Professional values and role socialization of new NPs.

ABSTRACT: This cross-sectional study focuses on assessing factors related to role socialization of new NPs. Participants identified caring as the most important professional value, followed by activism and professionalism. Role socialization factors including a sense of belonging and forming professional identities were higher for experienced NPs.

Securing the Future for a Major Academic Cardiovascular Program: Hardwiring a Referral Network and Preparing for a Transition to Value-Based Reimbursement.

The University of Kentucky College of Medicine and Albert B. Chandler Hospital opened over 50 years ago to serve Kentucky. After initial growth and expansion, both were struggling clinically, academically, and financially in the early 2000s. Difficulties were apparent in cardiovascular (CV) services, which captured only 11% of the regional patients hospitalized for cardiac disease. Over the next 15 years, CV services dynamically transformed to become the leading provider with a large network of regional partners, garnering 42% of market share. This article describes strategic plans and initiatives leading to clinical and academic growth. Future value-based initiatives are also described.

The Patient-Centered Discharge-An Electronic Discharge Process Is Associated With Improvements in Quality and Patient Satisfaction.

In this retrospective cohort study, 100 records were randomly selected from the intervention period (April 2012) and the control period (April 2011). The hospital's institutional database was queried to compare mortality, length of stay, and patient satisfaction, in the year prior to and the year after the integration of the new process. A chart review was performed to determine if the reengineered process was associated with an improvement in documentation. A scoring system was developed to gauge the quality and timeliness of the process. Institutional data regarding length of stay, mortality, patient satisfaction, and core measures compliance were compared for the pre- and postimplementation of the new process. The reengineered discharge process was associated with an improvement in patient satisfaction and in the quality of the discharge materials as measured by the "patient-centered transitions of care (PCTC) score." These improvements occurred without a significant increase in the time to complete a discharge.A redesigned discharge process resulted in system-wide improvements in the quality of information provided to the patient and their outpatient providers. This intervention was associated with an improvement in compliance with core measures, improvements in patient satisfaction and timeliness of discharge summary preparation.

Advanced Practice Providers' Perceptions of Patient Workload: Results of a Multi-Institutional Survey.

OBJECTIVE: This study examines data collected from a survey of advanced practice providers' (APPs') perceptions of reasonable versus actual APP-to-patient ratios and other factors that affect workload burden in both inpatient and outpatient clinical settings. BACKGROUND: Advanced practice providers provide accessible, cost-effective, and quality care in a growing number of specialty practices across multiple patient care settings. They are caring for higher volumes of patients and assuming more responsibilities while continuing to navigate highly complex healthcare systems. Limited evidence or benchmark data exist that would assist in determining optimal workload and staffing models that include APPs. METHODS: A group of advanced practice leaders developed and distributed a 43-question survey of workload factors to a highly diverse APP workforce. RESULTS: There were 1466 APPs across 37 areas of practice who responded to the survey distributed in 14 separate organizations. The perceived reasonable workload was lower than the actual workload for 22 specialty practice areas. The analysis included years of experience as an APP, work hours, on-call commitment, nonclinical responsibilities, and time spent in documentation, direct patient care, and performing procedures. CONCLUSIONS: There is a consensus among APPs, within their practice area, about what constitutes a reasonable patient assignment, despite the variability in APP experience, organizational culture, processes, and patient acuity.

Using dedicated nurses to improve core measures compliance.

To ensure The Joint Commission and Centers of Medicare and Medicaid Services core measures were being met, University of Kentucky Health Care created a team to explore the issues and create solutions. Six nurses were placed in the role of core measure nurse, who were responsible for identification of Core Measure patients, standard work, concurrent review, and working with the informaticist team to increase core measure performance. Building strong relationships with the bedside staff was also a key step to the success of these nurses. After the pilot, the compliance perfection scores were sustained as the roles were adopted by administration and made permanent.