Nurse-led initiatives in seven Boston-area hospitals measurably improved patient outcomes while demonstrating a combined fiscal impact of nearly $8 million in anticipated annual savings to the organizations.
Teams of staff nurses from each hospital developed the initiatives while participating in AACN Clinical Scene Investigator (CSI) Academy, a 16-month, hospital-based nurse leadership and innovation training program delivered and funded by the American Association of Critical-Care Nurses (AACN). The program empowers bedside nurses as clinician leaders and change agents whose initiatives generate quantifiable improvements in the quality of patient care and hospital bottom lines.
The Massachusetts AACN CSI Academy teams recently presented the results of their projects at an Innovation Conference in Boston, reporting noteworthy clinical and fiscal outcomes. These results and supporting materials are available online in the free AACN CSI Academy Innovation Database.
Among the teams’ clinical successes:
- Decreased the average length of stay in the intensive care unit (ICU) for ventilated patients by nearly eight days using an early mobility program
- Reduced incidence of pressure ulcers acquired while in the ICU by 50 percent
- Improved communication between units, leading to a 100 percent decrease in patient handoff incident reports
- Decreased the average number of mechanical ventilation days for ICU patients
- Improved assessment of ICU-related delirium in critical care patients, leading to improved cognitive scores and decreased benzodiazepine use in patients with documented delirium
Jeanette Ives Erickson, RN, DNP, FAAN, chief nurse and senior vice president for Patient Care, Massachusetts General Hospital, Boston, recognizes the potential long-term benefits of the program.
“In late 2012, AACN CSI Academy brought local nurses together to learn change management to improve clinical outcomes,” she said. “We are now well positioned to develop a program that sustains the gains made in the participating hospitals and to enlist new learners from other organizations.
“The CSI Academy initiatives also confirm the vital role nursing can and should have in the transformation of healthcare,” Erickson added.
In addition to Massachusetts General Hospital, other Massachusetts hospitals participating in AACN CSI Academy were:
- Baystate Medical Center, Springfield
- Beth Israel Deaconess Medical Center, Boston
- Brigham and Women’s Hospital, Boston
- Newton-Wellesley Hospital, Newton
- South Shore Hospital, South Weymouth
- Tufts Medical Center, Boston
Open sharing of clinical solutions and patient care innovations is a keystone of AACN CSI Academy’s broader mission to empower and inspire all acute and critical care nurses to lead change that benefits their patients and organization.
The AACN CSI Academy Innovation Database supports this mission by providing access to a compilation of CSI team results and documentation. This searchable database of real-world project plans, clinical interventions, data collection tools, outcomes and references will grow as additional CSI teams complete the program. Access the database from the AACN CSI Academy Web page at www.aacn.org/csi.
The Massachusetts nursing teams represent the third regional group to complete AACN CSI Academy, following Indiana and North Carolina. Groups continue at hospitals in New York, Pennsylvania and Texas, where participants are undertaking projects to address prevention of delirium, ventilator-associated pneumonia, catheter-associated urinary tract infections and pressure ulcers, and improved communication, teamwork and patient handoffs. In total, nursing teams from 42 hospitals will complete the program by the end of 2014.
As the only nursing excellence and leadership skill-building program that provides hospitals with both educational programming and grant funds to support project implementation, AACN CSI Academy represents a substantial investment of AACN’s expertise and money in nursing practice innovation — about $1.25 million during the program’s three-year first phase. The program reflects AACN’s high-level strategic response to the Institute of Medicine’s landmark “Future of Nursing” report.