Fourth Magnet® Designation – Three nurse appraisers from the American Nurses Credentialing Center’s (ANCC) Magnet Recognition Program® visited Goshen Hospital in November 2018 as part of the Magnet re-designation process. Appraisers were on-site to verify, clarify and amplify the examples of professional practice highlighted in our Magnet document.
Appraisers interviewed nurses, patients, members of the health care team and community leaders. They frequently commented that nurses should publish our work to share best practice with other facilities across the nation. The positive energy was palpable, and Colleague engagement across the continuum lead to a highly successful site visit.
Appraiser feedback validated the exceptional nursing practice and inter-professional collaboration utilized to provide excellent care for our patients, families and community. The report to the Commission on Magnet led to a unanimous vote to re-designate Goshen Hospital as a Magnet facility. In addition, six areas were highlighted as exemplars where we exceeded the Magnet standards of excellence:
- Nurse Satisfaction outperformed in all seven categories.
- Hospice initiative with the national We Honor Veterans program achieved Partner Level 3.
- MAAP It Out© patient education model and LACE Index Scoring tool developed.
- Do It Group (DIG) improved the Heparin Protocol.
- Exclusive Breastmilk Feeding Rate outperformed the national mean for eight consecutive quarters.
- Goshen Hospice data for Core Measure Bowel regimen for patients receiving opioids outperformed the mean for eight consecutive quarters.
American College of Radiology (ACR) Accreditation – The Center for Cancer Care achieved American College of Radiology (ACR) Accreditation in 2021. This three-year accreditation recognizes high quality radiation oncology practices. Nursing certification rates and experience are important components of achieving ACR accreditation. Nurses in the Center for Cancer Care are key to the radiation oncology mortality and morbidity program, which is a standard for accreditation. The Center for Cancer Care first received ACR accreditation in 2012 and received re-accreditation in 2015, 2018 and 2021.
ANCC Contact Hour Accreditation – Goshen Hospital has been accredited as a provider of continuing nursing professional development by the American Nurses Credentialing Center (ANCC) since 2005. Accreditation assures that the ANCC standards are followed in the planning, implementation, and evaluation of education for which contact hours are given. Nurses at Goshen benefit from the high-quality contact hour offerings provided and can earn contact hours at no cost.
Award of Excellence in Endoscopy- Perioperative services has been recognized with the Award of Excellence in Endoscopy since 2018. This award from the American Society for Gastrointestinal Endoscopy (ASGE) recognizes dedication to quality in endoscopy and promotion of high-quality patient care.
Baby-Friendly Hospital Designation – Goshen Hospital continues to hold a five-year designation as a Baby-Friendly Hospital, due to ongoing efforts by nurses in The Birthplace. The Baby-Friendly initiative is sponsored by the World Health Organization and the United Nation Children’s Fund. In 2010, Goshen was the first hospital in northern Indiana to receive the Baby-Friendly designation. The hospital successfully earned re-designation in 2015 and 2020.
Beacon Award – The Intensive Care Unit at Goshen Hospital received its fourth Beacon Award for Critical Care Excellence in 2019; the unit received gold ratings in 2013, 2016 and 2019. Given by the American Association of Critical Care Nurses, the award affirms that Goshen Hospital critical care nurses provide exceptional care.
Diagnostic Imaging Center of Excellence (DICOE) for Breast MRI, Breast Biopsy, Nuclear Medicine, Ultrasound, Vascular, CT, MRI, and PET – Goshen Hospital was recognized as a center of excellence in 2015, 2018 and again in 2021. This award recognizes delivering the highest levels of imaging quality, safety, and care by surpassing standard accreditation requirements from The American College of Radiology.
Go Clear Award Gold Level – Awarded by the Association of Perioperative Registered Nurses (AORN), this three-year designation was awarded to Goshen Hospital in 2019 for their commitment to a surgical smoke-free environment. Elimination of surgical smoke improves safety for both patients and the perioperative team.
Indiana Perinatal Levels of Care Designation – The Indiana Perinatal Levels of Care designation went into effect in September 2019. It requires all hospitals that offer obstetric and neonatal care to be certified as a Level 1, Level 2, Level 3, or Level 4 based on the services they offer. In September 2021, The Birthplace at Goshen Hospital achieved designation as an Obstetric Level of Care 1 and Neonatal Level of Care 1. The Indiana State Department of Health recognizes the positive impact multidisciplinary education has on the safe care of perinatal patients, which played a vital role in this designation.
INspire Hospital of Distinction – The Birthplace received the INspire Hospital of Distinction award in both 2020 and 2021. This award was developed to encourage Indiana hospitals to implement best practices in the care of mothers and babies. The award recognizes hospitals based on six key areas including infant safe sleep, breastfeeding, tobacco prevention and cessation, perinatal substance abuse, obstetric hemorrhage, and maternal hypertension.
Platinum Performance Achievement Award – Goshen Hospital received the Platinum Performance Achievement Award for the tenth time in 2021. This award by the American College of Cardiology recognizes exceptional treatment and outcomes for emergency heart attack patients. Nursing ensures that each patient receives guideline therapies as indicated across the continuum of care, from the Emergency Room and ICU/PCU through cardiac catheterization to cardiac rehabilitation.
We Honor Veterans Level 4 Rating – Goshen Health’s dedicated hospice nursing team reached the highest possible 4-star rating as part of the We Honor Veterans program in 2020. We Honor Veterans improves the ability to provide exceptional end-of-life care and recognize the unique needs of armed services veterans and their families. Hospice nurses engage members of local veterans’ organizations and patients to better understand the care needs and concerns.
MACademy Awards 2020
Jenni VanFleet, Childbirth Education Coordinator, implemented YoMingo as an educational tool for prenatal and postnatal education and was presented a MACademy Award in 2020. Childbirth education used to be offered only in-person. Jenni took it upon herself to explore the YoMingo program to expand options for families looking for childbirth education information. Jenni worked extensively on exploring the right program that would be a good fit for our community members. This program has the option to be utilized on its own or in conjunction with the live class. Jenni trialed the product with families. She provided education to OB colleagues about using the program and explained the resources available to our patients when they are discharged. Utilizing this program has positively impacted our patients. Before YoMingo, only 13.2% of patients that delivered at Goshen utilized a childbirth education component. After the implementation we have increased that number to 18.4% of deliveries in 2019.
Hilary Arroyo, RN, Callie Anglemyer, RN, Hannah Stutzman, RN, Brittany Baer and Dr. Bruce Hughes won a 2020 MACademy for their commitment to Patient Safety using simulations. Simulations provide the opportunity to learn new skills, improve existing processes and increase interprofessional communication in a safe environment. This team enhanced the simulation experience for clinical Colleagues by moving the simulation mannequin from the sim room to an actual patient room for a code blue simulation. By doing this, they provided a more realistic environment and were able to identify strengths and opportunities for improvement in this high risk/ low volume procedure. The work of this team positively impacted the clinical colleagues who respond when a code blue is called. They were able to identify better ways to proactively communicate during the code, improving teamwork and ultimately the quality of care for the patient and family.
MACademy Awards 2021
Marla Geigley, RN Case Manager, Hospice, was recognized for her exceptional work with a MACademy Award in 2021. Marla went beyond the call of nursing during the pandemic. A COVID positive patient was in ICU for over a month. The patient was vented for much of her stay and had three children in their late teens to early 20s. It was an incredibly hard decision for the patient’s children to make the decision to terminally wean from the ventilator. When the patient was extubated, Marla spent a lot of time caring for the family. Marla was with them, comforting them and helping them say goodbye… on her scheduled day off. The family decided the day before to extubate but waited until the whole family could be there. Marla came in to help them through the process, off the clock and on her day off.
Denise Gould, RN, Hospice Care, accepted a MACademy Award in 2021 for using her medical knowledge and skills to comfort those who are dying, but she also performs significant acts of kindness for the patients and families. According to a patient’s family member: My mother-in-law has mild dementia and was confused when she went to visit my father-in-law while he was in hospice, because he was unshaven. Denise took the time to shave him. Then my mother-in-law could sit by his bedside in the last 24 hours of his life and know this was her husband. Their children and grandchildren found comfort in knowing that this married couple of 61 years had this special time together, even though they couldn’t be there due to the visitor restrictions… Colleagues have witnessed Denise doing these “small things” for other patients and families that help ease the challenges of end of life.
Renee Miller, RN Nursing Manager, Med/Surg West, won a 2021 MACademy Award for living the value of Respect. Her nomination reads: My husband was hospitalized for 6 days with COVID. When I asked Renee if she had any ideas of how we could show our thanks, she turned the conversation back to my husband and me. She remembered him and asked how he was doing. She told me about changes they had made… She asked if we had any suggestions that could improve someone else’s care… She spent several minutes talking to me during an extremely busy patient load. She was kind and gracious. When I asked again how we could thank the nursing staff, she told me it wasn’t necessary, they were just grateful my husband had a positive outcome. Renee demonstrated the compassion and respect that I believe all Colleagues should emulate.
Kathy Yoder, RN Clinical Resource Unit, was awarded a MACademy for her compassion and the exceptional care she provides. Kathy was taking care of a patient with COVID. The patient was a Notre Dame football fan. He kept telling her all he wanted to do was eat pizza and watch the game coming up that weekend. The patient was surprised and grateful when Kathy showed up that weekend, on her day off, and brought the patient a pizza. Because the patient had COVID, he wasn’t allowed visitors. This act of kindness made him feel special. Kathy truly embodies what Goshen Health is all about. She is selfless and has the best interest of the patient in mind all the time.
Kelly Finnigan, Eloiza Flores and Cecily Valdez, RNs in the Center for Cancer Care, won a MACademy award in 2021 for their exceptional customer service. Their nomination reads: A patient was seen in the Emergency Department due to an auto accident on the Friday beginning Labor Day weekend. A CT was ordered and a mass in his chest was identified. The patient was very anxious after hearing this news. With it being a holiday weekend, Goshen Center for Cancer Care would not be open until Tuesday. Instead of making the patient wait, I contacted Kelly Finnigan, Nursing Director of the cancer center. With her help and the help of Cecily and Eloiza, the patient was seen over the holiday weekend! The way these Colleagues didn’t hesitate when asked exemplifies exceptional customer service.
Avoidable and Unavoidable ER Utilization by Patients on Systemic Therapy
This team of Colleagues including Josi DeHaven, RN, Kacy Davis, RN, Rhonda Griffin, RN, Dr. David Coil, Dr. Leonard Henry, Dr. Bruce Hughes, Dr Ebenezer Kio, Dr. Chris Owens and Sheila Kelty received a 2021 MACademy Award for their work reducing avoidable ED visits for patients on systemic therapy. When they started their project, Goshen Center for Cancer Care was at a 20 percent avoidable ED visit rate. This group scrubbed the data and came up with a matrix to reduce avoidable ED visits down to 5 percent. Their work was so outstanding, it was published in 2021 in the official journal of the Association of Community Cancer Centers: Oncology Issues.
The COVID Safety Team including nurses Allison Pinion, Ashley Claeys, Kim Senders, Joan Hunt, Heather Sloan and Josi DeHaven were awarded a MACademy in 2021 for their work providing education to Colleagues in the ever-changing environment during the beginning of the pandemic. They were passionate about keeping Colleagues safe and helping educate about proper PPE usage, including donning and doffing. The Safety Team also conducted audits to track compliance while providing just-in-time training and education. These Colleagues were fit testers and helped get many Colleagues properly fitted with an N95. While it was not an easy job, it was very rewarding.
The ED Surge Team included Angel Keene, RN, Abby Kamp, RN, Celia Impey-Delagrange, RN, Carrie Stump, RN, and Kamrin Medford. In the spring of 2020, this team crafted a plan to transition the ambulance bay into a patient care area by using mobile dividers and extra equipment to create exam spaces. The team’s effort allowed Goshen Hospital to be prepared and ready to handle the COVID surge. This team worked together to make sure what was once a garage was converted into a suitable space to provide the high level of patient care and won a MACademy Award in 2021 recognizing their exceptional work.
Auto-Infuser Medication Ball Charges Group including nurses Cindy Dailey, Kayla Borg, Catherine Evans, Polyanna Beasley and Pharmacist Dave Rippey won a 2021 MACademy for their work. This group identified inconsistent charging for the auto-infuser medication ball. This medication charge is a complicated process due to the many different departments involved in ordering, administering, charging and restocking. The group came together and broke down the barriers of the various departments who were involved in each step of the administration of the medicine ball. After MUCH data was collected and analyzed, they were able to streamline this process to generate almost $300,000 of revenue in a 12-month period.
The Safety Huddle DIG was formed by nurses in The Birthplace, including Amy Garoutte, Kristi Miller, Cindy Soto, and Danae Bell together with nursing assistants Linda Gordon and Abby Balke. The DIG group won a 2021 MACademy for developing a process to ensure safety concerns for each patient were addressed and discussed among the patient’s care team at daily shift huddles. Patients and their families have benefited from this cohesive team communication since all Colleagues on the care team are alerted each shift to any ongoing safety concerns. The group meets prior to each shift. By utilizing the report board, they are quickly able to run down the list of patients and identify safety concerns such as fall risks, social issues, hemorrhage risk and language barriers. The huddle also addresses potential discharges and care coordination issues that relate to each patient.
The COVID Reporting Team included nurses Sherry Robbins, Emily Grooms, Wil Beachy and Kathy Vanklaveren in addition to Frank Caprino, Jon Yoder, Ron Haskins and Seth Geiser won a 2021 MACademy. This team worked very well together, adapting to almost daily requests for new data and refinements to existing data. The group had to quickly learn new software and rapidly align reporting across multiple platforms. Many members were working seven days a week for months to assure the reporting was complete and accurate for our leaders to have ready at the beginning of the day. There were numerous changes with the regulations that had to be accommodated. The data collected around COVID testing helped keep our Colleagues aware of what was happening in the community. This team leveraged the strengths of their members to make “data-miracles” happen.
Rebecca Alexander -Labroi, MSA, BSN, RN, BSed, NE-BC, Using technology to improve work-life balance and enhance the patient experience. April 2021, Hospice News National Webinar Panelist
Deborah R. Gillum, PhD, MSN, RN, CNE, The Perceptions and Experiences of Newly Licensed Registered Nurses During a Pandemic. November 1, 2021, Online Indiana Nursing Summit
- Jared Berkey, BSN, RN, and Peggy Rupp Wysong, MSN, RN, CCRN-K, Compassion Satisfaction, Burnout, and Secondary Traumatic Stress in Nurses in a Small Community Hospital During COVID-19. November 8, 2021, senior nursing students, Goshen College, Goshen Indiana
- Julie Crossley, MSN, MBA, RN, NEA-BC, The Nursing Professional Practice Environment. March 30, 2021, senior nursing students, Bethel University, Mishawaka, Indiana.
Julie Crossley, MSN, MBA, RN, NEA-BC, The Nursing Professional Practice Environment. March 16, October 26, and November 15, 2021, senior nursing students, Indiana University South Bend, South Bend, Indiana.
- Julie Crossley, MSN, MBA, RN, NEA-BC, The Nursing Professional Practice Environment. April 29, 2021, senior nursing students, Goshen College, Goshen, Indiana.
Julie Crossley, MSN, MBA, RN, NEA-BC, The Nursing Professional Practice Environment. April 7 & 8, 2021, senior nursing students, IVY Tech South Bend -Elkhart, Elkhart, Indiana.
Henry, L., Deardorff, S., Li, J., Griffin, R., Davis, K., Coil, D., Kelty, S., & von Holzen, U. (2021). Avoidable and unavoidable emergency room utilization by cancer patients on systemic therapy. Oncology Issues, 36(1) pp 42.