State of the Department of Nursing Address Spotlights Nurses’ Role in Care Redesign

Jackie Somerville presents at the State of the Department of Nursing address.

At the 2012 State of the Department of Nursing address, Jackie Somerville, PhD, RN, described nurses' opportunity to play a role in care redesign as the health care landscape continues to change.

"I believe this time of change in health care is a great opportunity for nursing," said Somerville, senior vice president of Patient Care Services and chief nursing officer. "Nursing is well positioned to bring our expertise to care redesign efforts, and it's our obligation to do so." 

Citing the recent Institute of Medicine report, "The Future of Nursing: Leading Change and Advancing Health," Somerville noted that nurses represent the largest sector of the health professions, with more than 3 million nurses in the U.S.  The report states that nurses can fill new and expanded roles in the health care system and must practice to the full extent of their education and training, assuming leadership roles in the new landscape. 

The report recommends that nurses should achieve higher levels of education and training and be full partners with physicians and other health professionals in redesigning care in the U.S. 

The unique perspective that nurses bring to the health care team is relationship-based care, Somerville said. "Any nurse who performs a task in the absence of caring is not practicing nursing - or at least not BWH nursing."

Somerville challenged all nurses to make sure their voices continue to be heard on the care team. "Our obligation is to be present at interdisciplinary rounds and family meetings consistently," she said.

To emphasize the role that nurses can play in affecting policy, practice, technology and care, Somerville invited the clinical nurse co-chair from each of the Department of Nursing committees to participate in a panel discussion. They were asked to give examples of how their committees have improved outcomes and/or the human experience for patients and their families and to share their committee experiences. They also answered questions from the audience.  

Somerville concluded that the holistic perspective of the patient as a person-including what is meaningful to them, ensuring a plan of care that is congruent and meaningful to the patient's way of being in the world and advancing self management-is one of the important contributions made by nurses. 

The following is an overview of the reflections shared by the clinical co-chairs, including challenges, rewards and lessons learned. 

Stephanie Capello, BSN, RN

Quality, Safety and Care
Improvement Committee 

"It's very empowering to come together with a group to identify opportunities for improvement in care that will advance patient outcomes. Some of the work we've done has focused on reducing falls and pressure ulcers and improving hand hygiene compliance. 

"It's about engaging unit staff to bring issues forward. The biggest thing I've learned is how important it is to work together to make changes that will benefit our patients. The biggest challenge? Sustaining the changes you make."

Stephanie Capello, BSN, RN 

Tower 14AB

Deb Moody, BSN, RN

Patient Education Committee

"I can remember years ago when changes were made, and nurses would say ‘Who thought of this?' because it didn't make sense with our workflow. Since the committees were formed, you don't hear that very often.  Now, nurses truly have a say in the changes that are being made. 

"One of the exciting developments on the patient education committee recently is that we added the family member of a patient to the committee. This will help us truly make patient education more patient- and family-centered."

Deb Moody, BSN, RN
Hematology/Oncology

Diane Miller, MPA/H, BSN, RN

Standards, Policies and Procedures Committee 

"I have felt empowered to make changes in policies so they reflect the excellent care we provide. We have been able to remove obstacles to providing care as well."

Diane Miller, MPA/H, BSN, RN
Thoracic Surgery ICU

Suzanne Fernandes, BSN, RN

Nursing Practice Committee 

"This committee focuses on the character and wisdom of nursing practice. We try to define the characteristics of what excellent care looks like at BWH and what needs to be in place for the practice to flourish. Continuity looks very different on each unit. 

"Participating on this committee has changed me in many ways. I feel more supported and more aware of my own practice and the difference I can make. I realize how important it is to get to know the patient on a personal level. Developing a trusting nurse-patient relationship is so important."

Suzanne Fernandes, BSN, RN

Intensive Care Unit Float Pool  

Gary Zina, BSN, CCRN

Informatics Committee 

"One of our goals is always to have nurses driving technology, not the other way around. One of the things I realized in participating in committee work is how incredibly supported this BWH nursing environment is. We have opportunities to make our voices heard, and our leaders truly support us."

Gary Zina, BSN, CCRN
Shapiro 9 East