TEAM LEADERNeurological Rehabilitation

Clinical Leadership

Clinical outcomes for patients, professional satisfaction, and hospital performance all benefit from effective clinical leadership”

(Mountford et al, 2009)

Overview

To review the gaps in nursing service provision

To identify opportunities for improvement in coordination of services, nursing care , patient satisfaction, team communication and hospital performance

Team Leader

The purpose of this presentation is to highlight the merit of a new and innovative clinical nursing ‘Team Leader’ position on the Neurological Rehabilitation Unit at West Park Healthcare Centre.

Nurse Manager

Daily Operational function Orientation of new staff/students Administrative duties Coordination of Nursing on the floor Supervisory role

Needs Assessment

Communication Issues Rounds Case Management/Coordinated

Approach Review of Referrals Program Evaluation

Strategic Planning

Patient Care/Coordination

Team Function

Performance Indicators

Program Planning/Resource Management

Team Leader

An evolution of the nurse ‘manager’ shifting focus to leadership vs.

management

Hybrid of a ‘service leader’ and a ‘frontline leader’

Team Leader

To ensure the provision of coordinated and consistently high quality patient

care, maintain organizational and professional standards, facilitate

growth and development of the staff and the program, and to liaise with our internal and external partners

Performance Indicators

Functional Independence Measure (FIM)

Occupancy level on the unit Length of Stay Therapy provision (amount and type) Alternate Level of Care (ALC) beds ‘Response Time’ ‘Wait Time’ Start of therapy post-stroke (# of

days)

Response Time

The date the referral was sent to the receiving facility to the date of first response (accept, deny, re-direct, send back)

Current: 1.9 days

Goal: 1.6 days

Functional Independence Measures Score (FIM)

FIM is an outcome measure, validated and reliable in the stroke and ABI

population that measures functional independence and burden of care.

Current Mean Change: 19.7

Goal Mean Change: 21.5

Length of Stay

The amount of time (in days) a patient stays in hospital

Current: 33.83 days

Goal: 31 days

Occupancy

The number of hospital beds occupied by patients expressed as a percentage of the total beds available

Current: 84.49%

Goal: 90.06%

Alternate Level of Care (ALC) Beds

When a patient occupies a bed in a hospital that does not require the intensity of resources/services provided in that particular care setting

2010/11 fiscal year (to date): 5

Goal: 0

Stakeholders

Patient Acute Care referral sources Ministry of Health and Toronto

Central LHIN

Budget

One extra RN on day shift (7am-3pm), Monday to Friday

Minimum 5 years experience on the Neurological Service

$37.00/hour or $72,150 per year In-charge premium $1.70/hour or

$3123.75 per year Total expense: $75, 273.75 per year

Funding

First Year: Hospital funding – full cost

Second Year: Anticipated savings in 0ne-to-one care

and other costs associated with more ‘appropriate’ patients.

2010-2011 cost of one-to-one care alone was $47,000

Alternate source of funding

Toronto Central LHIN - HSIP program

Health System Improvement Pre-Proposal

Allows health service providers to articulate a request for funding – typically one-time only funding – in order to implement a new health service that the organization has not previously provided, or to improve efficiencies

and reduce barriers to care

Alternative

Absorb the position internally within the normal day shift nursing complement

The ‘In-Charge’ nurse for the day has partial responsibilities of a ‘Team Leader’

Backfill 4hours on day shift with an RPN to allow time and opportunity for the In-

Charge nurse to perform her ‘Team Leader’ duties (total cost per year: $26,460)

Challenges

Funding HR/Union/Administrative process Everybody will want it, so no one

gets it No template, no competitors have a

similar position

Leadership

Our business in life is not to get ahead of others, but to get

ahead of ourselves

E. Joseph Cossman

Opportunities

Pilot Project, evaluate, publish or present

Leaders in Best Practices in Stroke Care

‘Stroke Services Distinction Program’ -Accreditation Canada

Hospital-Wide Initiative

Leadership opportunity, career growth, job satisfaction, retention

Leadership

Innovation distinguishes

between a leader and a follower

Steve Jobs

Questions

http://www.youtube.com/watch?v=a0sGDjcFiok&feature=related