African American Nurses' Perspectives on a Leadership Development Program.

United States demographics are changing, but that change is yet to be recognized in the makeup of the nursing workforce. The underrepresentation of minorities in nursing is a longstanding problem, resulting in missed opportunities for culturally sensitive care that can foster optimal patient care outcomes. This report describes qualitative analysis of leadership opportunities emerging from a collaborative leadership development program between an urban baccalaureate nursing program and a large healthcare system in the northeast United States. The investigative team used qualitative methods to analyze the experiences of 19 participating African American (AA) RN graduates. Findings demonstrated that, for program participants, active engagement in personal and professional nursing leadership activities was enhanced. The academic-practice leadership program was an effective tool for enculturating AA nurses into the practice environment and into eventual leadership in nursing and healthcare.

Impact of a Repatriation Program Between Quaternary and Community Hospitals.

BACKGROUND: Capacity challenges at quaternary hospitals cause delays or denials in patient transfers from community hospitals that can compromise quality and safety. Repatriation is an innovative approach to increase capacity at the quaternary hospital by transferring a patient back to their originating community hospital after the quaternary portion of their care is completed. METHODS: A repatriation program was implemented at a large quaternary care teaching hospital over a one-year period (2020 to 2021). The authors characterized the rate of successful repatriation and associated patient characteristics, determined the impact on quaternary hospital capacity in terms of bed days saved, and estimated the resultant number of backfilled admissions that could be accommodated. The research team also monitored the rate of readmissions for repatriations back to the quaternary hospital. RESULTS: Overall, 215 repatriations were attempted, and 103 (47.5%) were successful. The most common diagnoses were sepsis (13, 12.6%), stroke (12, 11.7%), intracranial bleed (10, 9.7%), gastrointestinal perforation/obstruction (9, 8.7%), and trauma (9, 8.7%). The median length of stay at the quaternary hospital was 13 days (interquartile range [IQR] 7-20) and 12 days (IQR 4-26) at the community hospital. There were 2,842 bed days saved at the quaternary hospital, with a backfill opportunity of 431 admissions. The readmission rate to the quaternary hospital was 1.9%. CONCLUSION: By dynamically matching patient need with hospital capability at different phases of the patient's care, Repatriation can save bed days at the quaternary hospital, creating capacity to improve access for patients needing timely transfer. The low observed readmission rate suggests that repatriation is safe.