By Robin Overbay
Thursday, April 14, 2022
The pandemic caused unimaginable challenges for healthcare systems across the world. In central New York, St. Joseph’s Health was up to the task.
Measures taken prior to the pandemic and meaningful adjustments made in response to COVID-19 set St. Joseph’s Health up for success and enabled them to maintain capacity and serve their community during one of the most difficult times in healthcare’s modern history.
Fostering a team approach and shared governance set the precedence of unity by allowing nurses and other staff to share concerns which would then be addressed to improve patient safety, optimize positive outcomes, ensure job satisfaction, and elevate the overall experience of patients and their families. Working this way throughout the pandemic also brought the St. Joseph’s Health team closer together, which measurably improved resiliency among staff, something still evident in the recovery phase following the initial and subsequent COVID-19 surges.
“Our nursing team here is absolutely wonderful and comfortable with the ever-changing landscape, and they are able to effectively care for and support our community,” says Jamie M. Kabanuk, DNP, MSN, RN, NEA-BC, Chief Nursing Officer at St. Joseph’s Health.
Raising the Bar for Clinical Excellence
Kabanuk believes promoting employee engagement and empowerment — in tangible ways — can directly improve patient safety and outcomes.
“We promote a shared decision-making platform here at St. Joseph’s Health, and we use our shared governance committee and our unit practice committees to elevate the voice of our bedside colleagues,” Kabanuk says, noting how this approach allows for faster and better identification of issues so changes can be made to improve patient care and experience. This approach also empowers the clinical team because they know their input is heard, valued and taken seriously.
“Our Unit Practice Council (UPC) is right down at a unit level, including our licensed staff and unlicensed staff, ancillary staff and manager/leadership staff, to be a part of bringing the unit’s voice to the higher-ups,” adds Helen “Melba” James, MHA, RN, Interim Director, Capacity Management Center at St. Joseph’s Health.
St. Joseph’s Health uses a tiered huddle approach to make it happen. First, the UPC will meet and bring ideas to their managers and leadership. Leadership then huddles and passes this information to directors at another tier level, then it travels to administrators, and on to VPs. Messages heard during the initial UPCs are also heard by practice administrators, the CEO, finance officers and human resources.
“So, it really goes all the way to the top,” James says. “Now, when those concerns are communicated and employees start to see changes, they realize they are a big voice — not a little voice — in this organization, and that there is a whole team behind them at different layers and at different levels of administration willing to help them.”
Kabanuk says shared governance was exemplified when a bedside colleague expressed the need for a designated discharge nurse who could provide support and one-on-one attention to patients during the discharge process. Assisting patients during this process was often time-consuming for staff and sometimes confusing for patients. The administrators listened and decided to provide this new service — tangible proof that they responded to the concerns of their clinicians — which improved satisfaction for both patients and staff.
“We were the ones who were holding this pandemic at bay. I told staff, ‘One day students will read about you in their epidemiology books and learn from how we conquered and overcame — so take pride in knowing that in a way, you have sealed your identity in history.”
— Yuri Pashchuk, MSN, RN, CCRN-k, Clinical Director of Medical and Surgical Services, Critical Care and Careflight at St. Joseph’s Health
Recognition and Positive Reinforcement
Celebrating staff accomplishments — in a profession where burnout and compassion fatigue pose a real threat to healthcare systems — can go a long way toward boosting morale. Positive reinforcement also incentivizes and recognizes nurses who help make the organization successful, which translates to improved patient outcomes and satisfaction.
One of the important ways St. Joseph’s Health honors its staff is to give awards:
- The DAISY Award honors nurses who go “above-and-beyond” to provide quality, compassionate care to their patients. Nurses can be nominated by patients and/or their families, and by their colleagues.
- The Good Catch Award, a lapel pin featuring a baseball and catcher’s mitt, gives recognition to team members who identify and bring forward issues that could risk patient safety or quality before an adverse event occurs.
- The Sister Patricia Ann Award, named after one of the founding nuns at St. Joseph’s Health, recognizes team members who display tremendous healthcare leadership.
- The Spirit of St. Joseph’s Award is given to those who exemplify the hospital’s values and mission.
When Rewarding Reaps Rewards
Providing a consistent show of appreciation and respect across departments may also have something to do with the acknowledgments the hospital routinely receives for clinical excellence.
“St. Joseph’s has always been a leader in quality and outcomes with Leapfrog designations, the U.S. News & World Report Best Regional Hospital designation, Magnet designation, and the Beacon awards — the highest awards for clinical excellence in critical care — for both of our critical care units,” says Yuri Pashchuk, MSN, RN, CCRN-k, Clinical Director of Medical and Surgical Services, Critical Care and Careflight at St. Joseph’s Health.
Pashchuk says Magnet-designated hospitals offer not only improved patient safety and lower patient mortality rates but also job satisfaction and more options for personal development and growth.
“All of those [designations] translate to a culture that we have developed over the years, where we set a high bar for ourselves,” Pashchuk says. “Those who have stuck with us understand that and they rise to that level and encourage others to do the same.”
“Our nurses have a voice. Our staff has a voice. Our nutritional service members have a voice. It’s not just that we focus on our licensed nurses, but we know that in order for this whole organization to work well, we must hear the voice of everyone from every department. We try to be an all-inclusive culture to improve our community.”
— Helen “Melba” James, MHA, RN, Interim Director, Capacity Management Center at St. Joseph’s Health
An Enduring Alliance Moves Beyond the Pandemic
Staff shortages and burnout aren’t new to healthcare systems, but these problems have grown exponentially in recent years. According to ECRI, an independent non-profit healthcare quality and safety organization, the top two patient safety concerns of 2022 are staffing shortages and the effect the pandemic has on a healthcare worker’s mental health.
St. Joseph’s Health recognized the growing threat and moved quickly to employ policies and procedures that would improve patient outcomes, including taking good care of its team. Prior to the pandemic, St. Joseph’s Health already had some systems in place to reduce the duration of hospital stays and nosocomial conditions, ensure adequate community support on discharge, and reduce the risk of readmissions. However, when the pandemic hit, more adjustments were made, including:
- Introducing a new patient care tech position that enabled members without a formal healthcare education to receive in-house training to assist and reduce the burden on current staff
- Redeploying staff from other departments that were seeing lower than usual patient volume into areas that needed more support
- Using allied health colleagues to augment some of the work that would typically fall on their nurses
“Different executive orders brought all kinds of changes to health care,” Pashchuk says. “We needed to be agile and adapt quickly, and we needed to make sure that our staff had enough time to process that.”
Administration showed their support to frontline healthcare workers early, and it wasn’t uncommon to see the CEO, Chief Medical Officer or Chief Financial Officer rounding on these clinical units, including the COVID-19 unit.
“When we started seeing some of the first waves, it was a very scary time and we needed to be able to be very close at the elbow with our staff to make sure they knew we were in this together, no matter what level of leadership you were in,” Pashchuk says.
The C-suite donned the proper PPE and joined staff in solidarity to make sure they were visible, and that frontline staff had access to top leadership as close to real time as possible.
“Instead of coming to work in suits, we were coming to work in scrubs,” James says, adding that St. Joseph’s Health also introduced a manager-on-call initiative to share the burden more evenly. “Instead of you getting called to come in and me getting called on the weekend, how about I’m just on call for my unit and you for your unit.”
James says the change strengthened the leadership infrastructure and allowed for more uninterrupted downtime and recovery for staff members who greatly needed it.
“We definitely proved that we have each other’s backs,” she asserts. “Our managers have never been stronger, and our clinical managers continue to lean on each other to this day.”
St. Joseph’s Health administrative RN coordinators, whom James calls the unsung heroes throughout the pandemic, carried not only their own personal stress, but the stress of the staff, and that of the patients and patients’ families.
Pashchuk says he’s proud St. Joseph’s Health was prepared to help when COVID-19 cases were climbing, adding that their success was supported by a lot of hard work and processes they implemented years prior to the pandemic.
“That was something that the Department of Health and New York State watched very closely because our colleagues were at capacity,” Pashchuk says about other facilities. “St. Joseph’s was full but was able to maintain capacity and keep their doors open to serve the community for COVID-19 and other medical needs. We took a lot of pride in that, but that wasn’t something that was as obvious or as evident outside of these walls.
“Being a nurse at St. Joseph’s Health is not like being a nurse anywhere else in our community. I joined health care at St. Joseph’s health because I believe nursing can make a difference in people’s lives. We will continue to make decisions together and support the movement forward in our nursing journey.”
— Jamie M. Kabanuk, DNP, MSN, RN, NEA-BC, Chief Nursing Officer at St. Joseph’s Health
St. Joseph’s Health paid close attention to staff needs and responded with a variety of support, such as adjusting policies to ensure adequate staffing and access to medical supplies. They also implemented resilience rounding for team members who were under more intense stress due to COVID-19 surges.
“Our colleagues are very dedicated to the care of the patients, often putting the care of the community over their own care, and we want to be able to support them in the programs that we are able to provide here at St. Joseph’s Health,” Kabanuk says.
St. Joseph’s Health also has a diverse employee assistance program that provides mental health services including group therapy sessions, individual counseling and psychiatric services. As a Catholic institution, St. Joseph’s Health chaplains and interfaith colleagues are available to talk and pray with staff, provide grief counseling and other support services.
At the end of the day, nurses and other team members at St. Joseph’s knew their community needed them, and they were ready to look the viral enemy in the eye during this pseudo-wartime scenario.
“They rallied around each other and knew, if not us, then who? Who is going to step up and help our community? These were our family members, our neighbors,” Pashchuk says. “Our nurses have been some of our biggest champions and leaders through not only COVID-19, but all challenges where we continue to see improvement.”
Visit jobs.sjhsyr.org for more information on joining the St. Joseph’s Health nursing team.