The Voice Abstract: Achieving Improved Outcomes

Beth Finley, DNP, RN, NE-BC
Benjamin Casarez, BA

Nurse leaders are frequently called to manage urgent problems, meet quality metrics and implement new initiatives effectively. In a busy 200-bed hospital in Rio Rancho, N.M., the nurse leaders at Presbyterian Rust Medical Center said they faced the demands listed above and faced challenges similar to those faced by colleagues across the country. The hospital’s approach to quality improvement often involved reacting to isolated events, creating action plans and interventions, and addressing issues at the unit level under the guidance of ancillary departments. This event-driven problem-solving led to inconsistencies in standards and expectations across units, as each team approached similar challenges independently.

Furthermore, limited follow-up and accountability hindered the sustainability of improvement efforts, leaving leaders and staff overwhelmed by constant shifts in priorities. These challenges underscored the urgent need to address how quality improvement was approached and change the expectations for improvement efforts. While not widely adopted, Presbyterian’s process excellence (PE) team had developed a structured daily management system to foster accountability, streamline problem-solving and ensure continuous quality improvement across the organization. It was the goal of the adult inpatient units to fully embrace and implement the Presbyterian Daily Management System (PDMS), shifting the culture from “one more thing” to “this is how we do our work.”