Nurses work in a world of broken systems, wasted time and energy, which can be incredibly frustrating and detrimental to patient care. Most national studies show that nurses spend as little as 30 percent of their day engaged in direct patient care activities, and this can contribute to poor patient outcomes in terms of infections and other complications, poor patient and nurse satisfaction and poor quality of care overall. Nurses at hospitals in Maryland and North Carolina decided to do something about this problem, and worked with VHA Inc., the national health care network, to develop work processes that are more patient-centric and create a more efficient work environment.
"This program is a success because the front-line staff nurses, nursing leaders and chief nursing officers at these organizations are inspired to make a difference for their patients, and they've worked to move workflow back to the bedside and broken down barriers that have naturally developed through the years that have taken nurses away from direct patient care," said Crystal Mullis, RN, BSN, MBA, MHA, director of performance improvement for VHA's regional office in Charlotte.
The collaboration project, called Return to Care, began in September 2009 and is ongoing. As a result, several of the hospitals have increased the amount of time nurses spend engaged in direct patient care. One hospital increased nursing time at the bedside by two hours per nurse per 12-hour shift, and many are seeing improved patient satisfaction scores.