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 redesignation 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 healthcare team and community leaders. They frequently commented that nurses should publish our work to share best practices with other facilities across the nation. The positive energy was palpable, and Colleague engagement across the continuum led to a highly successful site visit.
Appraiser feedback validated the exceptional nursing practice and inter-professional collaboration as we provide excellent care for our patients, families and community. The report to the Commission on Magnet led to a unanimous vote to redesignate Goshen Hospital as a Magnet facility.
In addition, six areas were highlighted as exemplars where we exceeded the Magnet standards of excellence:
We Honor Veterans level 3 rating
- 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 were 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.
Goshen Health’s dedicated hospice nursing team reached the 3-star rating in 2018 as part of the We Honor Veterans program. We Honor Veterans improves the ability to recognize the unique needs of armed services veterans and their families and provide exceptional end-of-life care. Hospice nurses engage members of local veterans’ organizations and patients to better understand the care needs and concerns.
Veterans may experience life’s transitions differently due to past military service. They may need to connect with other veterans, especially near the end of life, to reflect on life experiences. Feedback from veterans encouraged hospice nurses to create a program where, if desired, veterans receiving hospice services
may receive visits or phone calls from other veterans in the community to provide a listening ear and interaction with a former comrade-in-arms.
At the suggestion of other veterans, hospice nurses also created ceremonies for veteran hospice patients, recognizing them for their service. Seeing the patients rally, helping the patient get dressed or be up in a wheelchair or standing with their cap and saluting during the recognition ceremony are proud moments for family, friends, other veterans and the veteran hospice patient. When the veteran’s journey ends, the hospice nurses recognize the veteran one more time, draping them with the American flag.
The Intensive Care Unit (ICU) at Goshen Hospital received its third Beacon Award for Critical Care Excellence in 2016; the unit received gold ratings in 2013 and 2016. Given by the American Association of Critical Care Nurses, the award affirms that Goshen Hospital critical care nurses provide exceptional care.
2018 Vision award
Vision First Eye Bank recognized Goshen Hospital with the 2018 Vision Award. Nursing staff coordinated efforts with Vision First representatives to support cornea donation. Their exceptional care for the 18 donors and their family members during a very difficult time resulted in renewed sight for 36 people.
Midwest vascular collaborative
Goshen Heart & Vascular Center was recognized in 2018 as a leader in long-term follow-up care of vascular patients. With a score of 99 percent, the center ranked second among hospitals in Indiana, Ohio and Kentucky that participate in the Midwest Vascular Collaborative. Nursing oversight of patients with vascular disease is critical to success. Kathy Maddox, RN, works closely with cardiologists, surgeons, radiologists and patients to ensure high quality, error-free 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 Circle of Caring 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 redesignation in 2015.
Platinum Performance Achievement Award
Goshen Hospital received the Platinum Performance Achievement Award for the seventh time in 2018. This award by the American College of Cardiology and the American Heart Association 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.
American College of Radiology accreditation
The Center for Cancer Care achieved American College of Radiology (ACR) Accreditation in 2018. This three-year accreditation recognizes high quality radiation oncology practices. Nursing certification rates and experience are important components of achieving ACR accreditation. Nurses in Goshen 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 reaccreditation in 2015.
Center of Distinction award
Goshen Wound Center received the Center of Distinction Award from Healogics, a network of wound care centers certified by The Joint Commission. The award recognizes achievements for outstanding clinical outcomes. Patient satisfaction rates at the Wound Center were higher than 92 percent, and wound healing rates were at least 91 percent in less than 31 median days.
American Board of Perianesthesia Nursing Certification (ABPNC) Achievement award
The Post-Anesthesia Care Unit received the prestigious ABPNC Certification Achievement award in 2018. The award recognizes that 75 percent or more of eligible perianesthesia nurses in the department have achieved CPAN® or CAPA® certification.
Beth Jones, Larry Allen and Juliet Leamon
Juliet Leamon, BSN, RN, NE-BC, Director of Oncology, and Beth Jones, BSN, RN, OCN, Oncology Clinical Nurse, are known for their compassion and for exceeding Colleague and patient expectations. Going beyond standard of care, they planned a wedding for a patient in the final stages of cancer. When the patient was discharged and admitted to a Fort Wayne facility the day before the ceremony, Juliet moved the wedding site and arranged for the pastor to go to the new facility. Juliet and Beth took the cake, decorations, flowers and wedding favors to Fort Wayne after work to make the patient’s wishes come true.
Heparin Protocol DIG
Pat Schneider, Falon Kuhn, Wanda Bontrager, Abby Kamp,
Angel Keene, Anika Wedel, Heidi Stoffel with Dr. Dan Nafziger
An interprofessional group of pharmacists and nurses updated the protocol for heparin, a high-alert medication that can cause serious patient harm. Nurses had manually managed the process in the past. Following the Do It Group (DIG), the pharmacists manage the heparin protocol. Automation was built into the new process for ordering, administering and monitoring this drug. The new protocol resulted in no medication errors in the first two months following the change. This DIG group also discovered other opportunities for improvement moving forward.
Quantitative Blood Loss DIG
Dawn Tadeo, Jennifer Knisley, Kristi Miller, Amy Garoutte, Kelly Simpson,
Dianne Hogan, and Dr. Ellen Cuddeback with Dr. Dan Nafziger. Not pictured: Jodi Hughes
Nurses took the newest recommendations for quantified blood loss during a vaginal delivery and changed the practice for Circle of Caring Birthplace. More accurate blood loss documentation allows quicker recognition of postpartum hemorrhage and more timely treatment. The practice change allows mothers to recover more quickly without the chain of events that can occur if postpartum hemorrhage goes undetected. Circle of Caring Birthplace is providing safer postpartum care to women due to the changes this group implemented.
Patient Education DIG
Wendy Meller, Marlene Marks, Angie Garber, Josi DeHaven, Krista Yoder, Wanda Bontrager with Julie Crossley.
Not pictured: Brittany Baer, Tracy Carlstrom, Jason Clay, Beverly Karpinski, Peggy Lechlitner and Allison Pinion
Patient satisfaction scores revealed that patients did not feel prepared for discharge. In response to this data, nurses across the organization came together to address gaps in the transition from inpatient to outpatient. They developed patient education methods focused on medications, follow-up appointments and action plans (MAAP It Out©) to help patients more effectively manage their care after discharge. To roll out new education to nurses, the team used a voice-over PowerPoint presentation and video that highlighted the patient experience. The team worked hard to ensure sustainability of the new MAAP It Out model in the hospital and throughout the system.
Commitment to education
Julie Crossley with Katrina Peters
Katrina Peters, MSN, RN, RN-BC, Professional Development Specialist, won the Commitment to Education award for her role in providing education and support for nursing students and newly licensed nurses. Katrina facilitated the Patient Care Extern (PCE) Program for several years. This program provides an educational experience for nursing students who completed their junior year of a Bachelor of Science in Nursing program. Many of the PCEs return to Goshen Health as newly licensed nurses following graduation.
Katrina also spearheaded the launch of the RN Residency Program for newly licensed nurses. She brought together a multidisciplinary group to create an engaging curriculum for the residency program. The support has helped first-year nurses more effectively transition into their new roles, which greatly impacts patients and other Colleagues. Katrina’s perseverance to make the program effective has raised the level of excellence in nursing care.
The Uncommon Leader (TUL) Ambassador award
Heidi Stoffel with Rob Myers
Heidi Stoffel, BSN, RN, OCN, 2 North Clinical Nurse, leads the core team building the Meditech Patient Care System (PCS) and chairs the Informatics and Electronic Documentation Committee. She works closely with the Clinical Advisory Board and Professional Practice Council to ensure the Meditech Expanse platform meets the needs of end-users. Colleagues recognize Heidi as a well-organized leader who bridges the gap between administration and staff nurses. She is an exemplary Colleague who embraces the TUL culture and is a mentor and role model for Colleagues.
Highest TUL Points
Anika Wedel with Susan Franger
Anika Wedel, MSN, RN, OCN, 2 North Clinical Practice Specialist, is eager to teach, encourage and lead others in honing their clinical skills. She is a wealth of knowledge and leaves no stone unturned when Colleagues ask questions. Anika is quick to research resources to help guide next steps. Her efforts have led to improved patient experiences and empowered Colleagues.
Colleagues generated over 29,000 points from JDIs, DIGs and projects. Anika earned 147 TUL points, the highest in 2018.
Randy Christophel, Goshen Health president and CEO presented Julie Crossley and Erica Prough
the President’s Award for their work on helping Goshen Health achieve Magnet designation.
Randy Christophel, President and CEO, selected Chief Nursing Officer Julie Crossley and Erica Prough, Director of Education and Professional Practice, as the 2018 President’s Award recipients. Julie and Erica worked closely together to lead the nursing team in the Magnet reaccreditation process. Nurses across the organization pulled together and transformed the nursing practice environment, leading to improved patient outcomes. The culmination of the team’s efforts occurred in January 2019 when our organization achieved its fourth Magnet designation. This puts Goshen Hospital in an elite group of approximately 59 organizations worldwide that have achieved this designation for a fourth time.
Brandie Yoder, MPH, BSN, RN, and Erica Prough, MSN, RN, RN-BC, NEA-BC, “Redesigning Governance: Engaging Nurses and Impacting Outcomes,” Poster Presentation, October 2018, Magnet Conference, Denver, Colorado.
Josi DeHaven, MPH, BSN, RN, CCM, and Deb Sweetser, BSN, RN, CCM, “Innovative COPD Program Reduces Barriers to Engagement,” Podium Presentation, October 2018, Magnet Conference, Denver, Colorado.
Josi DeHaven, MPH, BSN, RN, CCM, “Telehealth: Applications for Case Management,” Panel Discussion, November 2018, Case Management Conference, Michigan State University, East Lansing, Michigan.
Josi DeHaven, MPH, BSN, RN, CCM; Brandie Yoder, MPH, BSN, RN, CCM; Jessica Gotwals, MPH, BSN, RN, CCM; and Larry Allen, MD, “Building a Better Bridge: Transforming Health Systems to Coordinate Care,” Poster Presentation, March 2018, ACHI National Conference, Atlanta, Georgia.
Falon Kuhn, BSN, RN, RN-BC, “Inpatient Early Progressive Mobility Project,” June 2018, Indiana Hospital Association Patient Safety Summit, Indianapolis, Indiana.
Sherry Robbins, BSN, RN, CIC, “CAUTI Reduction,” June 2018, Indiana Hospital Association Patient Safety Summit, Indianapolis, Indiana.
Julie Crossley, MSN, MBA, RN, NEA-BC, “The Nursing Professional Practice Environment,” March 2018, senior nursing students, Bethel College, Mishawaka, Indiana.
Julie Crossley, MSN, MBA, RN, NEA-BC, “The Nursing Professional Practice Environment,” October 2018, senior nursing students, Indiana University South Bend, South Bend, Indiana.
Erica Prough, MSN, RN, RN-BC, NEA-BC, “Nursing Excellence: Using Quality Data to Improve Outcomes,” January and March 2018, senior nursing students, Goshen College, Goshen, Indiana.