Factors to Improve Reverse Integration: A Mixed Method Embedded Design Study.

Individuals with serious mental illness face inequity in receiving primary care services. The Substance Abuse and Mental Health Services Administration (SAMHSA) granted funds to Certified Community Behavioral Health Clinics (CCBHC) to integrate primary care and behavioral health specialties to increase access to care. This mixed method study aimed to measure the SAMHSA-defined levels of reverse integration at a CCBHC at one point in time. Providers and patients provided feedback through semi-structured interviews. Qualitative data was investigated for themes, while the quantitative data was run through inferential analysis with the Kruskal Wallis H test. Clinically meaningful results showed people using primary care at the integrated clinic were more satisfied and were more apt to continue seeing their current providers than those receiving non-integrated care. The CCBHC achieved level 4 integration; factors investigated confirmed proximity alone does not necessitate integration without effective communication and implementation of practice changes.

Leadership Science in Nursing: Creating New Solutions for New Challenges.

The Association for Leadership Science in Nursing (ALSN) November 2022 International Conference was held at the Frances Payne Bolton School of Nursing at Case Western University. ALSN is dedicated to uniting academic and practice leaders to shape leadership science, education in nursing, and the practice of nursing leadership. One hundred fifty-one nurse leaders from the United States, Canada, and Oman gathered to discuss leadership as highlighted in this column.

Influencing a Culture of Quality and Safety Through Huddles.

BACKGROUND: Literature shows that interdisciplinary huddles help promote clear communication and proactive reporting of potential errors. LOCAL PROBLEM: High reliability organization (HRO) and just culture models were implemented, yet fragmented team communication about patient safety remained. Huddles were implemented to identify and address patient safety issues. METHODS: A pre/postintervention design was used. Near-miss and actual event safety metrics, patient satisfaction, and employee satisfaction/work group perceptions were measured at 3 time points over 1 year. INTERVENTIONS: Daily interdisciplinary huddles were implemented to improve communication, reduce errors, and improve patient and employee satisfaction. RESULTS: Near-miss reporting increased across time points. Patient satisfaction with how the staff worked together to provide care significantly increased over time. Employee satisfaction and perception of work group communication, collaboration, and psychological safety scores improved, however, were not statistically significant. CONCLUSION: Implementing huddles demonstrated improved outcomes in patient safety, patient satisfaction, and employee satisfaction/work group perceptions.

Implementing a Peer Support Network to Promote Compassion Without Fatigue.

OBJECTIVE: The aims of this study were to implement a Peer Support Network (PSN) pilot project including education/training, peer support, and resiliency training and to explore how interventions impact compassion satisfaction (CS) and compassion fatigue (CF) in a community hospital. BACKGROUND: CF has been reported to negatively affect nurse retention. The PSN provides a 3-tiered team approach to enhance CS and support nurses experiencing CF symptoms. METHODS: Twenty nurses participated in PSN training and completed preimplementation and 6-week postimplementation surveys: Professional Quality of Life, Compassion Practice Instrument, and self-care resource utilization. RESULTS: Statistically significant improvements in CS and nonstatistical improvements in CF were found. CONCLUSION: Promoting a PSN may increase CS and potentially prevent work-related physical, emotional, social, and intellectual CF sequelae.

Achieving patient and family engagement through the implementation and evolution of advisory councils across a large health care system.

Over the past decade, hospitals and health care systems have responded to the call for increased patient engagement and person-centered care. Organizations across the country have developed models and tools to assist in the effort toward patient and family engagement in health care delivery. In addition, current literature and trends suggest that patient satisfaction and quality outcomes are improved when patients and families become partners in their own health care and the delivery of that care. However, to formalize a patient-centric structure and process across a large health care system that is aimed at patient and family engagement can be a daunting activity. Utilizing well-established tools, Catholic Health Initiatives was successful in implementing the structures to deploy the ideas of patients and families in multiple facilities and care settings across 19 states. Nursing leaderships, in partnership with patients and their families within this health care delivery system, were the key contributors to the implementation of formalized patient and family advisory councils in hospitals across the enterprise.

Partnering with families.

Those who know the patient best can help bridge the gap between hospital and home.

Putting patients first: Partnering with patients' families.

This is the sixth in a series of articles from Planetree, an international nonprofit organization founded in 1978 that's "committed to improving medical care from the patient's perspective." For more information, go to www.planetree.org.