2013 APNA Award for Excellence in Leadership-RN
Under Judy Linn, BS, BSN, MS’s leadership as the Director of Psychiatric Nursing, the 69 bed John George Psychiatric Hospital, a member of Alameda Health System has seen patient satisfaction scores leap from the first percentile to the 75th percentile. Her team has decreased seclusion and restraint episodes from 35 to 5 episodes per 1,000 patient days. The hospital, which has over 1,200 psychiatric emergency visits per month, has seen a 68 percent reduction in assaults. Wait times for patients arriving by ambulance have fallen from up to two hours to a mean ambulance turnaround time of 20 minutes. This has all happened in just over three years. “One of my best days in this position came this month,” says Linn. “A nurse manager reported that while interviewing for open positions, the candidates told him that they had selected our hospital because their patients were asking them to be transferred here!”
Linn’s team’s current project to continue their growth is the creation of groups of “champions” for various skills. “The Excellence Champions (multi-disciplinary staff) are given ten days to research a skill, create an in-service with an accompanying competency, and present the in-service to the rest of the staff,” she explains. Thus far the groups have presented on group facilitation, behavioral care planning, 1:1 reduction, and alternative interventions. Linn says that the “Excellence Champions have been a very powerful tool to increase patient satisfaction and patient engagement.”
What is Linn’s secret? “The key has been to help the staff remember why they are nurses – because they care,” she says. “Sometimes we need to be reminded of the humanity of all of our patients, even when faced with florid psychosis.” In addition to emphasizing the importance of taking even a minute to engage with a patient, Linn insists that it is important to pay attention to the small things. “Improving patient outcomes starts with simple things like a hot breakfast, clean sheets, and relating to patients as people with dignity,” she explains. Of Linn, her hospital’s Medical Director says, “Largely because of her efforts, there has been a palpable change in the quality of therapeutic interactions between patients, family, and staff at all levels.”
A huge part of this effort includes successfully mobilizing staff to share her vision. “People are invested in ideas they generate. You are not thrilled when someone said to you, ‘Here’s what you need to do’,” she observes. “PMH nurses are problem solvers and thinkers. They need to fully understand why something is needed and what the value of it is to their patients.” She has learned to never assume that someone automatically knows the why and the value. “Every time I have forgotten this, my leadership has failed,” she says. “Once they understand the why and value they are able to make everyday decisions to keep growing the initiative.” Linn sees being “a cheerleader” as a fundamental role of a leader. “Even when it seems that it is hopeless, it is so important that my team knows that I have faith in them,” she says. “They need to know that I believe that they can move from the first percentile in patient satisfaction to the 90th percentile.”
Linn’s tips for aspiring nurse leaders:
- Get Studer’s Nursing Leadership Handbook. It is the primer for nursing leadership that I wish I had had when I became a head nurse. It demystifies coaching staff and simplifies the basic financial information that a leader needs to translate ideas into financial support for change.
- Develop colleague support. Leadership can be lonely. Make sure that you have leadership colleagues and mentors.
- Try it. What’s the worst that could happen?