This year, during National Nurses Week, Madison County Hospital has special reason to honor the 80 men and women who work as nurses at the hospital.
"As we celebrate National Nurses Week May 4-8, we are honoring our nursing division for an unusual and outstanding accomplishment," announced hospital CEO Fred Kolb. "For the first time in our history, MCH has staffed without the use of agency nurses for over one year. It is rare for any hospital to aspire to this goal, much less achieve it. And our patient satisfaction scores are improving as a result."
"These milestones speak to the integrity of our nurses. They are very willing to help out and there is a sense of team work," says Jennifer Piccione, interim Chief Nursing Officer.
In April 2008, nursing leadership made the decision to become "agency free" meaning that the nursing units would no longer use contracted or agency nurses to supplement staffing needs. In the past, agency nurses were used when regular nursing staff members were ill or on vacation, or there were open positions. It’s a common practice used in most hospitals.
"Being agency free has benefited the organization in many ways," noted Piccione. "Agency nurses come into an organization to do a job. But their heart is not here and they aren’t familiar with our processes or our patients." She also cited that agency nurses are not familiar with the standards of behavior that all MCH employees are required to uphold.
"We have a culture of excellence and high expectations for each and every staff member who is employed here," Piccione noted. "Because agency nurses were only here short periods of time, and they were not familiar with our culture, it was difficult to hold them to the same high standards that our nurses practice every day."
To eliminate the use of agency nurses, the MCH nursing team committed to filling in staffing gaps by being flexible with their schedules, adjusting the models, and continually reviewing the needs of each department. Nursing leadership meets every afternoon to look at the staffing needs for each unit and then determines who is available. Staff members are reassigned to accommodate the needs of the patients.
"Maintaining our agency free status has not been without its challenges. It wouldn’t work without our nurses being completely committed and flexible." Piccione said. She attributes that to a different work environment where nurses feel valued, that their input matters and that they’re part of the decision-making.
Since the elimination of agency nurses, the initiative has led to over $200,000 in cost savings annually for the hospital. It also allows for more consistent care for patients, since the same nurses are dedicated to each unit.
Additionally, the nursing units have improved their patient satisfaction scores as rated by Press Ganey. According to its web site, Press Ganey works with more than 7,000 health care organizations to measure and improve their quality of care with research-based and –tested surveys. Press Ganey is the health care industry's most widely used approach to collecting stakeholder perspectives.
Hospitals strive to be in the 99th percentile—the very best score. MCH’s maternity unit has consistently ranked in the top 1% of all hospitals in eight key areas, including likelihood to recommend, staff addressed emotional needs, staff kept you informed, staff response to concerns and complaints.
"Being in the 99th percentile means that our maternity unit does a better job in regard to those questions than 99 percent of the other hospitals in the country regardless of size." Piccione explained.
Overall, patient satisfaction scores are improving in surgery, the intensive care unit, the emergency room and the medical-surgical nursing units.
"Madison County Hospital obviously wouldn’t be here without our nurses," Piccione says. "But we’ve taken that extra step now to make sure each patient’s experience is positive and memorable."