In May 2006, the department of nursing at the Milstein Hospital at Columbia University Medical Center campus of NewYork-Presbyterian set out to bring relationship-based care and primary nursing to the hospital. Since then, the Reigniting the Spirit of Caring program has been rolled out on 34 units on four campuses.
The nurse-patient relationship is the center of the care model, said Linda Valentino, RN, director of nursing at Milsteins Columbia campus. Primary nursing is a nursing delivery model that empowers nurses to provide patient-centered care that is both clinically competent and holistic in nature, Valentino said. It focuses on the patients concerns and empowers the primary nurse to coordinate all aspects of care in coordination with the patients needs and the other healthcare members.
To get the model going, staff members needed the resources to be properly prepared. So the patient care directors, who serve as leaders on the units, attended a weeklong series of workshops in Champaign, Ill., to prepare them for their role. The units were divided into five waves, with a director in charge of each wave. Staff nurses then attended a three-day training and education course designed to help reacquaint them with how they care for their patients.
Once the education component was complete, each unit participated in their unit practice council, where staffers met monthly to discuss the units vision. Status checks were conducted to discuss ideas and challenges or to give kudos to deserving staffers. During the first two years of the program, staff nurses also participated in the coordination council, or CoorC, a gathering of the director, two unit practice council members, the vice president of nursing and directors of nursing. From the council, committees were created to support the unit practice council and CoorC.
Four years into the program, the hospital has increased its Press Ganey scores with a four-point increase in overall patient satisfaction. Primary nurses may not give the actual care, but they plan the care, Valentino said. RBC helped from a leadership perspective.