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Saturday, January 30, 2016

Nursing Claims Data: What Does It Tell Us?

Recently, I participated in the webinar sponsored by Drexel School of Nursing and AON, Affinity Insurance Services, Inc.

The program introduced the findings of the 2015 Nurse Claim Report. Closed claim reviews of professional liability and license protection was presented along with risk management expertise with registered nurses and practical/vocational nurses.

The goal of the program was to identify liability patterns and trends to help nurses understand their areas of greatest vulnerability and to take appropriate action to protect patients from harm and nurses from potential litigation.

The program was excellent and provided valuable information that all nurses can use to ensure they are practicing safely and are covered in case a legal action.

The takeaway for me was the importance of having your own individual malpractice policy to defend you if you are involved in a lawsuit or called before the State Board of Nursing on a complaint or an issue that you were involved. 

Many of the lawsuits discussed were mistakes that occur when nurses are not paying attention to their organization's policy, failure to report an incident, not following the chain of command or by being distracted while delivery medications which caused an error to occur where the wrong med/wrong dose/wrong patient occurred.

As a Licensed Registered Nurse, you are responsible for the work you do, and the defense of that work if you are called for a deposition, involved in a lawsuit or brought up on disciplinary charges by your State Board of Nursing. Having your own malpractice insurance (not depending on your employer's policy) is critical for every nurse.

In closing, I urge each nurse (and other healthcare professionals) to please take the time to understand the risk management issues that impact your practice at the organizational level as well as the local, state and federal level. Ignorance is no excuse in a court of law, so be proactive and understand your scope of practice and responsibilities under your license or national certification. 

I welcome your comments and insights into this issue. Please leave a comment in the comment box below. 

Have a good week!

Monday, January 18, 2016

Reconnecting to Your Purpose to Improve Healthcare

The healthcare industry is experiencing frustration and worry among its stakeholders. Regulatory mandates for hospitals, physician practices and other entities are causing challenges to the system, as these mandates are linked to reimbursement for said stakeholders. The targets of regulations include, but are not limited to, quality of care, the patient experience, safety issues, care coordination, communication, discharge planning, unnecessary admissions, and end of life support.
Federal and state governments, commercial insurance companies, accreditation bodies, and quality improvement organizations have set standards that healthcare providers need to meet in order to receive monetary incentives and favorable public ratings that can allow them to increase their profiles and images to consumers and buyers of healthcare services.  When they fall short, penalties occur. As a result, health care leaders are working furiously to educate and empower their teams to be conscious of both how their departments are run and how outcomes are achieved.
Are these mandates working? Is healthcare more transparent? Are costs being contained? Are consumers satisfied with their care and with their healthcare providers?  Is the country healthier? It’s hard to say. In a recent article, Patrick Conway the Center for Medicare and Medicaid’s chief medical officer said, These programs are driving what we want in health care.” Most hospitals have improved since the programs began. However, even some hospitals that have gotten better are still losing money because they are not scoring as well as others. As a result, there is a renewed effort from organizations to ensure that they have people in place with the expertise to build better systems for analyzing performance and delivering better services in order to achieving better outcomes. Organizations, large and small, cannot afford to miss signs that impact their scores, as this impacts their reimbursements.
Organizations that are showing positive outcomes have two things in common--first, they recognize the need to keep the patient and caregiver at the center of the healthcare team. Second, they understand the importance of self-reflection and evaluation. They are taking the time to assess their core purpose and make sure their strategies and organizational culture sync up with their mission.
Hospital leaders, physicians, and other healthcare entities who want to stay relevant (and in business) need to better understand patients. These patients are their customer, and patients are the proprietors of their own health and health care.  As a result, there is a renewed effort to keep the consumer involved in matters of cost, quality, and access.
In addition, healthcare leaders are taking the time to reexamine their purpose and ensure that the strategies they put in place are meeting the needs of patients. I would encourage you to take time this week to exam your organization’s as well as your professional purpose. Are you working in line with what is important? At your next staff meeting, ask your colleagues if you, as a team, are meeting your mission through the services you provide and the work you are doing? Are you satisfied with the work you are doing? If not, what do you need to do to improve? Reflection allows you to be part of the solution and not continue the status quo.
In continuing with the thread of improving the patient experience, next week I will highlight some of the innovative programs organizations are implementing to ensure they are utilizing patients to strengthen the healthcare system. If you have a best practice you would to share, please email me at
Please share your thoughts and your insights on how you see our healthcare system functioning. Are you happy with it? Is it worth the dollars being spent? If not, what are you doing to address shortfalls?
To assist you in your reflections, I have shared articles that address value-based purchasing and how these strategies are working to improve  our healthcare system. I embedded the links into the titles so you can just click on the title read the articles.

Don't forget to sign up  by adding your email on the front page to ensure you receive all updates from Nurse Advocate.

Have a good week! 

Going Beyond Expectations to Create a Culture of Caring

Welcome to the 2nd year of Nurse Advocate. I hope you and you and your family had a Merry Christmas and will have a Happy and Healthy 2016.

My husband and I did something different this year for the holidays and took a Panama Canal Cruise. We sailed on the Island Princess, a member of the Princess Cruise Line. The ship was beautifully decorated which put everyone in a festive spirit. Christmas was spent at Sea, allowing for a relaxed day. New Years was spent in the Caribbean Sea after transferring through the Panama Canal, which was an exciting experience.

The ship provided lectures on the history of the Canal along with a few documentary films to prepare passengers for the crossing which added to the experience.  I did not know a lot about the history of the Canal and was glad to learn how the project came to fruition and was impressed with how it is still working 100 years later. Here is a link if you want to learn more the Panama Canal.

Throughout our trip, we experienced calm seas and smooth sailing for all but two of the 15 days. We traveled 4,701 miles from Los Angeles through the Canal and then back to Ft Lauderdale. Ports included Cabo St. Lucas, Nicaragua, Costa Rica, Cartagena, Columbia and Grand Cayman. It was a trip of a lifetime and a wonderful way to spend the holidays.

Besides the Port of Calls, the beautiful ship, and great activities, I also took in the diversity of the crew that was made up of people from over 50 countries! In talking to many members of the crew, I was impressed with their sense of adventure and their courage. Most were young (early 20s-mid 30s). For many this was their first assignment as well as their first time living away from their families. Contracts are usually 4-6 months’ time frame. The crew works seven days a week and long hours. It was not unusual to see the same people at breakfast at 8 am and again in the dining room at 10 pm, serving the guest, making conversations with couples or those alone, and doing their chores.

What impressed me the most was that they were always ‘up’ and ready to lend a hand. It was clear their goal was to make sure each passenger had a great experience. The Captain of the ship very visible. He was a true leader and always thanked his crew and asked passengers to let the staff know what they could do to enhance their experience. These were not just words, but a direct call to action for all to work together to ensure everyone had a positive experience.

Here are some of the attributes I observed from the crew and that helped make our experience one that we will never forget.
  • organization
  • attention to detail
  • positive attitude
  • courtesy
  • patience
  • professional appearance
  • neatly dressed
  • willingness to go out of their way to assist the customer
  • dedication to their employer
  • willingness to share personal information when asked; yet respect for our privacy
  • collaboration
  • team work
  • timely and pertinent communication
  • autonomy
  • respect
  • pride
  • dedication
  • smiles
As I write this post, I could not help but compare how the healthcare industry could benefit from the training and positive culture I experienced on the Island Princess for 15 days. If this culture could be incorporated into every hospital, physician practice and healthcare setting we would have a safe, cost-effective, and more efficient healthcare system. Today with the intense focus on improving quality and the patient experience having leaders who can ensure a culture of caring throughout the entire organization is critical.

I am sure there were problems on board the ship. With over 2200 guests of all ages challenges arose. If there were problems, they were addressed in private and not in the public arena. I never saw one crew member be nasty, challenge a passenger or raise their voice even when someone did something that was out of line. Everyone was treated with respect and as a guest in their home at sea.

Another group that caught my attention: the passengers. There were all ages represented, but Seniors were in the majority. As it was a holiday cruise, there were a number of families with multiple generations. There was also a good number of passengers who were disabled. As I have mentioned in the past, as a survivor of a Central Nervous System Brain Tumor I have been left with ambulatory challenges. As a result, I was now a member of this category of passengers.  What impressed me most was how determined those with physical challenges were in not allowing  their disability to derail their love of travel. It was truly inspiring.

I also noted how much caregivers do for their loved ones. I was grateful that I had my husband with me. He looked out for me to ensue I was safe yet allowed me to be as independent as I could. Going on our second vacation since my illness has been a good experience for us as it breaks up our daily routine and allows us to realize how much we love each other and enjoy each other's company.

As we had so many days at sea, I had a lot of time to think, plan and organize my goals for 2016. I look forward to an exciting year and hope you will join me by reading Nurse Advocate as we progress through the year. I look forward to your thoughts, comments, and suggestions. Please feel free to share each issue of Nurse Advocate with your family, friends, and colleagues.

You can reach me by email at   Again, all the best to you and your yours in 2016!