UPMC Nursing Strategic Plan

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UPMC Nursing’s Strategic PlanHolly Lorenz MSN, RNUPMC Chief Executive Nurse

Executive Summary 2UPMC Nursing over 12,000 nurses strongProviding over 3,500 clinical experiences per semesterOur belief “Every nurse is a leader”ANCC’s Magnet Model is our roadmapEvidence-Based Practice is our core interventionShared Governance keeps us groundedEmpirical Outcomes measure our final product

SWOT AnalysisINTERNALSTRENGTHSWEAKNESSES EXTERNAL20 Hospital health system offering a variety ofspecialtiesRich pipeline of nursing schools in our region3 UPMC Schools of Nursing- SHY designated asCenter of Excellence in EducationCurrently employ over 12,000 nursesAdvanced technology across the systemUPMC offers nearly endless opportunities to growand develop while gaining tenure within theorganization – career pathingFlexible nurse staffing options: casual, weekend,UPMC Worksource, Life Stages, FFT, PTInclusive Career Ladder High turnover on several nursing units potentialcauses: Acuity Horizontal violence Unit leaderLimited formal pipeline for crucial nurse leaderroles: CNO, Unit director, care manager, informatics,etc.Minimal frontline staff accountability for patientoutcomesTechnology growing faster than education to usersUPMC’s aging workforce – particularly in surgicalservices and care managementOPPORTUNITIESTHREATS Internal growth opportunity for nurses: i.e. CRNAs,nurse practitioner programs, CNLFaculty needed to meet demand from potentialnursing studentsPipeline of advanced practice nursesImpact of the financial climate: with nursing turnoverProjected growth in the national minority populationLeverage systemness to influence legislation relatedto professional practice Health care policy changesIncrease in public reportingAging nursing workforceUnion ActivityIOM Future of Nursing RecommendationsChanges in payment and reimbursementProjected Physician ShortagesPA State Board of Nursing regulation requiring an80% NCLEX pass rate for nursing schoolsNursing School Accreditation require BSN students tobe precepted by BSN level nurses

UPMC Nursing Strategies and TacticsTransformationalLeadership LeadershipDevelopment Succession Planning National/InternationalVisibility External Forces Financial Implications Communication Magnet /Pathways toExcellence4ExemplaryProfessional PracticeStructuralEmpowermentNew Knowledge and Professional PracticeModel Care Delivery Models Staffing, Scheduling andBudgeting Processes Interdisciplinary Care Accountability,Competency andAutonomy Ethics, Privacy, Securityand Confidentiality Diversity and WorkplaceAdvocacy Quality Care Monitoringand Improvement Culture of Safety ProfessionalEngagement: Shared Governance Engagement Survey Interdisciplinary ClinicalExpertise (Collaborationamong caregivers) Commitment toProfessionalDevelopment: Formal education Career progression Teaching & RoleDevelopment:Student experience DemonstrateCommitment to theCommunity Recognition of Nursing Patient Flow/Capacity New Technology Innovation Nursing Research & EPB Balancing DemandsResources/Staffing/Technology/Dollars1 to 3 year timelineInnovation

Transformational Leadership Leadership development and succession planningYear 1- Establish baselinemeasurement with NDNQIRN survey, turnover andpromotion of key positions- Identify future nursingleaders at each BU- Develop programs andstrategies for leadershipdevelopment at differentlevels- Develop toolkit/curriculumfor potential new frontlineleaders5Year 3- Demonstrate improvementin NDNQI RN survey forleadership- Demonstrate improvementin UPMC engagement surveyfeedback- Ongoing leadershipdevelopment opportunitiesoffered throughout thesystem- Increase of career ladderpromotionsBeyond- Transparent leadershipopportunities at all levels- Online tracking of potentialupcoming nurse leaders- Ease in filling vacantleadership positions

Transformational Leadership External forces and National/International visibilityYear 1- Vigilance in meeting thedemands pertaining togovernment regulations- Communicate to staffinformation regarding federal,state and local governmentregulations via newsletter,grand rounds, etc.- Establish baselinemeasurement of UPMCnurses participation innational, state and localprofessional nursingorganizations- Host a UPMC nationalnursing conference6Year 3- Enhance relationshipsbetween national andinternational sites- UPMC nursing on track tomeet IOM Future Nursesrecommendation- UPMC nursesdemonstrating in theirpractice knowledge of theimpact of health care reformBeyond- Ongoing flow ofcommunication andexpertise with internationalsites- UPMC Nursingrepresented within nationalnursing organizations- UPMC nursingrepresented on projects atthe national and state level

Exemplary Professional Practice Professional practice, care delivery system and staffingYear 1Year 3- “Your Care OurCommitment” spreadBeyond- New care delivery models- Evaluate skill mix to supportcare delivery model- 100% of hospital units usingreliable/variable rounder ondaylight shift- Develop and evaluateappropriate care coordinationmodels and handoffs acrossthe continuum- Establish the baselinemeasurement for patient andnurse satisfaction- Enhance recruitment anddevelop evidenced basedselection process7meeting patient, nurse, andsystems needs- Nurses practicing to the fullscope of their licensure- Active role for advancepractice nurses at thebedside- Patient and nursesatisfaction surveydemonstrates improvement- Decrease in turnover- Flexible staffingopportunities that meethospital and staff needs- High patient and staffsatisfaction- UPMC Nursing recognizedfor quality patient outcomesand staff satisfaction- Nursing at UPMC viewedas a lifelong career

Exemplary Professional Practice Culture of Safety, Quality Care Monitoring and ImprovementYear 1- Establish transparentbenchmarks for measuringclinical, financial and humanresource quality indicators- Educate staff to use thestandardized reports thatmeasure the top priorityquality and safety indicators- Pilot and apply evidencebased protocols to selectclinical indicators- Provide data to frontlinestaff that is meaningful, andthat can be used to drivepractice changes-Identify best practice forJoint Commission and DOHreadiness8Year 3- Achieve benchmarks forselect clinical, financial andhuman resource indicators- Managers demonstratingease with using reports onnursing dashboard- Spreading best practicereadiness for JointCommission and DOH- A Just Cultureenvironment demonstratedin nursing/clinicaldepartmentsBeyond- Exceed core measurestargets across the system- Exceed UPMC HCAHPStargets- A significant reduction insafety errors- Nurses in all milieus acrossthe system not work morethan 12.5 consecutive hours- Significant reduction inpreventable workplaceinjuries

Structural Empowerment Shared governance, career progression, teaching and roledevelopmentYear 1- Unit-based professionalpractice councils establishedat every facility- Pilot clinical partnershipmodels for effective studentexperience- Develop RN residency gapanalysis- Initiate nurse practitionerresidency program- My Nursing Careershowcased as a lifelongcareer opportunity at UPMC- Build upon the AcademicService Partnership toinclude national/regionalmembers9Year 3- Transparent reporting ofoutcomes andachievements of sharedgovernance councils- Clinical instructor programimplemented to supportnursing schools- Active transition to practiceresidency program advisoryboard-Nurse residency programcompletely implemented fornurse practitioners- Fully implemented onlinepromotional process for theMy Nursing Career LadderBeyond- NDNQI RN survey resultsdemonstrates the UPMCnursing workforce fullyengaged and empowered- UPMC nursing recognizedfor the seamless transition ofstudents to practice- National recognition for thecollaboration with academicservice partnership

Structural Empowerment Commitment to community and recognition of NursingYear 1- Promote educationalservice projects that benefitthe community and supportMy Nursing Career’sProfessional Contributions- Implement evaluation toolfor the summer nurseinternship program- System-wide publication ofawards and recognition viaannual report, nursingnewsletter- System-wide participation inDAISY, Nurses’ Week,Cameos of Caring Awards10Year 3- Create new models ofinteractive care in thecommunity for patient selfmanagement- Active calendar ofopportunities for nurses tosupport communityinitiatives- Process developed forconsistent UPMC nursingsubmissions fornational/regional awardsoutside of UPMC- Role of nurse leaders asthe chief retention officerfully implemented acrosssystemBeyond- Active partnership withUPMC Nursing and thecommunity- Local, regional, and nationalrecognition of UPMC Nurses

New Knowledge, Innovation and Improvement Evidence Based Practice (EBP) and researchYear 1- Establish evidence basedfellowships at selecthospitals- System-wide evidencebased council provide gapanalysis on initiatives acrossthe system and hostsymposium- Implement Lippincott foronline access of procedureguidelines- Continue providingeducation for conducting andreviewing nursing research- Partner with Pitt SON forcollaboration with nursingresearch11Year 3- Hospital basedimplementation of evidencebased councils and fellows- Faculty collaboration withEBP and Nursing Research- EBP internship availablethroughout the system- EBP council createtransparent best practicessharing across the system- Active nursing researchbeing conducted across thesystemBeyond- Bedside nursesdemonstrate knowledge ofEBP- Ongoing nursing researchhappening across the system- UPMC nursing recognizedfor high quality patientoutcomes

New Knowledge, Innovation and Improvement Information technologyYear 1- Establish plan forimplementation of SMARTtechnology- Continue documentationoptimization project- Meet targets for medicationreconciliation-Prepare for ICD-10implementation- Select capacitymanagement software12Year 3- Continue system andbusiness level upgrades ofthe electronic medicalrecord- All business units havecompleted capacitymanagement softwareupgrade- Continue to implementSMART technology- Continue documentationoptimizationBeyond- Reassessment of currentstate to identify goals astechnology continues tochange.

UPMC Nursing Strategic SolutionsOrganizationalSolutionsAreas of alPracticeOutcome:Pt. outcomesQualityPt. satisfactionStaff hip DevelopmentTExecutive/ManagerialSuccession planningNursing Grand RoundseRecruitmentNew Hire SelectionSchools of NursingTargeted InitiativesPerformance ManagementMy Nursing CareerRetention StrategiesAcademic PartnershipsStructuralEmpowermentNew Knowledge,Innovation mentClinical RotationsRN ResidencyStudent Intern ProgramAdvanced Practice NurseOperational ImperativesBenchmarking/DashboardsLabor Strategy/Safe Work Hours/Evidence Based PracticeWebsite and NewslettersHealthy WorkforceHealth Status of NursesInclusionWork-life Balancechnology

I N T E R N A L STRENGTHS 20 Hospital health system offering a variety of specialties Rich pipeline of nursing schools in our region 3 UPMC Schools of Nursing-SHYdesignated as Center of Excellence in Education Currently employ over 12,000 nurses Advanced technology across the system UPMC offers nearly endless opportunities to grow

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