Dive Brief:
- Novant Health, a 15-hospital system based in Winston-Salem, NC, discovered in 2010 that its nurses only spent 2.5 hours to 3 hours during their 12-hour shifts on direct patient care at the bedside. Nurses now spend 72% of their time in patient rooms, surpassing the original 70% goal.
- To effect change, Novant gathered its nurses to ascertain what kept them from the bedside. Nurses cited four main factors: seeking and gathering supplies, such as IV poles; getting medications; care planning, and the paperwork-heavy admissions process.
- Novant brought in certified nursing assistants to take over many of the activities keeping nurses from the bedside. Monitors were placed in patients' rooms so nurses could document there, and pharmacy techs put medications in patient rooms so nurses didn't have to hunt for them. Medical unit secretaries, freed by electronic health records from transcribing orders, also took on a more supportive role for clinical staff.
Dive Insight:
The catalyst for Novant Health's undertaking was information from Robert Wood Johnson Foundation. RWJF's Transforming Care at the Bedside initiative, which began in 2003 to address the nursing shortage, aims to improve nurses' work on medical-surgical units. In Novant's case, the hospital system reports seeing reductions in patient falls and infections, greater patient satisfaction and a decreasing nurse turnover rate, among other positives. Keeping nurses on the front-lines in this manner seems like a win-win: better patient outcomes and happier nurses staying put, achieved at relatively low cost to hospitals.
