Midland Memorial Hospital at Pathway to Excellence Conference

The Pathway to Excellence Program recognizes healthcare organizations that meet 12 practice standards essential to an ideal nursing practice environment. "Pathway-designated organizations are deemed the best places to work for nurses, with high nurse satisfaction and retention. Research shows that healthy work environments improve not only nurse satisfaction but also patient satisfaction and quality of care," Ellen Swartwout, MSN, RN, NEA-BC, said in her ANCC article "The Benefits of Pathway to Excellence Designation." Once designated, the organization is granted this achievement for three years and may then apply for renewal. These designations and re-designations are announced at the Pathway to Excellence Conference held every year in late spring. MMH has received this prestigious designation twice – once in 2011 and again in 2014 – and is among only 130 hospitals world-wide to ever receive the Pathway to Excellence designation. This year’s conference was particularly exciting for MMH as they were able to publicly accept their 2014 re-designation that they received last August.

Back Row: Cynthia Chavez, Christina Ramdeo, Veronica Overturf, Lynn Cooknell, Cori Armstead, Brittany Freeland, Lori Forbus, Shawn Nethery, and Joey Pascual. Front Row: Michael Hall, Aline Fuselier, Julie Green, Lynda Sanchez, and Jessica Hawkins.

Countless hours were dedicated to documenting the ways in which MMH qualifies for Pathway to Excellence and many of the conference attendees did this work on a volunteer basis in addition to their everyday jobs. The celebration at the conference was the reward for these individuals. Cori Armstead, V.P. and CNO, took the stage to accept the re-designation while the other 13 MMH employees cheered in the crowd, waved signs and banners, and passed out "self-empowerment bracelets" created by Joe Tye, the CEO and Head Coach of Values Coach Inc., who has partnered with MMH. Joey Pascual, a post-surgical RN, even leapt across the crowd in excitement. "It’s fun to be on the front door of something developing," Pascual said about his involvement in Pathway to Excellence.

Many people think Pathway to Excellence is just a stepping stone to the ANCC Magnet Recognition Program, but the conference taught Lynda Sanchez, a cardiac rehab RN, that Pathway is about culture while Magnet is about outcomes, Sanchez said. Shawn Nethery, a medical unit clinical manager, recognizes that our culture has changed tremendously for the better in the last 2.5 years. "Culture is important, because if it’s bad – who wants to come to work?" he said. Pascual found the keynote speech about "Delivering Happiness," the culture business model at Zappos, to be motivational, "It made me want to get the best of the best in our organization," he said.

The resounding takeaway from the informational sessions at the conference was that MMH is already doing all the things that are being taught. This was disappointing to those who were expecting to return home wiser, but was also a validation for everything they do and everything the hospital does as a whole. "We tend to think we’re mediocre, but really – we do a lot," Christina Ramdeo of Quality Management said. The team realized that MMH needs to be leading and presenting at these conferences. "We’re setting the standard – creating a new ceiling," Cynthia Chavez, the Nursery Unit Education Coordinator, said. Next year, they’ll submit at least five abstracts with descriptions of their ideas and the evidence to support them. The Conference Committee will then decide whether they want the team to put together a poster or a presentation.

Showing off their signs and MMH pride! All 14 MMH team members. Back row: Shawn Nethery, Joey Pascual, Cori Armstead, Christina Ramdeo, Lori Forbus, Cynthia Chavez, Lynn Cooknell, Michael Hall; Front row: Aline Fuselier, Julie Green, Lynda Sanchez, Veronica Overturf, Jessica Hawkins, and Brittany Freeland.

The team was able to take one poster with them this year (left). Lynda Sanchez and Lynn Cooknell, Cardio Care Coordinator, created the idea of "The 3 W’s," along with statistical help from Dr. Carol Boswell, a nurse researcher with Texas Tech University. The purpose of "The 3 W’s" is to prevent the top two reasons why open-heart surgery patients are re-admitted within 30 days of discharge: infection and heart failure. The three w’s stand for: wash, weigh, and walk. Sanchez put these three-word instructions along with a set of blank clock faces on a laminated poster to use as a tool to teach patients how to care for themselves after open-heart surgery. The blank clock faces are for hands to be drawn at the different times of day the patient needs to get up and walk.

Back Row: Shawn Nethery, Cori Armstead, Christina Ramdeo, Lori Forbus, Cynthia Chavez, Lynn Cooknell, and Michael Hall. Front Row: Joey Pascual, Aline Fuselier, Julie Green, Lynda Sanchez, Veronica Overturf, Jessica Hawkins, and Brittany Freeland.

Sanchez came up with the idea while talking with Cooknell about a patient that had surgery on a Thursday and was discharged on Monday. Patients are taught how to care for themselves upon admission and throughout their entire stay; however, cardiac rehabilitation nurses are only here Monday through Friday. This meant that patients who stayed only a short period of time, especially over weekends, were not receiving the teaching with the same intensity, Sanchez said. She wanted to find a way to get through to these patients as well as touch more than one way of learning. "Studies show that someone remembers only 50 percent of what you tell them," Sanchez said. Some people are auditory learners, some are visual, some learn by reading, and some learn by doing. By only telling the patients verbally that they need to wash, weigh, and walk, Sanchez was touching only one type of learner. She came up with "The 3 W’s" poster and found that "it encourages and empowers patients to become an active participant in their healthcare, rather than the nurse just dictating to them what to do," she said. Sanchez showed success in her numbers with the incr ease of mobility in her patients.

While at the Pathway to Excellence Conference, Sanchez was among a group of the MMH team members who had lunch with two of the Pathway Commissioners. Later, these commissioners visited Sanchez and Cooknell’s poster and thought it was innovative. The commissioners told Sanchez and Cooknell to apply for the Cerner sponsored Pathway Award, which will grant MMH $10,000 if their project proposal is selected. "This isn’t complex," Sanchez said with amaze and excitement on her face, "It’s just pictures and clocks on a poster, but sometimes the simplest things promote the greatest change."

Back Row: Lori Forbus, Brittany Freeland, Veronica Overturf, Lynda Sanchez, Lynn Cooknell, Cynthia Chavez, Shawn Nethery, and Julie Green. Front Row: Aline Fuselier, Christina Ramdeo, Cori Armstead, Jessica Hawkins, Joey Pascual, and Michael Hall.

"The 3 W’s" is just one example of many innovative improvements employees are making at MMH. "Most people think we do things out of books," Ramdeo said, "but really – we’re creating things." The Pathway to Excellence Conference is a great way to showcase this. The team is now re-energized and ready to push forward with their Magnet application and are on track to meet the April 1, 2016 submission deadline.