TEAM LEADERNeurological Rehabilitation
Clinical Leadership
Clinical outcomes for patients, professional satisfaction, and hospital performance all benefit from effective clinical leadership”
(Mountford et al, 2009)
Overview
To review the gaps in nursing service provision
To identify opportunities for improvement in coordination of services, nursing care , patient satisfaction, team communication and hospital performance
Team Leader
The purpose of this presentation is to highlight the merit of a new and innovative clinical nursing ‘Team Leader’ position on the Neurological Rehabilitation Unit at West Park Healthcare Centre.
Nurse Manager
Daily Operational function Orientation of new staff/students Administrative duties Coordination of Nursing on the floor Supervisory role
Needs Assessment
Communication Issues Rounds Case Management/Coordinated
Approach Review of Referrals Program Evaluation
Strategic Planning
Patient Care/Coordination
Team Function
Performance Indicators
Program Planning/Resource Management
Team Leader
An evolution of the nurse ‘manager’ shifting focus to leadership vs.
management
Hybrid of a ‘service leader’ and a ‘frontline leader’
Team Leader
To ensure the provision of coordinated and consistently high quality patient
care, maintain organizational and professional standards, facilitate
growth and development of the staff and the program, and to liaise with our internal and external partners
Performance Indicators
Functional Independence Measure (FIM)
Occupancy level on the unit Length of Stay Therapy provision (amount and type) Alternate Level of Care (ALC) beds ‘Response Time’ ‘Wait Time’ Start of therapy post-stroke (# of
days)
Response Time
The date the referral was sent to the receiving facility to the date of first response (accept, deny, re-direct, send back)
Current: 1.9 days
Goal: 1.6 days
Functional Independence Measures Score (FIM)
FIM is an outcome measure, validated and reliable in the stroke and ABI
population that measures functional independence and burden of care.
Current Mean Change: 19.7
Goal Mean Change: 21.5
Length of Stay
The amount of time (in days) a patient stays in hospital
Current: 33.83 days
Goal: 31 days
Occupancy
The number of hospital beds occupied by patients expressed as a percentage of the total beds available
Current: 84.49%
Goal: 90.06%
Alternate Level of Care (ALC) Beds
When a patient occupies a bed in a hospital that does not require the intensity of resources/services provided in that particular care setting
2010/11 fiscal year (to date): 5
Goal: 0
Stakeholders
Patient Acute Care referral sources Ministry of Health and Toronto
Central LHIN
Budget
One extra RN on day shift (7am-3pm), Monday to Friday
Minimum 5 years experience on the Neurological Service
$37.00/hour or $72,150 per year In-charge premium $1.70/hour or
$3123.75 per year Total expense: $75, 273.75 per year
Funding
First Year: Hospital funding – full cost
Second Year: Anticipated savings in 0ne-to-one care
and other costs associated with more ‘appropriate’ patients.
2010-2011 cost of one-to-one care alone was $47,000
Alternate source of funding
Toronto Central LHIN - HSIP program
Health System Improvement Pre-Proposal
Allows health service providers to articulate a request for funding – typically one-time only funding – in order to implement a new health service that the organization has not previously provided, or to improve efficiencies
and reduce barriers to care
Alternative
Absorb the position internally within the normal day shift nursing complement
The ‘In-Charge’ nurse for the day has partial responsibilities of a ‘Team Leader’
Backfill 4hours on day shift with an RPN to allow time and opportunity for the In-
Charge nurse to perform her ‘Team Leader’ duties (total cost per year: $26,460)
Challenges
Funding HR/Union/Administrative process Everybody will want it, so no one
gets it No template, no competitors have a
similar position
Leadership
Our business in life is not to get ahead of others, but to get
ahead of ourselves
E. Joseph Cossman
Opportunities
Pilot Project, evaluate, publish or present
Leaders in Best Practices in Stroke Care
‘Stroke Services Distinction Program’ -Accreditation Canada
Hospital-Wide Initiative
Leadership opportunity, career growth, job satisfaction, retention
Leadership
Innovation distinguishes
between a leader and a follower
Steve Jobs
Questions
http://www.youtube.com/watch?v=a0sGDjcFiok&feature=related