Building a Culture of Ownership at Children's Hospital of New Orleans

1. Building a Culture of Ownership Jamie Wiggins and Joe Tye Children’s Hospital Association CNO Forum Presentation March 18, 2019

2. Our Legacy • Originally opened as a rehabilitation center for physically handicapped children in 1955. • Expanded into a full-service hospital and renamed Children’s Hospital in 1976. • Today, we are a 224-bed, not-for-profit regional medical center offering advanced pediatric care to children from birth - 21 years. • 400+ physicians trained in more than 40 subspecialties and 100+ subspecialties • The only full-service hospital exclusively for children in Louisiana and the Gulf South.

3. Hurricane Katrina is a reminder of the vital importance and deep responsibility shared by the people who work in healthcare. Post Katrina: tremendous rise in non-profits; people hoping to be part of the solution. The reality: fragmented groups and initiatives competing for the same issues; need for a unified vision and community collaboration.

4. 4 LCMC Member Hospitals • 247 bed not-for-profit pediatric hospital • Only full service hospital exclusively for children in Louisiana and Gulf South • Second oldest hospital in the System – 165 years • Affiliates – Crescent City Physicians, Touro at Home, and Woldenberg Village • The oldest hospital in the System – 281 years • Only Level 1 trauma center in the Gulf South Children’s Hospital Touro Infirmary University Medical Center • 80 bed hospital Opened 2014 • Bringing healthcare back to New Orleans East New Orleans East Hospital West Jefferson Medical Center • 435 bed not-for-profit hospital • Regional leader in acute, preventative, and rehabilitative healthcare services

5. METRICS • 17% Turnover • 2 % Certification Rate • 70% BSN • 15% Vacancy Rate • 5.5% Best Place to Work • Patient Satisfaction ↑ing from baseline • Patient Safety and Quality

6. Framework for Excellence Local, Regional, National Magnet Designation School of Nursing Alignment/Affiliations Practice and Personnel Development Resources Clinical Programs, Supports and Interfaces Performance Improvement & Nursing Research Nursing Practice Recognition Programs Accountability and Continuity Practice Model Staffing Resources Managerial Competence and Leadership Philosophy of Nursing Adapted from Burritt, J. E. (2005) Organizational Turnaround: The Role of the Nurse Executive. JONA. 35 (11). pp 482-489

7. Local, Regional, National Magnet Designation School of Nursing Alignment Affiliations Practice and Personnel Development Resources Clinical Programs, Supports and Interfaces Performance Improvement & Nursing Research Nursing Practice Recognition Programs Accountability and Continuity Practice Model Staffing Resources Managerial Competence and Leadership Philosophy of Nursing

9. Transformation • Physical Plant • Informational Technology • Culture

10. Children’s Hospital

11. Behavioral Health

13. Building the Framework for Excellence • Mandatory OT – ended April 2017 • New Hires – First year • 180 RNs • 40 Nurse Techs • Dedicated Transport Team • Employee Health Nurse • Wound Care Program Development • Vascular Access Team Initiation • 100% Certification Support Program • Target Specialty Education • Nursing Symposiums • Leadership Development • Daisy Awards • Certification Recognition • Care is MAGIC • Employee of the Month • Technology – Elemeno and EASE App • Emergency Department Summit • Emergenetics Program • Initiated clinical ladder • Joint Development – Pediatric Nurse Practitioner Acute and Primary Care Tracks • New Graduate Nurse Residency • Local, regional, and national presentations • All Leaders pursing graduate degrees • 5 leaders pursuing research doctorates • NDNQI Participation • Annual Nurse Satisfaction Survey • Magnet Journey • Service Line Educators • Education Department Assessment • Float Team Development

18. Creating the right culture is nothing more and nothing less than knowing who you want to be and doing the things needed for that transformation to occur.

20. January 2017 •Start March 2017 •Sr. Director Retreat •Nursing Division Reorganization September 2017 •Nursing Leadership Retreat •The Florence Prescription October 2017 •Florence Prescription to all patient care services November 2017 •Joe Tye Keynote at Quality and Safety Colloquium January 2018 •Executive Discussion February 2018 •TJC Survey April 2018 •Beginning of 36 month project

21. All Employee Information Sessions

22. LSU Pediatric Residents

23. Executive Team Support

24. Daily Practice Huddles and Daily Safety Brief

25. The current state of LA: #50NoMore • LA #50 in American’s Health Rankings 2018 • We haven’t had the discipline to focus • We must be better • What is the role of a Children’s hospital in influencing change? • What’s our why? DO WHAT’S RIGHT FOR KIDS 28% of children live in poverty Ranked 50th in Community and Environment Ranked 47th in Violent Crime Ranked 48th in all Health Outcomes

26. Inspiring Change • Creating a culture of ownership • It takes all of us – empowerment

27. Proceed Until Apprehended CULTURE OF YES

28. #HereWeGrow #CHNOLAproud

29. Values Coaches

30. Measures of Success VACANCY 6 % BSN 78 % 74th TURNOVER 12.4 % 33 % CERTIFICATION PATIENT SATISFACTION QUALITY AND SAFETY

31. Treat employees like they make a difference, and they will. Percent of respondents who rate Children’s Hospital a 9 or a 10 for overall workplace experience. 2018

32. Culture does not make people, people make the culture.

33. Thank you!

34. CHNOLA – Backside Approach

Building a Culture of Ownership at Children's Hospital of New Orleans

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