Concurrent Session 2 Monday April 8 2019 500 PM 600 PM Conflict of Interest We hereby certify that to the best of our knowledge no aspect of our current personal or professional situation might reasonably be expected to affect significantly myour views on the subject on which we ID: 1022201
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1. Striving for Excellence: Using Data to Enhance Occupational Health Nurse CompetenceConcurrent Session 2 – Monday April 8, 2019 (5:00 PM – 6:00 PM)
2. Conflict of InterestWe hereby certify that, to the best of our knowledge, no aspect of our current personal or professional situation might reasonably be expected to affect significantly my/our views on the subject on which we are presenting.
3. Learner OutcomeBased on this education, the learner will… 1.Identify strategies used to measure and evaluate Occupational Health Nurse competency. 2.Recognize uses of data in driving continuous improvement.
4. Sharon Petersen, MSN, RN, COHN/CMDirector, Employee Health OperationsSuzy Winsor, DNP, RN, COHN-SEmployee Health Nursing Project Manager
5. 37,000 Caregivers300 Volunteers1400 Physicians and APCs5000 Affiliated Physicians 23 Hospitals180 ClinicsHome Care DivisionSupply Chain Center and WarehouseLaundry FacilityLife Flight Air Medical OperationsHealth Plans Division
6. BackgroundSituation: Organization restructure. Opportunity to rethink and continuously improve Employee Health (EH) structure and operations. Situation: Non-clinical supervisors didn’t know how to evaluate their Employee Health Nurses (EHN) and requested guidance.Situation: Desire to increase EHN professionalism and improve EH program.
7. BackgroundNo standardized performance measures. Standardized tools available but not an orientation program. Majority of EHNs had non-clinical supervisors. Unclear expectations and variable evaluations.Very few metrics for EH productivity and success. Nurses have variable occupational health experience and nursing education. No data to understand gaps.
8. 2019 Current StateCentralized Reporting Structure to Clinical EH Leadership Evidence Based Performance MeasuresDefined Metrics to Measure Personal Progress & Program SuccessFuture StateImplement and Utilize New ToolsContinuous ImprovementProfessional Development
9. Gap Analysis of Occupational Health Nurse Competence
10. Evidence Based ResourcesAAOHN Competencies in Occupational & Environmental HealthAAOHN Standards of Occupational Health Nursing Nursing Theory: Benner’s Novice to Expert Theory
11. Where to Start Presented proposal to HR leadership to conduct a Gap Analysis SurveyUtilized Internal Research ResourcesConsultation about purpose and content of surveyHelped write and format valid questionsSoftware to administer surveyIRB requirements ConfidentialityStrategize Participation (barriers, incentives)Intentions (publishing)
12. Survey Content DemographicsAll 22 AAOHN Competencies Perceived CompetencePerceived ImportanceNursing Activities (how are they interpreting and applying occ health principles into practice) Internal Resources Time Allocation
13. Survey Administration Provided time to take survey during prescheduled meeting Discussion about the purpose and specific content of each Competency 100% participation (34 nursing staff)
14. Data Analysis Quantitative Data: Data AnalysistQualitative Data: Self-Analyzed No program. Just our own spreadsheets to determine themes. Observations and experience as a point of reference.
15. Data Analysis – Lessons LearnedData Speaks! Seek help from those who are statistically skilled.You are smart and have good ideas. You have help!
16. Gap Analysis Results
17. Demographics: Nursing ExperienceExperienced NursesLimited Occ Heath ExperienceMajority of Occ Health experience has been within Intermountain Healthcare.
18. Demographics: Education
19. Demographic: Professional Involvement
20. NoviceAdvanced BeginnerCompetentProficientExpertTotal Worker HealthPrinciples of Nursing PracticeCulturally Appropriate, Evidence Based Practice
21. Promising Gaps NoviceAdvanced BeginnerCompetentProficientExpert
22. Competence Factors/PredictorsDemographicStatistically SignificantNon-StatisticallySignificantYears of Occ Health Experienceþ >5 years<5 yearsNursing Experienceþ >15 years<15 yearsGraduate Nursing Degreesþ Member of Professional Associationþ Certificationþ Unable to measure because of small sample size: Non-Nursing Degrees
23. Poll Question: Can you quantify your competence-- for yourself, your boss, and your organization?Yes. I use the AAOHN Competencies for Occupational and Environmental Health NursingYes. I document the tasks I complete during the yearNo. I have not been able to develop a way to quantify what I do in an acceptable business formatI am not asked to quantify my competence as an occupational health nurse. (My RN license is considered my competence.)
24. Collecting and Using Data to Support Occupational Health Nurse Competence
25. Developing Performance Measures: Important ConsiderationsProfessional StandardsChanging Healthcare EnvironmentAlign with OrganizationBoard GoalsStructure, Resources, ExpectationsProgram Standards Strategy Deployment Model and Tools
26. Evidence Based Performance Measures What Evidence Do We Include? AAOHN Competencies AAOHN Standards of Occ Health NursingWhat Has Been Done Before? Sparse data r/t occ healthBest practices from other nursing specialtiesCommon theme: Benner’s Nursing TheoryCommon theme: Changing Healthcare EnvironmentHow Do We Make it Applicable to What We Do Everyday? Job Descriptions: Very specific content about role expectations. Unique to our healthcare industry. Team of experienced Employee Health Nurses to provide input
27. Organizing the Performance MeasuresNoviceCompetentProficientExpert-Limited experience and understanding of Occupational Health Nursing-Works closely with mentor to learn established protocols and procedures-Maintains safe nursing practice-Foundational knowledge of Occupational Health Nursing.-2+ years nursing experienceKnowledgeable in and works under the guidance of Employee Health policies, protocols, guidelines, and practice standards -Promote safe and competent practice -Professional association involvement-2+ years Employee Health Nursing experienceUnderstands role and scope in the organizational structure-Participates in ongoing Continuous Improvement activities of Employee Health program-Active in professional associations-Holds ABOHN certification (preferred)-5+ years Employee Health Nursing experience-Mentors colleagues and caregivers -Holds ABOHN certification (recommended)Competency CategoriesWorkplace Prevention, Assessment and Mitigation of HazardsAccurate Recordkeeping, Documentation, Data Management and CompliancePrevention and Control of the Transmission of Communicable DiseasesCase Management and Medical SurveillanceLeadership and Communication
28. Poll Question: How are you measured on what you do best?Through clearly defined program metricsThrough an annual performance evaluationThrough an employee health program dashboardThrough injury rates
29. Metrics and Measurement Tools
30. Measurement StrategyAnnual Self-Assessment of EH Performance Measures*Regular Check-In Performance Evaluation Biannual Program Review at Facility Level Regular Program MetricsCustomer Service*
31. Defining MetricsPerformance HR Evaluation ProcessPerformance MeasuresInjury DataRatesPost- Injury Cause AnalysisTimeliness and Accuracy of Case Management EH Visibility in the Organization (Rounding) Documentation of ADA AccommodationsCustomer ServiceImmunization ComplianceMedical Surveillance Tracking
32. Spring 2018 Self Assessment Data Results
33. Spring 2018
34. Lessons Learned and Opportunities for EH LeadersOrientation Tool for new EHNsMentoring ProgramTraining and Development Offerings
35. Customer ServiceNo standard measurement. Internal Research Team recommended another type of gap analysis to understand how our customers perceive Employee Health and the work we do. Performed and analyzed a qualitative survey. Provided results and recommendations.
36. Customer Service Gap Analysis ResultsKey Findings: Employee health is perceived as generally responsive, helpful, and supportive of current needs and requests2. Common recommendations for improvement include:Proactively leading and initiating changes to support board goal and zero harmSpending more time rounding in other departments
37. Customer Service MetricBased on your experience with Employee Health, how would you rate your Employee Health team members’…PoorFairGood Very GoodExcellentAvailability when you need themResponsiveness to your questions or requestsEfforts to keep you informed and updatedProactive efforts to help you and your team improve caregiver and patient safety and meet Zero Harm objectives. What, if anything, about your experience with Employee Health has been most positive? What opportunities, if any, do you see for Employee Health to improve the services they provide?
38. SummaryStrategies used to measure and evaluate Occupational Health Nurse competency Data-driven continuous improvement
39. Thank You