A Time of Rapid Change:Leading Graduate Nursing Students to Improve Outcomes with a Microsystems Model

The American healthcare system is at a historic time of change with emphasis on improvement and metrics that support valuable initiatives. As a result, the generic Masters of Nursing curriculum at Fairfield University was... [ view full abstract ]

The American healthcare system is at a historic time of change with emphasis on improvement and metrics that support valuable initiatives. As a result, the generic Masters of Nursing curriculum at Fairfield University was redesigned to an award winning program emphasizing improved patient care. The culminating experience of graduate nurses in the Masters of Nursing Leadership (LEAD) is focused on leading change in a clinical setting. The student utilizes a variety of skills and knowledge gained through course work with clinical expertise to lead an interdisciplinary team in a microsystems approach to improvement. Utilizing a model developed by Nelson, Godfrey and Batalden, students complete a thorough assessment of a clinical unit (microsystem) to identify priorities issues for improvement. Faculty work closely to mentor students in a structured improvement process and identify metrics that measure success over time. Student use a Plan-Do-Study-Act process to work through tests of change. In the LEAD program student commit a minimum of 350 hours to the improvement process over a 10 month period. The success of the model over the last 5 years has centered on the flexibility of the model to adapt to a variety of healthcare settings. With a foundation of assessing the microsystem, the improvement can be designed with key stakeholder to be appropriate for the culture of the clinical area. Outcome of recent projects have been especially valuable in a time of rapid change in healthcare. The presentation will focus on a variety of clinical projects that have been completed with this model and the associated metrics. Settings include acute care, home care and the primary care environment. Examples of initiatives will include issues of care coordination, medication safety, hand-off communication initiatives, as well as projects around reducing infections. The role of faculty mentoring will also be discussed.