appropriate use of resources.

Intervention/Strategy: The Staffing Matrices is to be updated/reviewed in collaboration with the Unit Manager/Director, Finance Manager/Director and Chief Nurse Executive. Each Medical Center is to use the Regional Template for completing each unit’s staffing plan. The regional template identifies the com-mon job skills and allows for customization of additional roles that are included in the unit’s budgeted HPPD. Additionally, the regional template gives visibility to efficient and inefficient census points based on the budgeted HPPD and productivity.

Outcome: A Standardized Staffing Matrices establishes a clear comparison among all SCAL Medical Cen-ters with the common skill mix identified to four levels.

Focus: Further standardization of data and practice across SCAL Medical Centers and to expand the cost centers use for non-direct patient care and/or nursing support functions.

Intervention/Strategy: The following roles are identified to have inconsistent practice across SCAL Medical Centers: Monitor Techs, Lactation RNs, and RNs floating to a non-nursing unit (ED and PACU). Monitor Techs will have their own cost center as well as Lactation RNs. A third cost center will apply to RNs floating to ED and PACU due to bed capacity.

Outcome: To support the goals of a “clean” HPPD comparisons and standard Staffing Matrices at all Southern California Medical Centers.

Completed 2nd Phase of Cost Center Standardization




PATIENT CARE SERVICES/ MEDICAL SURGICAL/ CRITICAL CARE By: Staci Harrison, DNP, RN Director, Medical Surgical & Critical Care

Medical Surgical Unit Based Team Care Experience Conference

The purpose of the Conference was to improve the care experience for our medical and surgical patients. The con-

ference focused on understanding current performances across the region while identifying medical centers and

unit opportunities for improvement. The conference provided the opportunity to share best practices and learn

from experts and high performing teams. Frontline nurses and nurse leaders participated in meaningful exercises in

which were taken back to medical center teams. Additionally, participants learned and heard directly from patients

as they highlighted what matters most including inspiring learnings from Marcus Engel. With over 200 participants

in attendance, the nurses gained valuable knowledge and motivation to share learnings, inspire and lead teams to

ensure extraordinary care delivery to our patients and families.

Ambulation and Mobility

Patient mobility is important to the health of our members

and our hospitalized patients. Ensuring our patients are

adequately ambulating at the time of their discharge home

is of utmost importance. The adult inpatient team aimed to

sustain or improve in 90% of patients discharged from all

adult units and 90% of patients are ambulated two times

and/or mobilized three times during each 24-hour period

in all adult areas. To accomplish this, quarterly meetings

are held to connect all medical centers in order to review

data, discuss challenges and share best practices. Addition-

ally, regional weekly Ambulation and Mobility meetings

occur to discuss updates and/or issues related to the data

while addressing questions from medical centers.

Outcome: As a region, we improved our scores by 2.9% since last year. All medical centers successfully improved in

90% of patient discharged from all adult units and 90% of patients are ambulated two times and/or mobilized three

times during each 24-hour period in all adult areas.

Infection Prevention: Catheter-Associated Urinary Tract Infection (CAUTI) & C. Difficile Infection (CDI):

The adult inpatient team aimed to decrease the standardize infection ratio (SIR) for Catheter-Associated Urinary

Tract Infection (CAUTI) and C. Difficile Infection (CDI) across the region. In order to accomplish this, quarterly meet-

ings facilitate the communication of data with the infection control and nursing representatives from all 15 Medical

Centers. During these meetings, representatives review the overall scores and performance, share best practices

from high-performing Medical Centers, and provides a comprehensive system analysis and root cause analysis of

Hospital-Onset CAUTI. Additionally, the regional team reviews materials from KP National to ensure work alignment.

As a region, Kaiser Permanente Medical Centers decreased the SIR for both CAUTI and CDI from the previous year.

The CAUTI rate decreased by 11.1% and CDI rate decreased by 21.1%.

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“Call to Excellence” Magnet Recognition Forum

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Promotion of Nursing

Excellence

Clinical Nurse Presenters

40+ Posters

70+ Abstract Submissions

20 Ted Talks

6 Prime Time Presenters

Nursing professionalism is valued at Kaiser Per-

manente and showcased through the Southern

California Regional Nursing Shared Decision-

Making Council. Frontline clinical nurse repre-

sentatives from 15 Southern California Medical

Centers, including representatives from KP Na-

tional, Regional, and labor partners, meet quar-

terly to identify nursing strategies, share best

practices, support nurse engagement, and pro-

fessionally development.

The “Call to Excellence” Recognition Forum was

developed in alignment with our KP strategic

priorities and SCAL Nursing Shared Decision

Making Council’s goal to create a platform for

frontline clinical nurses to showcase exceptional

clinical work under one of the four categories:

Professional Development & Leadership, Patient

Care Experiences, EBP, Research & Innovation,

and Quality and Patient Safety. The Professional

Practice Team (PPT) designed a structure and

process which led to the embodiment of the first

inaugural KP Southern California recognition

forum.

“Next to excellence is the appreciation of it”

- William Makepeace Thackeray


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The Kaiser Permanente Southern California Regional Nursing Residency Program is an opportunity for frontline, clinical nurses to develop their competency in professional practice, development, educa-

tion, research, and evidence-based practice. The aim is to improve staff performance, promoting pro-fessional lifelong learning, and enhancing the clinical practice environment for high quality safe and

exceptional care. This 24-week Residency Program is a mentored experience designed to enhance the residents’ professional growth and to promote sustainable change in the work unit culture.

Southern California Regional Residency Program

Pro

fess

ion

al P

ract

ice

Res

iden

t

Marnie Morales, MSN-ADM, RNC-NIC

“The Residency allowed me the opportunity to be part of Kaiser Permanente’s strategic planning toward Magnet designation that is driven by innovation and sustainability; reinforcing the foundation’s mission, vision, and values to our nursing profession.”

Res

earc

h R

esid

en

t

“I took this opportunity to participate in multiple steps of the nursing research process starting with proposal development to dissemination. As the cur-rent local Baldwin Park Research Chair, I plan to ap-ply the knowledge and skills to improve patients’ out-comes and grow my BPMC colleagues’ research com-petencies.”

Rosalina Mendoza, BSN, BSC, RN

EBP

Res

ide

nt

Dawn successfully completed the Frequency of Routine

Vital Signs and Physical Assessment for Adults in Acute

Care. Dawn is writing a manuscript based on this evi-

dence review. She desires to share with the EBP Coun-

cil at Downey Medical Center to mentor and grow the

next generation of nurses.

Dawn Sanchez, MSN, RN, RNC-NIC

Additional Nurse Residents included: Araceli Soto, MSN, RN: Professional Practice Resident; Irvine

Medical Center; Nathalie De La Pena-Gamboa, MPH, BSN, RN, PHN, CHES: Professional Devel-

opment Resident; Los Angeles Medical Center, Allison Gray, BSN, RN: Professional Practice Resident,

Downey Medical Center, Brenda Rojas, BSN, RN, PHN: Professional Development Resident, Los

Angeles Medical Center; Perla Pena, MSN, RN: Professional Practice Resident, Baldwin Park Medical Center

Our work is driven by our unwavering commitment to consistently deliver high quality and exceptional care, while creating the best place to

have and grow families. Key strategies are to operationalize evidence-based practices and best practices in a variety of focus areas. The

One KP approach to care drives standardization of policies and tools to ensure the best experience are met every family, every time. In part-

nership with the Southern California Permenente Group, we ensure a continuum of care approach within a life course cycle which empow-

ers us to deliver high quality and safe care.

Perinatal

In 2019, significant progress to meet Healthy People 2020 goal of 23.9% for Perinatal Core Measure-02: Uncomplicated first time

pregnancies delivered by cesarean section. Regional average for 2019 was well below goal at 21.5%

Kaiser Permanente SCAL completed region wide Integration of Fetal Monitoring System and Health Connect Documenta-

tion System. This technology integration is transforming the experience of clinicians by replacing manual data recording

with real-time patient data flow and on-screen nursing documentation that feeds directly into KP HealthConnect. This re-

sults in seamless documentation while allowing clinicians to focus on direct patient care.

Utilizing Human Centered Design principles, Help@ Home tool kit was co-designed with members, bedside nurses, and

other health care professionals. The toolkit integrates member facing and staff facing communication tools, technology,

and takes a cross-continuum approach. Community resource guide built to provide Medical Center specific information to

assist mothers and families transitioning home.

Pediatrics

Transport

For the last several years, Southern California has been re-imagining how best to provide pediatric care. Kaiser Permanente Pediatric Care (KPPC) strategy is designed to produce the best possible patient outcomes, improve member satisfaction, and enhance service, quality, and access while maintaining affordability. In 2019, the focus was on the following:

Care without Delay

Practice Standardization

KPPC transport team increased capacity with the addition of a new team. Today, there are KPPC transport teams

located in Downey, Fontana, and Panorama City which completed more than 1300 transports.

Initiated an integrated quality management approach to assure timely coordinated care along the continuum. This

approach supports our strategy by ensuring right level of care at the right time and the right place.

Utilized evidence-based literature and best practices to develop policies and education on Continuous Albuterol, G

-tube care, Trachcare Home Vent Program Diabetes Management education and more. Development of Pediatric

Sepsis, Stroke, and Delirium Protocols are under way.

NICU

Kangaroo Care

Standardized Evidence-Based Care

Provided evidence-based care to improve clinical outcomes of infants in NICU setting through increased skin-to-skin

contact between infant and caregiver. This has been a focus since 2017 and over the past year we have increased

number of patient days when caregivers are present with one or more skin-to-skin contact by 10%.

NICU Medication Side Effects Communication

Regional policy template developed to standardize NICU Visitation Policy to ensure same expectations and experience from parents across

the Region. Practice standardization for cooling measures were developed for the most critical patients.

The MSEC was spread to NICU this year. Best practices identified through Perinatal and Pediatric were applied to sustain and spread. Tools

developed included nursing and parent education, bedside tools and development of NICU specific medication side effect communication.


By: I. Christine Lee, MPH, RN, BSN, PHN, CPH, CHES Maternal Child Health Practice Specialist

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EXEMPLARY PROFESSIONAL PRACTICE

Safety Alignment with the Southern California Magnet® Journey By: Robin K Sustayta, MHA, CPHRM, CPPS

15

FOCUS: Partner with Magnet® program leads to ensure integration of safety programs and metrics

OUTCOME: Continued spread of the Hester Davis fall prevention program. Initiated Regional

data trending for Team STEPPS and Simulation and created a sustainable model for Observation Reliability Cycle Learning [ORCL] (supporting Universal Protocol).

Building a “Reporting” Culture

FOCUS: Build patient safety partnerships and tools across the Region to effectively measure culture and increase reporting.

INTERVENTION/STRATEGY: Rounded at each SCAL Medical Center to support the Medical Centers with their safety culture

and provide lessons learned from other areas. Inter-Regional collaboration through Lokahi grant work on “Near Miss Re-

porting” (NMR) best practices.

OUTCOME: SCAL Medical Centers have a method for monitoring their National Patient Safety Goals, are completing a gap

analysis as new recommendations from Joint Commission are published, and are meeting Joint Commission's 18 month

guideline on Failure Modes & Effects Analysis. A “Near Miss” playbook is scheduled to launch in 2020.

INTERVENTION/STRATEGY: Promotion of “Executive Walk-Arounds” and aligned key safety

program to Magnet® Journey elements of performance

Common Areas of Focus for Patient Safety and Workplace Safety


Every

Moment

Matters!

“They may forget your name, but they will

never forget how you made them feel.”

- Maya Angelou


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17

Inpatient

Care Experience

2018-2019

Strategic

Priorities

Driving

Improved

Patient

Outcomes

Medication Side

Effects Bundle

Nurse

Communication

-Implementing The Connection Bundle, Narrating care and Teach Back -Enculturating NKEplus; Hourly Rounding, Leadership Rounding on patient and staff -Narrating care and Teach Back

Language

Matters

Quiet at Night

Healing

Environment

Care

Experience

Conferences

-Implementing Medication Side Effects Bundle with continued focus on Medicine Service Line -Standardized education materials for Med/surg, Crit Care, ICU, Chemo, MCH, NICU/Peds/PICU

-Implementing Quiet at Night Playbook in-cluding high impact/ low effort processes followed by high effort processes -Hospital-wide unit-specific and ancillary department practices. “All Hands on Deck” approach

-Med/Surg UBT Nursing Conference, focused on personal connections and Unit Based Teams sharing best practices -3rd One KP Support Services Conference with 300+ participants: EVS, FANS, Facilities, Security, Transportation, Admis-sions

-Minimum criteria defined for when inter-pretive services are required. -Standardized toolkit (guidelines, tools & workflows -Meaningful reports to track performance. Mandatory KP learning modules developed & implemented



Kaiser Permanente Nurses

Committed to Lifelong

Learning

Exemplifying Nursing Excellence

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Kaiser Permanente strives to create opportunities for nursing professional development growth. Whether a nurse desires to obtain an advanced degree, pursue a specialty certification, or attend a professional conference, Kaiser Permanente encourages and promotes lifelong learning to ensure exceptional patient care delivery and clinical

excellence.



Regional Nursing Professional Development & Education

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Standardization

To promote workforce development in 2019, the Regional

Professional Development and Education team, in align-

ment with our Magnet journey to nursing excellence, col-laborated the Directors of Professional Development and Education Peer Group to update and implement an annual survey tool for a continuing education needs assessment. Additionally, the Peer Group co-developed a Transition to

Practice Standardized Template integrating the six ele-ments (Program Leadership, Organizational Encultura-

tion, Development and Design, Practice-Based Learning,

Nursing Professional Development Support, and Quality Outcomes) of Transition into Practice.

Experienced Nurse Transitions We are proud of the 979 experienced nurses that graduat-ed into a new clinical practice setting in 2019. This reflects the positive impact of nursing professional development across the Southern California region.

Leadership Development In 2019, six offerings of the RN Leadership Development Program in partnership with Nurse Executives, Senior la-bor leaders, PCS leaders and managers were offered at Baldwin Park, Panorama City, Riverside and South Bay, and Sand Diego Medical Centers including Joint Goal Set-ting with local managers. Nurses throughout the SCAL re-gion attended the Regional Preceptor Training Program, highlighting the commitment of our KP Nurses to exem-plary nursing professional practice and to the provision of excellent, safe patient care.

Adult Inpatient

In 2019, nurses in the Southern California Region success-fully completed the ten-week Regional Critical Care Course.

The Regional Critical Care Course helps transition nurses to the critical care practice setting, so they can provide safe, quality care for acutely ill adult patients. These nurses from five medical centers in Southern California; Downey, Pano-rama City, Riverside, South Bay, and Woodland Hills, suc-

cessfully completed the Essentials of Critical Care Orienta-tion (ECCO) through AACN, a 10-week preceptorship with

an experienced critical care nurse, and six simulation days

in partnership with the KP School of Anesthesia.

Nurses throughout the SCAL region completed the Interme-

diate Care Course, designed to prepare the registered nurse to care for patients in the step down or DOU setting, and the

Acute Monitored Care Program, which educates nurses who care for patients on a monitored unit. Southern California

KP nurses furthered their professional development with the Regional ECG Workshop, demonstrating knowledge in

identifying cardiac rhythms using a systematic approach. In 2019, the Professional Development and Education team collaborated with South Bay Medical Center to create a Sep-

sis escape room. The goal was to increase knowledge about

Sepsis, impact care outcomes, and offer a gamified learning

experience for nurses in alignment with adult learning prin-ciples. After the Sepsis escape room was offered, CAUTI inci-

dents at South Bay Medical Center went from 13 (January 2019) to 1 (June 2019).



Regional Nursing Professional Development & Education

20

Perioperative

The Professional Development & Education Periop-erative Specialty Training programs included the Periop 101 Specialty Training at Woodland Hills, Regional Laser Safety Training offerings hosted at Riverside and Woodland Hills Medical Centers, and Regional Introduction to PACU Trainings hosted at the West Los Angeles and Riverside Medical Cen-ters. In 2019, Regional PCS Professional Develop-ment & Education hosted the Regional Advanced PACU Training at Downey, Panorama City, and Riv-erside Medical Centers. This collaboration involves an inter-disciplinary team including the School of Anesthesia, physician colleagues, Regional Consult-ant and Medical Center leaders.

Maternal and Child Health

The Professional Development & Education Mater-nal Child Health (MCH) program offered the Region-al MCH Specialty Training Courses which included: Intro to NICU (Panorama City), the Labor and Deliv-ery Scrub Course (Riverside), NICU and Perinatal Breastfeeding Class (Online), and the APHON Chem-otherapy Course (Downey). Lactation Counselors improve the initiation and duration of breastfeeding as they promote the art of breastfeeding and apply the science of lactation. The support of these coun-selors serves as an extension of the Maternal Child service into the community. The Certificated Lacta-tion Education Counselors (CLEC) training program developed registered nurses as they elevate their understanding of breastfeeding best-practices with-in their local communities.

New Graduate Nurses

In 2019, 53 new graduate nurses were welcomed and transitioned into the organization. Each nurse success-

fully completed the “Regional New Graduate RN Program,” actively engaging in six simulation and profes-

sional development days, didactic-based education, and a 10-week clinical preceptorship. We celebrate the success of these new nurses to Kaiser Permanente and their commitment to providing extraordinary nursing

care, every patient, every time. The success of the new graduate RNs is coupled with the commitment of our

experienced clinical nurse preceptors supporting and guiding newly licensed nurses and nurses new to the

organization. During 2019, the clinical nurses showed commitment to their professional development, exhib-ited through participation in the regional specialty courses.



Kaiser Permanente Regional Volunteer Partnerships

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Giving Back to the

Community

After completing her night shift, Carla O’Boyle, RN, and her

daughters, took time to volunteer repacking food for those

with food insecurity in the Los Angeles area. The MLK Day

of Service supports Kaiser Permanente’s mission and the

belief that health extends beyond the doctor’s office and

the hospital and starts in our own communities. Nurses

from Downey and South Bay Medical Centers rolled up

their sleeves to give back to the community by volunteer-

ing their time at the Foodbank of Southern California in

Long Beach. An organization that provides food to the im-

poverished children, families and seniors residing in the

Los Angeles County, Foodbank of Southern California helps

sort and repackage food to ensure people in the communi-

ty have adequate food supply.

Kaiser Permanente volunteers from Downey and South Bay Medical Centers gathered to honor the leg-

acy of Dr. Martin Luther King Jr. on the Day of Service. Employees, families, and close friends assembled

and repackaged pallets of food donated by local supermarkets. Hundreds of canned goods were in-

spected, cleaned and repackaged into boxes, ready for shipment to all the local foodbanks in the Los

Angeles County. “As nurses, we should extend our services beyond the walls of the medical center. The

people in our community need food, clothes and shelter and we, as healthcare providers, should give

back to the people we take care of in the hospital,” stated Carla O’Boyle.

Regional Nursing Research &

Evidence-Based Practice Program

By: June Rondinelli, PhD, RN, CNS | Director, Regional Nursing Research Program

Academy of Evidence-based Practice (EBP)

The Academy of EBP creates a collaborative environment for linkages across the academic-to-service divides to foster evidence-based practice for optimal patient outcomes. Created in 2010, membership has grown from the 4 original nurse members to a committed inter-professional group of 19. The Academy of EBP website also celebrated 6 years of providing EBP and evidence review resources, tools, education, and links to the commu-nity at large and is used by public safety hospitals and Schools of Nursing BSN, MSN, and doctoral programs from around the world. The open-access website repository saw 242 visitors, with 2,316 pages viewed for 2019. The Top 5 downloaded pages were the Integrative Review Overview, Evidence Leveling System, FAQ, Qualitative Grading Scheme, and Tools of the Trade. See web link: http://www.academyebp.org.

Nursing Research Studies

There were 31 nursing research studies in 2019. This includes ongoing, new and closed studies. 21 studies for the start of 2019 - 10 new studies were added, all including a nurse investigator - 8 studies closed 23 studies remain open moving into 2020

Abstract and Poster Workshops

A total of 8 Workshops were conducted in 2019 with more than 180 participants - 3 Combined Abstract/Poster Workshops were conducted in person at the following sites and events: San Diego Nursing Research Conference, Ontario Medical Center, and The Regional Professional Practice Shared Decision-Making Council - 3 in-person Abstract Workshops at the regional office - 2 web-based Poster Presentation Workshops

22

Evidence based resources available at:

http://kpscnursingresearch.org/integrative-reviews

http://kpscnursingresearch.org/literature-reviews

3

Research-based

publications

13 podium

presentations

18

poster presentations

5 Evidence-based publications (quality improvement/ literature review/expert opinion/clinical practice)

2 Posted Open-Access Evidence Reviews

NEW KNOWLEDGE, INNOVATION & IMPROVEMENT

http://www.academyebp.org

http://kpscnursingresearch.org/integrative-reviews

http://kpscnursingresearch.org/literature-reviews


RECOGNITIONS

Father’s illness inspires nursing career Meet Qing Zhou, one of Kaiser Permanente’s 2019 Extraordinary Nurse Award recipients.

“Also, my mother was a nurse. I was inspired by her compassion for her patients. She was well respected and loved

by everyone. I knew when I was young that nursing was what I wanted to do.” Now, Zhou, a registered nurse, is

charge nurse and specialty coordinator in general surgery at the Kaiser Permanente Irvine Medical Center in South-

ern California. “As a child, I saw nurses give my father shots, draw blood, give medication instructions, and talk to

him about taking care of himself. I don’t think my father could have lived this long without their care.”

How does your work contribute to Kaiser Permanente’s efforts to transform health and health care?

As a nurse for Kaiser Permanente, quality care and safety are our top priorities. I initiated our participation in the

Go Clear program from the Association of Perioperative Registered Nurses (AORN). The goal is to create a smoke-

free environment in surgery. With support from our staff and leaders to reduce operating room smoke from surgi-

cal equipment, the rate of staff calling in sick decreased and we won the AORN Go Clear Silver Award in 2018. We

were the first operating team in the state of California to win this award.

Describe one of your most memorable moments as a nurse.

Four years ago, a surgeon and I picked up a patient from the emergency room who had a ruptured abdominal aneu-

rysm. He looked very pale and was unresponsive. His abdominal area was tender, which was a clear sign of internal

bleeding. Based on our experiences, the patient was in critical condition and needed surgery immediately, so our

entire team was mobilized — we ordered blood, collected surgical instruments, and got a graft ready. The anesthe-

siologist put the patient to sleep very quickly. Surgery started less than 10 minutes after we brought the patient in-

to the operating room and lasted more than 3 hours. During that time, we gave the patient 20 units of blood. The

patient survived. I still remember that day and the wonderful feeling of being part of our team efforts that saved a

patient’s life.

Watching nurses and her mother care for her ill father led

Qing Zhou to nursing. “My father was always sick when I

was little and often in the hospital because of rheumatoid

arthritis. I saw what the nurses did to care for him,” said

Zhou, who has worked at Kaiser Permanente for 21 years.

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RECOGNITIONS

7 Southern California Medical Centers named top hospitals

Kaiser Permanente hospitals in Southern California joined an exclusive group of U.S. medical centers based on performance on the highest known standards for quality and patient safety. In California, only 16 hospitals made the list. Kaiser Permanente Southern California's 7 recognized hospitals made up 44% of the state's top hospitals.

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health.

Downey Medical Center

Fontana Medical Center

Irvine Medical Center

Anaheim Medical Center

Panorama City Medical Center

Riverside Medical Center

San Diego Medical Center

Reference: The Leapfrog Group

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Recognizing Excellence in Nursing Research & Evidence-Based Practice

Congratulations to the Baldwin Park Medical

Center Evidence-Based Practice Nursing Research Council on their wonderful

achievement in obtaining programmatic status for the first time.

Congratulations to the West Los Angeles Medical Center

Nurse Knowledge and Innovation Committee on their

wonderful achievement in obtaining renewal of programmatic status for 2019-

2021!


RECOGNITIONS

Extraordinary Nurses at Kaiser Permanente

Daisy award recipients from Kaiser Permanente Southern California

organizations include the following extraordinary nurses in 2019:

Shayla Jackson, BSN, RN Downey Medical Center

Mayola Blando, BSN, RN Downey Medical Center

Family Center Care Team Downey Medical Center

Erlinda Domasig, BSN, RN Downey Medical Center

Mary Grace Provido, RN Moreno Valley Medical Center

Joe Frank Rapada, RN Moreno Valley Medical Center

Moriah Mwesa, RN Moreno Valley Medical Center

Kimberly Hayes, RN Moreno Valley Medical Center

Angie Di Donato, RN Moreno Valley Medical Center

Cameron Purdey, RN Moreno Valley Medical Center

Annie Joseph, RN Woodland Hills Medical Center

Stephen Colaco, BSN, RN Woodland Hills Medical Center

Krystle Mangaccat, BSN, RN Woodland Hills Medical Center

Ethel Bravo, RN Baldwin Park Medical Center

Melanie Tan, RN Baldwin Park Medical Center

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Nicole Goodman, RN South Bay Medical Center

Elaine Atangan, RN South Bay Medical Center

Grace Tatlonghari, RN South Bay Medical Center

Jay Olegario, BSN Anaheim Medical Center

Neelima Tigulla, MBA, BSN, RN, CCRN Anaheim Medical Center

Emergency Department Anaheim Medical Center

Lyn Patulot, BSN, RN Anaheim Medical Center

Rose Devigne-Jackiewicz, RN San Diego Medical Center

Carol Knieff-Wishnek, RN San Diego Medical Center

Tomi Dosunmu, RN Zion Medical Center

Anitalyn Barber, BSN, RN Irvine Medical Center

Jacob Reeves, BSN, RN, CCRN, CMSRN Irvine Medical Center

Ermelinda Canapi, RN Baldwin Park Medical Center

Gerson “Jojo” Cua, RN Baldwin Park Medical Center

Karen Bacosa, MSN, CNS, RN, PCCN, SCRN Woodland Hills Medical Center

Nushu Zhao, RN Baldwin Park Medical Center

Cecelia Delgade, RN Baldwin Park Medical Center

Manuel De Los Reyes III, RN Irvine Medical Center

Adrienne Mombasa, RN Baldwin Park Medical Center

Stephanie Galvan, RN Baldwin Park Medical Center

Pliny Mindoro, RN Baldwin Park Medical Center


RECOGNITIONS

Extraordinary Nurses at Kaiser Permanente

Carly Weck, BSN, CLE West Los Angeles Medical Center

Vee Wongproundmas, BSN West Los Angeles Medical Center

Ittel Unger, RN, PCCN West Los Angeles Medical Center

David Borowicz, RN West Los Angeles Medical Center

Claire Urbano, BSN West Los Angeles Medical Center

Keith Kupper, BSN West Los Angeles Medical Center

Carmina Durich, BSN West Los Angeles Medical Center

Lisa Lankhamdaeng, BSN West Los Angeles Medical Center

Philip Pingual, BSN West Los Angeles Medical Center

Armida Averion, RN Anaheim Medical Center

Alejandro Rodriguez, BSN, RN Anaheim Medical Center

John Ibarra, BSN, RN Anaheim Medical Center

Luigi Mendoza, MSN, RN Ontario Medical Center

Randolph Sevilla, BSN, RN Ontario Medical Center

Lennie Cirilo, BSN, RN Ontario Medical Center

Theresa Austin, BSN, RN, MSNc Panorama City Medical Center

Francis Suobiron, BSN, RN, CCRN Panorama City Medical Center

Rhea Orante, RN Baldwin Park Medical Center

Pliny Mindoro, RN Baldwin Park Medical Center

Marissa LLagan, RN Baldwin Park Medical Center

Yvonne Deemer, RN Riverside Medical Center

Suzanne Price, RN Riverside Medical Center

Amiel Ansus, RN Riverside Medical Center

Salve Orante, RN Baldwin Park Medical Center

Adrienne Mombasa, RN Baldwin Park Medical Center

Dominque Oskierko, RN Los Angeles Medical Center

Stephanie Jacobson, RN San Diego Medical Center

Heather Ott, RN San Diego Medical Center

Stephanie Lam, RN Baldwin Park Medical Center

Stephanie Galvan, RN Baldwin Park Medical Center

Melanie Tan, RN Baldwin Park Medical Center

Esperanza Arcena Los Angeles Medical Center

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RECOGNITION

Celebrating Exceptional Work The Southern California Unit Based Team (UBT) Reward & Recognition program continues to encourage teams to improve care experience for our patients and families. This program started in 2008 to motivate our inpatient teams to improve performance, share and spread best practices. This year, the focus was on Nurse communication-RN Explained things un-derstandably.

This is a quarterly program for our Med Surg and Maternal Child Health UBTs, with two annual award opportunities: our “Sustain Award” which recognizes the highest performance on RN explained things understandably for a rolling 12 months, and our “Most Improved Performance Award” which recognizes improved performance on this dimension from the previous performance year. We are pleased to announce the following winning UBTs.

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2019 Most Improved Performance Award

Ontario Medical Center - 4 West Med Surg UBT

Moreno Valley Medical Center - Maternal Child Health UBT

South Bay Medical Center - 3400 Med Surg UBT

West Los Angeles Medical Center - Maternal Child Health UBT

Fontana Medical Center - 6 North Med Surg UBT




West Los Angeles Medical Center - 2A Med Surg UBT

Moreno Valley Medical Center - Maternal Child UBT



2019 Sustain Award

Quarter 4 Highest Performing Teams




Moreno Valley MCH Sustain, Highest Performing &

Most Improved Award Winning UBT

Fontana 6 North Most Improved Med/Surg Award

Winning UBT

West LA 2A Med Surg Med/Surg Sustain Award Winning UBT

Most Improved


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Extraordinary Nursing Care. Every Patient. Every Time.

Documents

2019 NURSING YEAR IN REVIEW