We/Me = Teamwork

Ochsner Medical Center–Jefferson Highway (New Orleans, Louisiana)

CSI Summary

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CSI Presentation

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CSI Toolkit

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Project Topic


Hospital Unit

Medical-Surgical Unit (MSU)

CSI Participants

Laila AbuTaye, BSN, RN
Angelle Bonura, BSN, RN
Kiara Dillard, BSN, RN- BC
Jennell Melancon, BSN, RN
Nicole White, BSN, RN

Project Goals/Objectives

  1. To improve team perception of teamwork
  2. To reduce annual turnover 10%
  3. To increase Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores through the improvement of communication amongst healthcare providers and patients by achieving 50th percentile rank or greater

Project Outcomes

  1. Increased HCAHPS score for "recommend the hospital" 55%
  2. Increased HCAHPS score for "communication with doctors" 32%
  3. Filled all unit leadership positions
  4. Demonstrated improved work environment by:
    • reducing overtime to < 1%
    • eliminating need for agency/temporary staff by decreasing vacancy rate 93%

Project Overview

Our medical-surgical unit (MSU) had inconsistent and inexperienced leadership from charge nurses through unit directors during the past three years. The unhealthy work environment that resulted led to poor outcomes, high turnover and inconsistent performance metrics. The MSU maintained some of the lowest employee engagement scores and poorest HCAHPS performance scores in the whole health system. As a result, our CSI team focused on creating a solid foundation of leadership and core staff as well as changing the mindset of working as a team.

Collaborating and partnering with multidisciplinary team members throughout the hospital is an ideology the unit deserves and sought for a long time. Working through obstacles and challenges remained difficult, but the guidance of leadership and the structure of this project helped our team make great strides in collaborative teamwork. Our patients deserve the best possible experience, and creating a framework for the team has proven to do exactly that.

After ten months, there has been progress on many of the identified challenges.

  • The physical location of the unit had been was formerly split on two floors; MSU is now together on one floor.
  • The unit director, in coordination with the unit-based physician dyad partner, has diligently collaborated to create structure for physician rounds; this remains a work in progress.
  • Many of the staffing challenges due to call-ins and vacant positions have improved.
  • The leadership team filled all but one vacant position.
  • Nurses stepped up to pick up overtime on an as-needed basis during priority times; before this project, many staff picked up weekly hours just to fill needs on the schedule.
  • Patient acuity remains a conversation throughout the leadership team and additional processes are being implemented to mitigate these challenges.
  • We also noted that from 2019 to 2020, our floor codes decreased 9%.

The overarching positive outcome from this project is a fully staffed, engaged leadership team on the MSU that remain supportive of improving processes and listening to the voice of the team, as well as putting plans in motion to continue growing and developing the team with overall high-quality outcomes to sustain a healthy work environment.

Permission to Reuse Materials
The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.

The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.