A description of the applicant organization in terms of:
- Geographical Location
- Services Provided
- Number of Licensed Beds
- Total RN Full-Time Equivalents
- Population(s) Served
Porter Adventist Hospital is a part of Centura Health, Colorado's largest healthcare system, and shares the same mission, vision, and values as we relate to fellow associates and serve our communities.
Mission Statement for Centura Health and Porter Adventist Hospital
Our mission guides us in all that we do. For us health care is not merely a business; it is a calling and we strive daily to extend the mission and provide leading-edge and compassionate care that each of our patients deserve.
Why our mission matters
Most mission statements may seem like platitudes, but ours really matters to us, and because it does, it makes a difference to you. It affects the quality of service and care you receive when we welcome you to Porter Adventist Hospital. Every single day, over 1,500 Porter Adventist Hospital associates put our mission in motion in ways that truly make a difference.
Because we are a not-for-profit organization, we have no shareholders and no earnings to distribute. All of our resources go toward fulfilling our mission.
While our associates bring to their work some of the best skills healthcare has to offer, they also bring with them kind hearts, loving hands and innovative thinking. Ours is a calling like no other; we strive to give you the best that science and spirit has to offer.
Even if you haven't come through our doors, you or someone you know has likely been touched by our mission. We hope that by reaching out with resources, tools, compassion and expertise, we can render meaningful aid to those in need.
Vision Statement for Centura Health and Porter Adventist Hospital
Our Plan for Creating a Stronger and Healthier Tomorrow
At Porter Adventist Hospital, a member of the Centura Health network, we recognize the challenges faced by today's health care providers. Our vision is to improve the quality, consistency, availability and affordability of health care to communities throughout Colorado. With this vision in mind, we collaborated with thousands of Centura Health key stakeholders, including nurses, physicians, associates, patients and caregivers, major employers and rural residents, to map out a system-wide strategic plan named Centura Health 2020 (CH2020). The CH2020 Plan supports our belief that we have a responsibility to lead the way in delivering innovative healthcare for the future for Coloradans.
This vision is focused toward creating consumer-centric environments for extraordinary healthcare delivery in Colorado. There are three main components to the CH2020 Plan: strengthen our foundation, create systems of care and move upstream to manage health.
Strengthen the Foundation
There are more than 15,000 people committed to improving the quality, cost and coordination of health care in Colorado-our ongoing effort is to strengthen the foundation of Centura Health. Part of strengthening the foundation is investment in technological advancements and establishment of electronic health records linking our physicians, clinics, hospitals, long-term care facilities, and home care services.
Create Systems of Care
Centura Health's "System of Care" currently consists of 13 hospitals, seven senior living communities, 55 medical clinics, seven surgery centers, nine imaging centers, Flight For Life® Colorado and home care and hospice services. As the largest health care network in Colorado, we are afforded with the unique opportunity to provide coordinated care delivery systems throughout Colorado by utilizing our network and shared resources.
Move Upstream to Manage Health
Our Mission has always been to improve the health of the people in our communities. CH2020 further enables Centura Health to fulfill our mission as we go beyond providing the best possible illness care to providing wellness care, thereby potentially reducing health care costs by helping patients to maintain good health.
Core Values for Centura Health and Porter Adventist Hospital
Porter participates, utilizes and adheres to Centura Health's Values Impact Analysis process (VIA). Values Impact Analysis is a tool designed to use Centura's Core Values in a consistent way and to be accountable to our sponsors and community for values driven decisions. This provides an important framework for Centura associates and leaders in making key decisions according to our Mission, Vision and Values.
Henry Porter had a vision of healthcare delivery based on a philosophy of whole-person care which would encompass a blending of the best of science and spirit. Mr. Porter had previous first-hand experience with the Adventist hospital philosophy of remarkable kindness and focus on healthful living. In addition, he was treated with state-of-the-art hydrotherapy, a revolutionary treatment at that time. Mr. Porter was so moved by this healthcare experience that, in 1929, he donated 40 acres of land and money to build a hospital to embrace the Seventh-day Adventist philosophy of whole person care.
When the hospital opened as the Porter Sanitarium and Hospital in 1930, staff members were committed to continuing the legacy of compas sion, integrity and quality experienced by Mr. Porter. The commitment was not to simply cure individuals seeking care in the hospital, but to help each individual understand how to live well so as not to be in need of hospital care.
In 1963, the hospital's name was changed to Porter Memorial Hospital. It is now Porter Adventist Hospital and has matured into a full service acute care hospital, known for its cardiovascular services, oncology care, joint replacement, transplant services and a rehabilitation program.
In 2007, Porter completed a $90 million construction project, adding 100,000 square feet of new space to the hospital and refurbishing another 100,000 square feet of space. This exciting renovation provided the community with cutting-edge care, including: a brand new emergency department designed to streamline patient admissions while providing the most medically advanced patient care; the most state-of-the-art surgical suites in Denver; and thirty-six new intensive care beds, thereby, combining cardiac and surgical intensive care units with efficiencies that allow nurses to provide better patient care and offer faster response times.
The renovation offered a new entrance and lobby designed to reflect the commitment to whole-person care. It offers features for body, mind and spirit, including intimate, comfortable waiting spaces, access to a medical library, a nearby café and other amenities. Porter has an extensive education area that includes a multi-use auditorium and seven meeting rooms. This space allows Porter to provide classes and programs for patients and members of the community, as well as training for physicians and other healthcare providers.
Porter continues to expand in ability to provide the most innovative technologies. In 2011, Porter completed construction on a endovascular procedural suite that enables the vascular team to perform traditional open and minimally invasive vascular surgeries simultaneously if necessary. Another major addition to Porter in 2011 was the development of the Porter Robotics Institute (PRI). PRI was the first comprehensive robotics surgery program in Denver and the Rocky Mountain Region and performs more robotics surgeries for more conditions than any other facility in Colorado.
Despite the pressures of health care today, Porter Adventist Hospital retains commitment to compassion, integrity and high quality, with a keen interest in health, rather than a focus limited to illness and treatment. This focus is a reflection of the Adventist foundation and is an important characteristic that is honored at Porter and its sponsor the Adventist Health System.
In 1996, Adventist Health System (AHS) and Catholic Health Initiatives (CHI) hospitals in Colorado formed Centura Health, a faith-based, nonprofit health care network designed to manage, and strengthen, their hospitals and services in Colorado. Since their earliest days, Adventists have been active in establishing hospitals that place an emphasis on whole-person care and on illness prevention. Catholics are well known for their tradition of caring for the poor. Both sponsors have preserved an unwavering commitment to their values and an understanding of the vital role that ministering to spiritual needs plays in health care.
The Adventist Approach
Seventh-day Adventist Christians believe a wholesome lifestyle contributes to good physical health and enhances a person's metal and spiritual potential. Recognizing the importance of whole-person health and the relationship of physical well-being with emotional and spiritual well-being, the founders of the Seventh-day Adventist Church opened a new kind of health center in Battle Creek, Michigan, in 1866.
In the mid-1800s, many medical treatments were as harmful as the diseases they were supposed to cure. The new sanitarium not only treated disease, it also taught people how to prevent disease through good nutrition, exercise and sanitation. Each person was valued as a creation of God and caregivers created a positive healing environment by providing extraordinary patient care.
Within years, the Battle Creek Sanitarium and its famous physician and health educator, John Harvey Kellogg, MD, gained international recognition. From that time, the Seventh-day Adventist healthcare ministry has grown to include more than 700 healthcare facilities worldwide, dedicated to helping people achieve physical, mental and spiritual wholeness. Today, the Adventist Health System is the largest not-for-profit, Protestant healthcare organization in the Unites States, with healthcare facilities in 13 states and Puerto Rico. The Adventist Health System employs more than 40,000 people and serves more than 2 million patients annually.
Porter is located in a quiet, residential neighborhood in south Denver. The population is a mix of slightly older than average citizens and new, younger families moving in to a neighborhood consisting of mostly older, well-maintained homes. The level of care required by patients that frequent the hospital is more complex due to their age and subsequent healthcare needs. Porter is known in the community for providing outstanding care to the sickest of patients. Porter understands the health care needs of the community.
Services Provided at Porter
- Full-service Heart Institute
- Cancer Care Center
- Center for Joint Replacement
- Spine Institute
- Head and Neck
- Women's services (not including obstetrics)
- Breast Care Center
- Transplant program for kidney, liver, pancreas
- Liver Care Center
- TIA Clinic
- Wound Care Clinic
- Diabetes Education Clinic
- Cardiac Short Stay
- Inpatient Adult and Geriatric Behavioral Health
- Outpatient Behavioral Health
- Community Resources, including Ask-A-Nurse®, extensive web-based medical, symptom and drug assessment resources, classes and programs, personalized web page to help family and friends of patients communicate.
- Porter's award-winning, full-service Heart Institute offers screenings, diagnostics, chest pain evaluation center, cardiac catheterization lab, electrophysiology lab, open-heart surgery program, and the heart success line---an outpatient follow-up program for congestive heart failure patients, as well as rehabilitation and prevention services.
- The Porter Cancer Care Center offers standard comprehensive services, PET-CT diagnostic scanning, linear accelerator, IMRT, genetic counseling, complimentary therapies and more. The Porter Cancer Care Center is nationally accredited by the American College of Surgeons and the American College of Radiology.
- The Porter Center for Joint Replacement is one of the largest programs in the region. It has an international reputation for research and surgical excellence.
- Porter's Women's Services has been a leader in providing minimally invasive gynecological surgery. Porter's expert medical staff offers laparoscopy and hysteroscopy procedures to diagnose and treat a wide range of gynecological conditions.
- The Porter Breast Care Center is a full-service program offering interventional treatments for breast cancer. This center features a full-time nurse specialist as well as a dedicated breast radiologist who is fellowship trained in breast and women's imaging.
- Porter's transplant program has performed more than 850 organ transplants, including kidney, kidney/pancreas and liver transplants since its inception in 1986.
- The Porter Liver Care Center is a unique service dedicated to the highly complex care of patients with liver and other hepatobiliary system diseases. Created in 2000, the Liver Care Center holds weekly conferences which are attended by physicians from appropriate subspecialties to diagnose and present treatment options for complex liver diseases. This service is offered to any and all referring physicians free of charge to them or their patients.
- Porter's Head and Neck services offers unique regional cancer treatment and surgery in ENT and other head and neck-related problems. We provide care that is unparalleled in the Rocky Mountain Region. Our surgeons have received education at some of the country's premier hospitals and universities for head and neck specialties. Their research is regularly published in the top medical journals and they care for hundreds of patients throughout a five-state region each year.
- Porter Robotics Institute was the first comprehensive robotic surgery program in Denver and the Rocky Mountain region. Our robotic physician partners have performed more than 2,000 robotic surgeries, placing them among the most experienced robotic surgeons in the country.
By the Numbers
- 1,250 associates
- 980 affiliated physicians
- 10,796 annual admissions*
- 24,725 annual emergency room visits*
- $14.1 million in uncompensated and charity care provided annually*
*For the fiscal year ended June 30, 2012
Number of licensed beds
Licensed beds: 368
Total RN full-time equivalents
The RN FTE value is: 431.57
This includes all RN licensed employees.
Ethnic profile of the nursing staff, client population, and community served .
Nursing Staff at Porter
Client Population at Porter
Community Served at Porter
Porter Adventist Hospital completes an annual survey of surrounding communities. The Porter Adventist Hospital service area covers three counties with diverse demographics characteristics:
- Population- Our counties have changed in population, particularly to our south. Our counties are 3 of the 4 largest counties in the state, with a combined population of 1,706,704 residents. This is an increase in every county as noted below.
- Arapahoe County has grown by 17%
- Denver County has grown by 8%
- Jefferson County has grown by 1%
- Age - While all counties in Colorado are aging, as a population, our counties show disparate numbers. Jefferson County is in the top 5 of the oldest population counties in the state, while Arapahoe is in the top 5 with the youngest population.
- Race- While Jefferson County is predominantly white, with 88% of the population in this group, Arapahoe and Denver counties show more diversity. Denver's population has 32% Hispanic and 10% Black, while Arapahoe has 18.4% Hispanic, 10% Black.
- Education - Denver is among the most highly educated counties in the state, with 39% of the adults holding a bachelor's degree or higher. Arapahoe and Jefferson Counties fall in the mid-range of education for the state.
- Income - Again, we have diversity within our service area. Jefferson County is in the top ten counties for income in our state, while Denver is among the lowest. Arapahoe is at the state average, but has wide variation within the county from the very wealthy to those in poverty.
- Single Parent Homes - one of the key contributors to poverty is single parent homes headed by females. As noted in this graphic, Arapahoe County has a higher than state average number, while Denver is at the state average and Jefferson County is lower than the state.
- Employment - The unemployment rate in Denver County is higher than the state mean. The unemployment rate in Jefferson County is below the state average and Arapahoe County sits at the average for the state.
The current Chief Nursing Officer's: Job Description and Curriculum Vitae
Sharon H. Pappas, RN, PhD, NEA-BC
Chief Nursing Officer- Porter Adventist Hospital
Chief Nursing Executive - Centura Health
Sharon Pappas, PhD, RN, NEA-BC, is the Chief Nursing Officer at Porter Adventist Hospital and Chief Nursing Executive for Centura Health, the largest hospital and healthcare network in Colorado. Dr. Pappas has served in the role of Chief Nursing Officer (CNO) at Porter Adventist Hospital since 1998. During her tenure, Dr. Pappas also held the role of Chief Operating Officer (COO) from 2000 to 2003. Dr. Pappas was appointed to the position of Chief Nursing Executive for Centura Health in 2008. As Chief Nursing Executive for Centura Health, Dr. Pappas is the permanent chair of Nursing Council and provides executive leadership to chief nursing officers for 13 hospitals, seven senior living communities, medical clinics, Flight For Life® and home care, and hospice services.
Involvement in the Community
One of the main values of Centura Health is to serve the community. In her service to the community, Dr. Pappas serves as an amazing example of nursing professionalism at its best and acts as one of the top nursing leaders in the State of Colorado. Dr. Pappas was appointed by Gov. Bill Owens to serve on the Colorado Board of Nursing in 2003 and the Governor's Task Force on Nurse Staffing in 2007. During her tenure with the Colorado Board of Nursing, Dr. Pappas served as president from 2005 to 2007. Dr. Pappas has also served as president of the Kappa Alpha Chapter of Sigma Theta Tau International Nursing Honor Society, is a founding member of the Colorado Center of Nursing Excellence and is a member of the Arvada United Methodist Church serving on multiple church committees. In her service to the Colorado Center for Nursing Excellence, Dr. Pappas has served as a member of the Advisory Board and as vice-Chair of their Board of Directors from 2006-present and chair of the Board of Directors from 2011-present.
Dr. Pappas has been recognized as a leader with various state and national awards. Dr. Pappas was awarded the Circle of Excellence Award for nursing leadership awarded by the Colorado Organization of Nurse Executives in 2005, the Leadership Award granted by the doctoral class at the University of Colorado in 2007, the American Organization of Nurse Executives (AONE) Nurse Research Award for the nursing administration research that had the greatest utility in practice in 2007, the Colorado Nightingale award for nursing excellence presented by the Colorado Nurses Foundation in 2009, the Doris Biester Award for Excellence in Leadership from the Alpha Kappa Chapter at Large, Sigma Theta Tau International in 2012, and the 2012 Distinguished Alumi Award awarded by CU College of Alumni Association. Dr. Pappas was appointed adjunct assistant professor at the University of Colorado College Of Nursing in 2008 and continues to serve as an expert in leadership and nursing professionalism.
Dr. Pappas completed her PhD at the University of Colorado Health Science Center with research focus on cost and clinical outcomes that are sensitive to nursing. In addition, Dr. Pappas has authored numerous articles for peer-reviewed journals and has presented at numerous conferences throughout her career focusing on the role nurses and the nursing environment play in patient safety and hospital costs.
Copies of the most recent annual reports, quality and strategic plans for the organization and nursing services. (TL1)
The following documents are located as follows:
Annual Board Report (OO3-1)
Porter in Focus January 2012 (OO3-2)
Porter in Focus April 2012 (OO3-3)
2012 Porter Nursing Metrics (OO3-4)
Professional Development 2011 Annual Report (OO3-5)
Quality and Strategic Plans
Nursing Practice Council Strategic Operating Agenda FY 2012 (OO3-6)
Clinical Excellence Committee Medical Director Council Strategic Operating Agenda FY 2012 (OO3-7)
Clinical Management Council Strategic Operating Agenda FY 2012 (OO3-8)
Professional Development Council Strategic Operating Agenda FY 2012 (OO3-9)
Evidence Based Practice and Research Council Strategic Operating Agenda FY 2012 (OO3-10)
People Council Strategic Operating Agenda FY 2012 (OO3-11)
Patient Experience Council Strategic Operating Agenda FY 2012 (OO3-12)
Behavioral Health Council Strategic Operating Agenda FY 2012 (OO3-13)
Cardiac Council Strategic Operating Agenda FY 2012 (OO3-14)
Medical Director Council Strategic Operating Agenda FY 2012 (OO3-15)
Oncology Council Strategic Operating Agenda FY 2012 (OO3-16)
Orthopedic Council Strategic Operating Agenda FY 2012 (OO3-17)
Transplant Council Strategic Operating Agenda FY 2012 (OO3-18)
The administrative and nursing organizational chart.
Describe the CNO's structural and operational relationships to all areas in which nursing is practiced. (TL4)
CNO's Structural and Operational Relationships
Dr. Sharon Pappas, RN, PhD, NEA-BC serves in the role of Chief Nursing Officer of Porter Adventist Hospital and reports to the Chief Executive Officer, Dr. Randy Haffner. Other members of the executive team include Andrew Gaasch, CFO; Dr. Dianne McCallister, CMO; and Carrie Koh, Vice President of Business Development. The CNO is a member of the Executive Council who guides strategic and operational decisions for the Organization. Dr. Pappas is an ex-officio member of the Medical Executive Council and a regular attendee to the Porter Board of Trustees. In this role, Dr. Pappas participates in discussions regarding Porter operations and governance.
In the CNO role, Dr. Pappas is accountable for nursing practice in all areas within the hospital. This includes nurses in the departments that report directly to her and to those nurses who work in departments that report to other leaders in the executive suite. One example of this indirect reporting relationship is within the radiology department, nurses report to the Director of Oncology and she reports to the CNO. This reflects a teamwork oriented matrix reporting structure. Many departments have matrixed reporting relationships and the organizational chart shows relationships.
Coordination and integration of nursing services across Porter is facilitated by Dr. Pappas in collaboration with two Associate Chief Nursing Officers and five Nursing Directors. The role of Associate Chief Nursing Officers was created in 2011 to add additional leadership support as the duties of Centura Chief Nursing Executive grew. Under the direction of the CNO, the Associate Chief Nursing Officers and Nursing Directors have operational and clinical oversight of the departments under their span of control and coordinate care with other nursing leaders in order to provide a unified nursing division. Dr. Pappas meets weekly with the Associate Chief Nursing Officers/ Nursing Director team to review nursing and hospital performance and to develop cohesive strategic initiatives for advancing the practice of nursing at Porter. In addition, Dr. Pappas meets monthly with the Associate Chief Nursing Officers and with nursing directors individually. Their primary function is to coordinate all departments at Porter into one body of nursing.
Dr. Pappas also serves in the role of Chief Nursing Executive for Centura Health. In this role, Dr. Pappas reports to Gary Campbell, President and CEO of Centura Health. As the Chief Nursing Executive, Dr. Pappas serves as the Chair of the Centura Nursing Council and is a member of the Centura Senior Executive Council, Value Optimization Council, Centura Nursing Practice Council (ad hoc), EHR Steering Committee, Corporate Responsibility Management Committee and Risk Oversight Committee. In addition, Dr. Pappas serves as Co-Chair of Joint Council and Clinical Integration and Standards Council. In the role of Chief Nursing Executive, each of the Centura facility CNO's have an indirect reporting structure to Dr. Pappas.
Porter Adventist Hospital Organization Chart (OO5-1)
Porter Nursing Organizational Chart (OO5-2)
- Earned professional certification(s);
- Professional organization memberships, activities, and offices held; and
- Professional development programs and formal academic education attended during the 24 months prior to documentation submission. (TL6)
A table that displays direct-care nurses' participation in professional nursing organizations/associations and activities at the local, state, national, and/or international levels. Include office(s) held. (SE2)
The policies and procedures that govern/guide professional development programs, such as tuition reimbursement; access to web-based education; and participation in local, regional, national, and international conferences/meetings. (SE3, SE4, & SE5)
Policies at Porter Adventist Hospital can be hospital specific or system-wide policies. Porter Adventist Hospital / Centura Health have the following polices/processes:
Professional Development Programs
Access to Web-Based Education
Centura - Wide LEARN Module Approval Process Policy (OO8-4)
Patient Care Services- Mosby's Clinical Procedure Policy (OO8-5)
The assessment for the continuing education needs of nurses at all levels and settings, and the related implementation plan. (SE5)
The following are the educational needs assessments and the subsequent education plan for the various areas of the hospital. Leadership needs assessment and education plan are included and account for advance practice nurses, clinical coordinators, assistant nurse managers, clinical managers, directors, associate chief nursing officers and the CNO. Units are listed in order of appearance on the Magnet demographic information form.
Medical, Surgical and Critical Care Inpatient Unit Educational Needs Assessments (OO9-1)
Medical, Surgical and Critical Care Inpatient Unit Educational Plans (OO9-2)
5 North Cardiac Telemetry, 5 East Medical Telemetry, 4 North Total Joint, 4 East Spine, 3 North General Surgical/Transplant, 1 North Oncology, MICU/Step Down Unit
Preoperative/ PACU/Ambulatory Educational Needs Assessments (OO9-3)
Preoperative/ PACU/Ambulatory Educational Plans (OO9-4)
OR, Women's Surgery, PACU, Preop.
The Surgical Welcoming Center is included in the Preop assessment group for educational assessments and educational plans.
Ambulatory Procedures Educational Needs Assessments (OO9-5)
Ambulatory Procedures Educational Plans (OO9-6)
GI Lab/Minor Procedures, Infusion Center, Wound Care, Diabetes Education Center, Cath Lab, ECT, Interventional Radiology, Radiation Oncology
- For Infusion Center educational needs assessments are completed as part of individual PFD Performance Appraisals.
- For Diabetes and Radiation Oncology settings educational needs assessment and plans are completed as part of individual PFD Performance Appraisals. ECT Educational Needs Assessments and Plans are included in the Behavioral Health Educational Needs Assessments and Plans
Specialty Practice Educational Needs Assessments (OO9-13)
Specialty Practice Educational Plans (OO9-14)
Cardiac Rehab, TIA Clinic, IV Therapy, Transplant, Breast Center, Outpatient Oncology, Outpatient Behavioral Health
- For Cardiac Rehab, Breast Center, Outpatient Oncology, and Outpatient Behavioral Health settings educational needs assessment and plans are completed as part of individual PFD Performance Appraisals.
- For Transplant settings the educational needs assessments are completed individually and the plans are completed per department needs.
All Others Educational Needs Assessments (OO9-15)
All Others Educational Plans (OO9-16)
Case Management, Float Pool, Nursing Administration, Patient Safety/Quality, Performance Services, Clinical Informatics, Workman's Compensation.
- Case Management educational needs assessments are completed on an ongoing basis at unit meetings and one on one individual meeting. Educational plans are developed based on these meetings.
- For Nursing Administration, Patient Safety/Quality, Performance Services, Clinical Informatics, Workman's Compensation settings educational needs assessment and plans are completed as part of Leadership Educational Needs Assessments
Leadership Educational Needs Assessments (OO9-17)
Leadership Educational Plans (OO9-18)
Advanced Practice Nurses, Clinical Coordinators, Administrative Coordinators, Assistant Nurse Managers, Clinical Managers, Directors, Associate Chief Nursing Officers and the CNO
A list of the continuing education programs (classroom and/or electronic) and the number of nurses completing each during the past 24 months. Do not include orientation activities or in-service education. Include programs covering each of the following topics: The time frame used for this report is October 2010- September 2012 (SE5)
- Research, including protection of human subjects
- Evidence-based practice
- Application of ethical principles
- ANA Bill of Rights for Nurses (American Nurses Association, 2001a)
- Professional standards of practice and performance
- Cultural competence
- Data and information analysis competencies
- Quality improvement
- Nurse Practice Act (or similar document for international applicants)
- Patient privacy, security, and confidentiality
- Regulatory requirements
Master list of continuing education programs from October 2010 - September 2012 (OO10).
Exemplary Professional Practice
Describe the Professional Practice Model(s) and the Care Delivery System(s) in use in the organization. The Professional Practice Model is a schematic description of a theory, phenomenon, or system that depicts how nurses practice, collaborate, communicate, and develop professionally. A Care Delivery System delineates nurses' authority and accountability for clinical decision-making and outcomes. If possible, provide a depiction of each model. (EP1, EP1EO, EP2, EP3, EP4, EP5, EP6, EP7, & EP12)
The Porter Adventist Hospital Professional Practice Model is a multidisciplinary model that can be applied or lived by each member of our staff. We believe that our model is a reflection, a guide, and an outline of how we practice. We used the following announcement and explanation to our associates about our professional practice model in an article published in the Porter Perspectives on September 1, 2011 (OO11-1). This story will provide the description of the Porter Professional Practice Model (OO11-2).
Porter's Journey for Magnet Redesignation
One of the characteristics of a Magnet Hospital is that associates have a clear purpose in how they perform their work. This purpose can be demonstrated through a model. In the past several months, Porter associates from different parts of the hospital have been meeting to design a model that reflects important concepts that drive how/why we do our work. The following story is from Jon Massey, a night shift RN from ICU, who helped in the design of our new practice model:
Professional Practice Model:
The Pinwheel Concept
By Jonathan Massey, RN, BSN, CCRN Charge Nurse, MICU/SDU
The pinwheel is an object of both potential and actual energy. At rest it has the ability to be affected by other forces yet when put in motion it becomes something with observable and real energy. Whether the pinwheel has an even or odd number of vanes it maintains a constant, necessary symmetry and balance in order to be efficient. Furthermore, it needs to be perfectly centered for all of its components to have equal dimensions.
In thinking about the qualities a pinwheel contains it becomes apparent that it is symbolically very similar to the systems Porter Adventist Hospital has in place to achieve it's goal of quality patient care. A conceptual model was developed with this in mind and can be used as a tool by all associates at Porter.
To understand the model, take a look at each element by itself; starting with the outer ring. Our Mission, Vision, and Values act as the catalyst that sets everything in motion and is the reason Porter exists as an entity. It's the wind, so to speak, that starts the wheel turning. Once the wind hits the surface of one of the vanes it exerts a force that carries energy to the center hub and starts a reaction. Each vane contains a key element of practice at Porter. The base or foundations of the vanes contain the Core Values that are placed as a reminder for personal and performance expectations. The inner circle contains four words. Self, Family, and Community all surround the Patient and act to represent Relationship Based Care. The Self symbolizes being true and taking care of oneself. Family and Community can be many things. Community can symbolize an immediate care team, department, or the geographical community itself and Family is both personal and professional. Finally, at the center is the Patient for whom everything is directed.
Taken independently each element of this model can stand-alone and produce a final product. For example, Evidence Based Care is the driving force behind providing quality outcomes. Transformational Leadership focuses on developing both a culture and the people within it by positively leading through change and developing new leaders. Ultimately, the seven Core Values guide associates and set expectations. However, examining any one part of this model is only looking at one piece of Professional Practice at Porter.
It isn't until all elements are systematically put together and set in motion that the Model develops a culmination of Professional Practice. Each associate possesses the potential to turn the pinwheel as well as be an elemental component within. This coupled with the idea that the Mission, Vision, and Values provide the force will keep the pinwheel turning well into the future.
Porter's Care Delivery System
The Porter Philosophy of Nursing outlines our belief in patient- centered care. This belief is essential to the care delivery system at Porter.
Porter's Care Delivery system exists to define the overall use of care delivery personnel and to differentiate the roles of the professional nurse and non-licensed staff. The care delivery system also delineates the application of the nursing process as the definition of nursing care. Various foundational items are used to form the care delivery system including the American Nurses Association (ANA) Scope and Standards of Nursing Practice, the Colorado Nurse Practice Act and the Porter Nursing Division philosophy and theoretical frameworks. Florence Nightingale's tenets serve as the theoretical framework for our model of care. Two distinct concepts provide the building blocks for this model:
- The patient is the center of care
- Professional nurses at Porter serve in the patient advocate role
The following model reflects Porter's Care Delivery Model
The Hospital Plan of Care Policy describes the care delivery system at Porter. The following excerpt is found under the Nursing Administration section of the policy, page 43. ( Hospital Plan of Care , OO11-4)
The Chief Nursing Officer (CNO) for the organization is designated as the senior nursing leader. The CNO has ultimate responsibility for planning, organizing, directing and controlling the administrative functions of patient care; delegating appropriate levels of supervision and provision of nursing care in the patient care areas; establishing standards of nursing practice and assuring achievement of goals, adhering to hospital policies and standards set forth by State and Federal/Regulatory agencies. In as much as the CNO is responsible for the above in all areas where nursing care is delivered, collaborative activities have been established to ensure that this occurs.
The Nursing Directors are members of the management team, and are responsible for the management functions of planning, organizing, directing, controlling, implementing and evaluating as they relate to the clinical delivery of patient care.
Nursing care is an organized and systematic process provided by or under the direction of a registered nurse. A delivery of care methodology exists to define the overall use of personnel, differentiate roles of the professional and non-licensed staff and delineate the implementation of the nursing process as the definition of nursing care. The delivery of care methodology facilitates maxim and efficient use of all levels of personnel by articulating the process by which care will be delivered, the assignment and appropriate use of human resources, and caregiver reporting mechanisms. The principles in the delivery of care methodology are fundamental to care delivery anywhere in the organization. Nursing Directors and Unit Managers are expected to adhere to these principles as they further articulate the delivery mechanisms specific to their respective areas.
The delivery of care methodology at PAH is consistent with State and National standards of nursing practice, the goals and philosophy of the Division of patient Care and National and State accrediting bodies. The RN and LPN function within the limits of the Colorado Nurse Practice Act. In addition, the nursing staff is the patient's advocate and in that role is responsible for the coordination of treatment, medications, diagnostic testing, and other entities that affect the patient/significant other during hospitalization. Direct patient care is administered by registered nurses, licensed practical nurses, certified nursing assistants and nursing extenders. Each member of the nursing staff is assigned clinical and/or managerial responsibilities based on education preparation, licensing laws and regulations and an empowerment, collaboration and encouragement of innovation. Nursing care encompasses patient teaching; administering, supervising, delegating and evaluating nursing care and practice; and the implementation of nursing standards of patient care utilizing protocols and procedures both interdisciplinary and multidisciplinary. Individual patient care areas have further defined unit and department -specific care delivered.
Competency plans have been initiated and are being utilized in each department where nursing care is delivered. There is an organized orientation for all new employees providing patient care. Competency determination begins during this time. An on-going competency program has been identified for nursing as a whole.
Staffing is limited by nursing care hours required per patient, and ultimately matched to patient need. Nursing Administration concentrates on efficient utilization of team members in order to allocate as much of the financial resources as possible to patient care level. An RN is designated in charge of patient care activities for each shift to coordinate overall unit activities, verify physicians' orders, and direct the implementation of those orders. The nurse in charge is accountable for determining the competency of all unit staff prior to delegating assignments and responsibilities.
Each unit specializes in serving different patient populations, each with unique patient care needs. The application of the delivery of care system will vary among units based on patient care needs on each unit. The staffing configuration is varied on each unit to reflect the patient care needs. In this manner, the patient care system reflects the current patient population, the environment of the unit, and the skill mix including the knowledge and competency of patient care staff. Each unit has developed a Charge/Resource Nurse Assignment of Care Guidelines to provide the scope, outline, staffing consideration and expectations for the team in caring for unit specific patient populations. The following examples from 1 North Oncology Unit and the Operating Room demonstrate the application of patient care delivery in multiple types of areas within the hospital and the attention to patient population specific needs.
Exemplary Professional Practice
Nurse satisfaction or engagement data for a 2-year period to include data from a least two (2) survey cycles. If available, include the levels of statistical significance as compared to the benchmark. Include a graphic display of the data that clearly identifies benchmarks. (EP3)
- Medical, Surgical and Critical Care Inpatient Unit Press Ganey Nursing Satisfaction Graphs
- Preoperative/ Ambulatory Press Ganey Nursing Satisfaction Graphs
- Ambulatory Procedures Press Ganey Nursing Satisfaction Graphs
- Behavioral Health Press Ganey Nursing Satisfaction Graphs
- Rehab Press Ganey Nursing Satisfaction Graphs
- Emergency Department/ Cardiac Short Stay Press Ganey Nursing Satisfaction Graphs
- Specialty Practice Press Ganey Nursing Satisfaction Graphs
- All Others Press Ganey Nursing Satisfaction Graphs
Nursing Satisfaction - Press Ganey
Porter participates in two nationally recognized satisfaction surveys. The first of these surveys is Press Ganey Employee Partnership Survey. This survey was completed in September of 2010 and in April of 2012. Press Ganey reports results in a mean score and compares results with the National All Facility Database (National Rank). Results are given on seven different sections including: Systems and Leadership, Resources, Teamwork, Direct Management, Our Organization, Our Work, and My Work. The following graphs display the 2010 and 2012 hospital and unit level results with the hospital/unit mean, the Press Ganey database mean and the database percentile as a line with percentile.