ANNUAL NURSING REPORT 2015N U R S I N G N E V E R S T O P S . All day, all night, all year, nurses look after our patients, keeping them safe and providing top quality care with compassion and concern to contribute to healing. Help us honor the care that

never quits during National Nurses Week, May 6 through 12.

Bozeman Health: RE ady.

406-414-5000 | bozemanhealth.org

HONORING OUR NURSES dURING NaT IONal NURSES wEEk

bozemanhealth.org

Letter from the Chief Nursing Officer 1

Who We Are 2 Philosophy Practice Model

Demographic Information 3

Transformational Leadership 5 Strategic Plan 2014-2016 EPIC Abstraction Clinical Informatics Operations Team (CIOps) Super Users/Trainers MyChart for Patients

Structural Empowerment 8 Clinical Ladder Mentorship Continuing Educational Offerings DAISY Awards

Exemplary Professional Practice 12 Shared Governance Council Members Community Impact International Outreach Reducing C-Section Rates Supporting Mothers in the Valley Interdisciplinary Collaboration to Fulfill the Mission of Bozeman Health

New Knowledge, Innovation and Improvements 18 Research Projects Nurse Led Research Projects Research Mentorship and Partnership with Montana State University Evidence Based Practice

TABLE OF CONTENTS

1

915 Highland Boulevard | Bozeman, MT 59715 | 406-414-5000 |

bozemanhealth.org

I am pleased to present you with our 2015 Nursing Annual Report. In

the following pages

you will find evidence of the impact Bozeman Health nurses make e

very day.

2015 has been a year of significant change for Bozeman Health. 201

5 brought a change

in organizational leadership, opening of the Big Sky Medical Center

and implementation

of a new electronic health recordEPIC. I have marveled at the flexib

ility and resilience of

the nursing staff despite these substantial transformations, and the c

onsistent delivery of

compassionate, patient-centered care that has been provided in ever

y venue.

Change is defined as the act of making something different. It seem

s that the one

surety in healthcare is change. The challenge in an ever-changing he

althcare environment

is to be able to maintain excellence and stay true to our Core Values

: Service, People,

Integrity, Respect, Improvement and Teamwork. I honor each nurse

at Bozeman

Health for taking the lead in ensuring the delivery of a consistent, pe

rson-centered,

compassionate, high quality, safe experience to every patient and th

eir family.

As we move into 2016, our goal is to become a Pathway to Excellen

ce hospital, where

our efforts will focus on ensuring that our nurses are able to practice

in an environment

where they feel satisfied, fulfilled and supported. In this environment

, change can occur

but our commitment to excellence and values remains steadfast.

I am honored to serve as a nursing colleague with the finest group o

f nurses I have ever

been privileged to know. The profound difference that each of you m

ake in the lives of

our patients and families on a daily basis is amazing. The following r

eport is a tribute to

the talent, spirit and commitment of the nurses at Bozeman Health.

Please enjoy the year

in review and accept my heartfelt appreciation of each one of you

and the work you do

each day.

Sincerely,

Vickie Groeneweg, MSN, RN, MBA

Chief Nursing Officer

LETTER FROM THE CHIEF NURSING OFFICER

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WHO WE ARE

Philosophy

Nursing at Bozeman Health is practiced through patient-centered caring relationships, using clinical judgment and advocacy in the care of individuals, families, communities and populations to promote, improve, maintain, or recover health; and to achieve the best possible quality of life, whatever the disease or disability, from the beginning of life through a dignified death.

Practice Model

Our nursing practice model is the overarching framework for nurses and nursing practice at Bozeman Health. It is a detailed depiction of how nurses practice, collaborate, communicate and develop professionally. It unifies our identity as nurses and provides a description of the theories from which to base practices and performance.

3

In 2015, Bozeman Health Deaconess Hospital employed 1891 people. Of those, 552 were nurses, comprising 29% of total employees.

BDHS Nurses in 2015

Licensed Practical Nurses 15

Registered NursesDirect-Patient-Care 460

Registered NursesNon-Direct-Patient-Care 55

Advanced Practice Nurses 22

Total Nurses 552

DEMOGRAPHIC INFORMATION

4

DEMOGRAPHIC INFORMATION

Specialty Nursing Certifications2015

5

TRANSFORMATIONAL LEADERSHIP

Strategic Plan 2014-2016

Our strategic plan was developed to help align nurses with the mission, vision and values of BHDH. It uses the Magnet Recognition Program as a framework for how we plan to build and achieve an environment that fosters excellence in nursing practice to promote optimal community health and quality of life.

MAGNET COMPONENT

GOAL STRATEGY

Transformational Leadership

Develop strong risk-taking leaders who model and articulate nursing excellence in day-to-day operations

All Nurse Managers achieve National Certification.

Establish Nursing Manager Core Competencies based on ANAs Scope and Standards for Nurse Administrators.

All Nursing Leaders involved in National Professional Organizations.

Establish Tuition Reimbursement program.

Develop and implement Nursing Leader Academy.

All Nursing Leaders will have a succession plan.

CNO will participate in credentialing of all APRNs.

ANAs Scope and Standards of Nurse Administrators implemented as basis for job description and evaluation.

Create a structural and operational relationship to the CNO in all areas in which nursing is practiced.

Structural Empowerment

Create a structural framework for the development, implementation and sustainability of patient care excellence

Establish RN-Physician Council to develop and sustain patient care collaboration.

Establish Patient-RN Council to improve the delivery of patient care.

75% of RNs participating in professional organizations.

Establish and sustain BSN level education at >80% for all direct care RNs.

Develop and implement required ANCC Policies.

Establish participation by APRNs in Shared Governance.

Implementation of self-evaluation and peer evaluation into staff annual performance evaluation.

Establish Nurse Manager Leadership at the MSN educational level by 2020.

Exemplary Professional Practice

Attract, develop and retain competent, compassionate nursing professionals committed to excellence in nursing practice

Increase RN Certifications to 50%.

Extend Certification pay to RNs in BDHG.

RN Satisfaction Scores in 75%ile as measured by NDNQI.

Develop and implement clinical continuing education plan.

Develop and implement Nursing Professional Ethics Council.

New Knowledge, Innovation and Improvement

Create an environment conducive to the improvement of nursing practice through knowledge and innovation.

Develop and implement Nursing Grand Rounds.

Establish Journal Club.

Develop and implement BDHS IRB.

Support RN Lead research projects yearly.

Develop and implement Nursing Research Residency Program.

Empirical Outcomes

Create a culture of superior clinical performance

Achieve top 10%ile in all Nurse Sensitive Indicators as measured by NDNQI

Achieve top 75% for all HCAHPs components by 2016

Achieve 5 of 8 consecutive quarters of required data above national benchmark

Formalize Community impact plan for BHDH Nurses

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TRANSFORMATIONAL LEADERSHIP

EPIC

Across Bozeman Health, all nurses and other employees planned for, trained and embraced a huge transition during the first week in December to a new electronic health record (EHR) called Epic. Fully 1,303 Bozeman Health Employees invested 106,953 hours in this project. Epic consolidates patient records from three separate computer software systems to a single EHR platform. This OneChart system ultimately provides a more streamlined integration of patient data and faster, more accessible communications with patients, which will lead to more efficient and safer delivery of care.

Abstraction

Bozeman Health Medical Group nurses spent countless hours abstracting data from the previously used NextGen system into the new Epic system. This helped cut down on wait time for patients before seeing their provider at the next scheduled visit after Epic was implemented. The nurses abstracted during regularly scheduled hours in between patients, and at the end of the day during abstraction blitz events hosted by Chief Nursing Officer Vickie Groeneweg. Weekend blitz events also were hosted by our CNO to help pre-load as many patient charts as possible prior to the records system switch. A total of 597 staff, including 219 NextGen abstractors and 85 preload abstractors, worked on this project. Nurses from the inpatient units also volunteered to be trained abstractors to help pre-load patient charts.

Clinical Informatics Operations Team (CIOps)

During the past few years, the Clinical Informatics Operations Team prepared our clinical and non-clin