"That requires considering the challenges of each unit and the patient populations they serve individually and then empowering nurse managers to work with their team to devise solutions," Yost says.
At Ascension Via Christi, that has led to the creation of several new support roles designed to let nurses focus on patient care tasks that require the education, experience and training of a professional nurse.
For example, the Wichita hospitals' environmental services department once employed hospitality specialists who answered call lights, filled water pitchers, tidied rooms and provided other non-clinical patient support.
That role went away several years ago with the hospitals' transition to Touchpoint, established by the Compass Group to provide food, nutrition and environmental services to Ascension facilities nationwide. The hospitality duties they performed fell back to the nursing team, primarily the certified nurse assistants.
"Listening to patients and the voice of my team, we determined that we needed people who could help out our CNAs," says Adrianne King, nurse manager for the sixth-floor orthopedic unit at Ascension Via Christi St. Francis. "Many patients just want someone to talk to and our CNAs just didn't always have the time."
So with the support of nursing leadership, King revised the prior job description and recruited and hired three patient care techs with a hospitality focus to cover the day, evening and weekend shifts. She also arranged for ambulatory training so that they could serve as the second person on a two-person patient lift and help escort post-surgical joint replacement patients to therapy.
"This allows our CNAs to focus on their clinical duties, which in turn helps our nurses focus on theirs," says King, which enhances the patient and caregiver experience.
Several other nurse managers followed suit, says Kris Hill, St. Francis' vice president of Nursing, and added hospitality staff, "specifically looking for happy people with a call to service and who easily live our mission."
Natalie Hertzel, nurse manager for 5SE at St. Francis, a stroke and general medical-surgical unit, says that it's important that patients are up and walking, but there are many other things that her increasingly sicker patient population needs. Consequently, she was excited when her unit was one of two chosen for a collaborative effort by Nursing and Physical Therapy to hire, train and supervise entry-level staff to walk patients who do not require therapy services.
"It requires putting an order in and we're still working to make that a habit, but so far it's really good," says Hertzel. "Patients seem happy so they can get up and about more frequently and our nurses like it because they enjoy seeing their patients up and moving more often, too."
Sue Willey, director of Physical Therapy at St. Francis, says two of the three mobility techs are working with patients as they undergo training and the third will be joining them soon. "It's a six-month pilot with highly specific goals and we'll look at expanding it further based on the results," says Willey. One of those is to keep patients more active, helping them to return home sooner and to prevent deconditioning during a hospital stay."
Other clinical and non-clinical roles are being looked at as needs and potential solutions are being identified.
Says Yost: "Every unit, like the nurses who staff them, has unique characteristics and needs. We are simply listening and responding to those needs in a more individualized manner so we can continue to provide the high-quality, personalized care that our patients deserve."