N u r s i n g A nn u a l R e p o r t 2 0 0 9
I Care
OUR Mission:
To provide healthcare as we expect for our own family.
OUR Vision:
Northern Michigan Regional Hospital will be recognized
as the best place for patient-centered care and excellence in
quality, people, service, and financial performance.
Our Guiding Principles:
Northern Michigan Regional Hospital is guided by our
principle to SERVE...
Safety...of our patients and staff
Excellence...in all that we do
Respect...for everyone all the time
Value...in all that we offer
Enthusiasm...as our way of life
Our Vision for Nursing:
Nursing at Northern Michigan Regional Hospital provides
exceptional patient-centered, interdisciplinary, evidencebased care. We place quality-caring relationships at the
center of our practice resulting in a safe, compassionate,
and healing environment.
Messages from Our Leaders and Mentors
Every day I see great things happening at Northern Michigan Regional Hospital. Dedication to your patients, your
fellow Colleagues, and your organization is truly inspiring. I believe that patient-dedicated nursing professionals
continuously set the benchmark for quality, safety, and best practices.
Through teamwork, our nurses support an impressive roster of advances and innovations in healthcare, including
the use of bar coding and Smart Pump technology, the reduction of clerical errors, and the implementation
of extensive safety protocols. I am especially proud of the hand-washing campaign and your involvement in
drastically reducing the incidence of Hospital-acquired infections. These are just a few of your accomplishments;
there are many, many more listed in this report.
It is through your professionalism and leadership that we are able to provide the best care for our patients and families, community,
Colleagues, and self. It is our mission to provide healthcare as we expect for our own family.
Thank you for everything you do each and every day.
Mary-Anne D. Ponti, RN, MSN, MBA, CNAA-BC
Chief Operating Officer/Chief Nurse Executive
On behalf of the Board of Trustees of
Northern Michigan Regional Health System,
I would like to thank the entire nursing staff
for its commitment to providing excellent
care. Your unyielding and compassionate
contact with our patients leaves a lasting
impression. We are very proud of all of you.
The year 2009 was one of change and
challenge for Northern Michigan Regional Health System and for our
country as we prepared for healthcare reform. As the debate continues, our
diligence in providing the best care today and every day for our patients is
unwavering. We know that we must combine resources and talent across
our entire region to provide high quality, affordable care to all who enter
the Health System. Hospital nurses are at the forefront of this ongoing
effort; you are the professionals, the caregivers, and the nurturers, who
are ready with support for our patients and their families. We honor your
efforts and your dedication as you care for those who depend upon you.
While the healthcare reform debate
continues in Washington, here at
home we stay focused on our role as
healthcare providers for the local and
regional populations. We know that
true healthcare reform first must be
addressed at the community level,
by which nurses, medical staff, and
Colleagues work together to identify and
address the healthcare needs of the residents we serve in the 22
counties throughout northern Michigan and the eastern part of
the Upper Peninsula.
This proactive approach keeps Northern Michigan Regional
Health System in the ranks of exemplary healthcare facilities
in the state, and even the nation. A nursing and medical staff
devoted to the highest levels of care, world-class specialists,
leading edge protocols, Hospital-wide patient safety and
quality strategies, and hundreds of highly motivated Colleagues
department-wide help us provide healthcare as we would expect
for our own families.
The Board is confident that Northern Michigan Regional Health System
has the nursing, medical, and management expertise, plus the necessary
technology to achieve our goals and position us as a healthcare leader
well into the future.
At Northern Michigan Regional Health System, we pursue quality
every day, in all that we do, so that all of our neighbors and
healthcare partners will have access to the very finest patientcentered care available anywhere.
Wendy Walker, MD
Chair, Board of Trustees
Reezie DeVet, RN, EdD
President & CEO
In the long history of nursing, there has been one constant: the desire and the ability to nurture others who need
help. Our dedication to our profession is deep and profound. We know of no better way to serve our patients. The
nursing Colleagues at Northern Michigan Regional Hospital strive for excellence, both individually and collectively,
every day. Professional dedication, ongoing training, and rigorous attention to protocols and standards get results.
2 0 0 9
N
u r s i n g
A
nn u a l
R
e p o r t
1
S t r at e g i c P l a n
The Ongoing Pursuit of Excellence
O
ur pursuit of Magnet status is a journey we began in 2007, and while that goal is never out of sight, we know
that the process itself is paramount to our eventual success. It is, after all, the journey that guides our decisions,
big and small, immediate and long term. We know that the individual steps we take to achieve Magnet status
are, in total, what supports making our Hospital the excellent facility that it is today.
The enclosed information expands and clarifies each of the eight components of our Nursing Strategic Plan and
highlights the three key drivers* that guide us in our pursuit of excellence: 1) Colleague empowerment; 2) open,
honest two-way communication; and 3) workplace satisfaction.
* Determined through the 2009 PRC nursing Colleague job satisfaction survey administered.
2009-2014 – Nursing
Capabilities
2
Strategic Plan – Division of Nursing
Customer
Financial
Leadership
• Leadership Development
• Succession Planning
• Shared Governance
• Collegial Interdisciplinary
Relations
Satisfaction
• Patient
• Colleague
• Physician
• Community
Education
• Advanced Education
• National Certifications
• Continuing Education
• Partnerships with
Schools of Nursing
Vision For Nursing
Recruitment and Retention
• Clinical Ladder Program
• Benefits and Compensation
• Effective Staffing
• Mentoring
• Career Counseling
• Personnel Policies and
Procedures
This Nursing Strategic Plan is consistent with the overall
Northern Michigan Regional Health System (NMRHS) Strategic
Plan relative to its Value, Physician-Health System Alignment,
and Partnership Strategies as follows:
• NMRHS Value Strategy: All Inclusive
• NMRHS Physician-Health System Alignment Strategy:
Satisfaction
• NMRHS Partnership Strategy: Satisfaction, Professional
Practice, and Education
2 0 0 9
N
u r s i n g
Resource Utilization
• Cost Management
• Effective and Flexible
Staffing
• Bright Ideas Program
• Revenue Enhancement
Nursing at Northern Michigan Regional Hospital provides
exceptional patient-centered, interdisciplinary, evidence-based
care. We place quality-caring relationships at the center of
our practice resulting in a safe, compassionate, and healing
environment.
A
nn u a l
R
e p o r t
Quality
Culture of Safety
• National Patient Safety Goals
• Keystone Projects
• Environment of Care
Professional Practice
• ANA Scope and Standards of Practice:
Autonomous Practice
• Emerging Technologies/Electronic
Medical Record (EMR)
• Ethics
• Professional Organization
Membership
Quality Care
• Evidence-based Practice
• National Quality Measures
• Nursing Standards
• Nursing Research
• Performance Improvement
Quality of Care
Living Our Mission
E
very day, nursing Colleagues deliver healthcare that they would expect for
their own families. Since 2003, Northern Michigan Regional Hospital has
participated in Michigan Health & Hospital Association (MHA) Keystone
Center collaboratives for patient safety and quality. Participating with the state’s
leading healthcare professionals, nursing Colleagues are sharing evidencebased best practices to prevent infections, reducing surgery complications and
Hospital inpatient days, improving patient safety, reducing healthcare costs, and
establishing a culture of safety.
Northern Michigan Regional Hospital is now participating in two new MHA
Keystone patient safety collaboratives:
MHA Keystone: Obstetrics (OB) Northern Michigan Regional Hospital
participated in the 2008 OB pilot program. In Fall 2009, the Hospital was
one of the first in the state to formally participate in this new patient safety
initiative, which focuses on timely interventions for elective induction of
labor, coordinating a safe progression of labor, and appropriate responses to
fetal distress.
Karri Gauthier, RN, Direct Admit Room, (standing) and Erin
McCoubrey, RN, Emergency Department (seated)
MHA Keystone: Emergency Room (ER) seeks to improve safety, reduce
overcrowding, and recognize and treat early-stage sepsis, in addition to
coordinating emergency room treatments to insure that the most critically ill
patients receive treatment first.
MHA Keystone: Gift of Life continues to
pursue ways to increase organ donation
within Michigan. In 2009, Northern Michigan
Regional Hospital received the esteemed
silver medal of honor for converting 75% of
eligible deaths into organ donors.
In addition to these new MHA Keystone collaboratives, Northern Michigan
Regional Hospital is participating in ongoing patient safety initiatives
including: Intensive Care Unit (ICU); Hospital-Associated Infection (HAI);
Gift of Life; and Surgery.
Joint Commission Results
The Joint Commission conducted its
unannounced triennial accreditation
survey at the Hospital in November
2009. The survey measures and
validates continuous quality and safety
improvement efforts. Joint Commission
surveyors were highly complimentary
of the Hospital, Colleagues, medical
staff, and Board of Trustees. The
nursing team played a critical role in
achieving this high accolade. Northern
Michigan Regional Hospital is fully
accredited for another three years.
“Patient safety and quality are at the very center of what we
do. Our participation in these studies will further ensure that
patients receive the safest, highest quality care, and that both
patient and Colleague satisfaction will increase.”
– Gretchen Schrage, MBA, MT(ASCP)SH, CPHQ
Patient Safety Officer
K e y to Q U alit y I nitiatives
The NPSGs and NDNQI icons found throughout this book are indicators of participation in national
safety initiatives. These signifiers mean that patient safety influences every decision made by
Hospital nurses, today and every day.
NPSGs
National Patient Safety Goals
2 0 0 9
N
NDNQI
u r s i n g
A
National Database of Nursing
Quality Indicators
nn u a l
R
e p o r t
3
Culture of Safety
N
ational Patient Safety Goals (NPSGs) provide
measurements to guide healthcare professionals
in the quest for safe patient care. Northern
Michigan Regional Hospital strives for 100% patient safety
compliance which supports achievements in evidence-based
practice goals. Nursing Colleagues strive for excellence in
practice every day.
Safe Patient Handling
NPSGs
NDNQI
In 2009, Northern Michigan Regional Hospital completed
a three-year minimal lift project for safe patient handling.
This initiative began with the purchase of lift equipment
and friction reducing devices in 2006. Following education
and training, the program was implemented in January.
During the last three years, there has been a reduction in
Colleague back and other patient handling injuries – a
savings of over $250,000 in 2009 alone.
Use of the new electronic Patient Safety Precaution Form
in 2009 improved assessment of patients for appropriate
lifting equipment and device usage. Most 2009 injuries
were the result of patient repositioning from a supine
to seated position or a seated to standing position.
Continuing education for Colleagues facilitates patient
repositioning using the MaxiSlide, MaxiMove,
and SARA devices.
Keeping Infections Away
NPSGs
Several Hospital initiatives have made a
significant impact reducing or eliminating
Hospital-Associated Infections (HAI),
requiring the collaboration of many
different departments. Impressively, the
Hospital has gone two full years with
zero central-line associated blood stream
infections in the Intensive Care Unit and
near zero Hospital-wide. In addition for
2009, hand hygiene compliance met the
goal of reaching/exceeding 90% by yearend. Further reductions were realized in
the following areas: urinary tract infections,
ventilator-associated pneumonias, and
surgical site infections.
Patients & Families
Staying Safe
I Care
“I care about my patients here at the Hospital. I do whatever I can
to treat their conditions, calm their fears, and maintain their comfort.
I am dedicated to them, and, by extension, to their families.”
4
2 0 0 9
N
u r s i n g
A
nn u a l
R
– Tammy Vizina, RN, BSN
Progressive Pool
e p o r t
Hand Hygiene Compliance 2009
100%
90%
80%
70%
60%
50%
40%
30%
2008 YTD 1/9
2/09
3/09
4/09
5/09
6/09
7/09
8/09
9/09 10/09 11/09 12/09
Identified with the highest percentage – an impressive 99% – of scanned
medications in conjunction with the most medications, Adam Brege, RN, and
Mandi Kucharek, RN, are role models for their commitment to patient safety
and safe medication administration.
Target
Keystone Comparative
2008 High Score
Northern Michigan Regional Hospital Compliance
Empowering Patients
5
NPSGs
The Hospital Critical Assessment Team (CAT) encourages
patients’ active involvement as a safety strategy through early
recognition of clinical changes that could lead to life-threatening
episodes. Early intervention and detections are the goals.
Typically, symptoms appear approximately seven hours ahead
of a life-threatening episode, ample time to effectively handle
an event. For 2009, implementation of the Team decreased the
number of patients who experienced life-threatening episodes 10
outside of intensive care and emergency rooms.
8
30
9
Correlation Between CAT Calls & Non-ICU Codes
25
4
C at Ca l l s
5
C ode s Ou t s ide
7
6
2
0
20
1
01/09 02/09 03/09 04/09 05/09 06/09 07/09 08/09 09/09 09/09 09/11 09/12
Non-ICU Codes
CAT Calls
Preventing Errors
Linears (CAT Calls)
3
2
1
8,688
4,551
2,001
2002
6,927
7,339
2006
2007
0
7,711
5,505
3,127
2003
2004
2005
2008
2009
5
Nurse Colleagues continue to lower the number of medication
errors at the Hospital. The decline in the 2009 number of errors
was due to several factors including:
• improved daily medication drawer exchange process;
• modified introduction of graduate nurses into the organization;
• use of error prevention data for performance improvement; and
• elimination of traveling nurses.
0
Making Progress
10
2
4
Medication Errors Prevented
4
15
3
0
Pumps in 2009, Northern Michigan Regional Hospital
has completed the three major recommendations from
the Institute of Medicine (IOM) including:
• Automated Dispensing Systems (Pyxis)
• Bar-Coding Medications
• Smart Pump Technology
6
Critical Assessment Team
8
6
Linears (Non-ICU Codes)
NPSGs
Nationally, medication errors account for thousands of deaths
annually and billions of dollars in excess costs. Smart Pumps,
featuring built-in safety checks, go a long way in addressing these
issues. Already years ahead of the national curve for the adoption
of leading-edge safety technologies, Northern Michigan Regional
Hospital was one of the first hospitals to adopt a bar-coding
program for medication safety. With the addition of Smart
Northern Michigan Regional Hospital continues its
adoption of Cerner electronic medical record (EMR),
also known as PowerChart®. Of the seven stages of
implementation, the Hospital is currently at Stage
3, with Stages 4 and 5 in process. Fewer than 9.4%
of hospitals nationwide have achieved Stages 6 or 7;
most Michigan hospitals are at Stage 2. Of the current
nursing Colleagues, 489 participated in PowerChart
refresher courses, plus 69 new Colleagues and 156
nursing students were trained in 2009.
2 0 0 9
N
u r s i n g
A
nn u a l
R
e p o r t
5
P r o f e ss i o n a l P r a c t i c e
Division of
Nursing Professional
Models of Care
Doing The Job
are
H
f
o
Quality-Caring
Theory
Principles of American
Nursing Association
D
eliver
Tier #1:
Mission / Vision / Guiding Principles
The Hospital Division of Nursing shares the
mission, vision, and guiding principles of
the entire Health System. In the process
of providing healthcare as they would
expect for their own families, nursing
Colleagues work tirelessly to further
the goals of the Hospital and the
communities it serves.
Clinical
Practice
Model
y
Each tier of the Professional Models of Care builds upon
itself to further the best practices in quality healthcare.
Each component functions both independently and as
a foundation for the next level.
C
ospital nursing Colleagues embrace the
technological advances of the nursing profession,
maintain an ethical approach to all situations,
and operate within the best interest of their patients and
families, community, Colleagues, and self.
Tier #2:
Mission / Vision / Guiding Principles
Principles of American Nursing Association
Nursing Colleagues are
guided by the American
Nurses Association (ANA) Scope
and Standards of Practice and the Nursing Code of
nursing practice and to improve healthcare outcomes
Ethics. This is their commitment to serve patients, their
through the eight elements of the theory: mutual problem
families, and the community with knowledge, expertise,
solving, attentive reassurance, human respect, encouraging
and evidence-based practice.
manner, appreciation of uniqueness, healing environment,
basic human needs, and affiliate needs.
Tier #3:
Quality-Caring Theory
Tier #4:
Quality-Caring Theory forms the midpoint of the care
Clinical Practice Model
model. Developed by Joanne R. Duffy, RN, FAAN,
The Clinical Practice Model (CPM) supports a healing
PhD, Professor Indiana University School of Nursing, the
environment and professional culture that is beneficial to
Quality-Caring Model and Quality-Caring Theory build
both patients and caregivers. This partnership-based model
upon the work of healthcare theorists to offer a dynamic
yields holistic patient-centered care that embraces patients
framework of comprehensive knowledge that freely
and families while addressing their physical, emotional,
engages Colleagues, patients and families, and community. cultural, and spiritual dimensions.
Nursing Colleagues are able to advance the professional
6
2 0 0 9
N
u r s i n g
A
nn u a l
R
e p o r t
S at i s fa c t i o n
2 0 0 9 D ais y Award W i nn e r s
P
atients and families have the opportunity to honor nursing Colleagues for extraordinary efforts in caregiving with the
DAISY Award*, a collaborative effort of The American Organization of Nurse Executives (AONE) and Cinnabon®.
Winners receive a handsomely presented certificate, a DAISY Award pin, a hand-carved Shona stone sculpture entitled
“A Healer’s Touch,” and a bottle of Makara Cinnamon from Cinnabon.
* Representing Disease Attacking the Immune System, a national program created by the family of Patrick Barnes in January 2000.
C o ngratulati o ns t o
Jennifer Gertz
ICU
Douglas Hill
CVU
Laurie Laughbaum
NICU
the 2009 Award Recipients
Matt Malkowski
Level 2 North
Linda Schofield
ICU
Alison Sibbald
Level 2 South
Melissa Tarvudd
Level 2 North
Colleagues
Honoring Those Who Serve
National Nurses Week 2009, “Building a Healthy
America,” celebrated and honored the work of Northern
Michigan Regional Hospital nursing Colleagues.
Northern Michigan Regional Hospital Foundation
sponsored the guest speaker Lisa Milleto, CRNA, MS,
Director of Oakland University’s Beaumont Graduate
Program of Nurse Anesthesia, who spoke about the
multigenerational dynamics that impact healthcare
professionals. Six nurses were presented with the peernominated Florence Nightingale awards:
• Administration – Shelly Germain
• Education/Research – Paula Jo Shingler
• Nurse in Non-Traditional Role – Karen Doherty
• Staff Nurse Practice – Emilee Kennedy
• Advanced Nurse Practice – Jennifer Jensen
• Lifetime Achievement Award – Gisele Nicholas
I Care
“I care about each and every Colleague. They are my support system,
just as I am part of theirs. Together, we work to ensure that our patients
feel safe, cared for, and can begin their healing process.” – Patty Walton, RN, MSN
Clinical Liaison
2 0 0 9
N
u r s i n g
A
nn u a l
R
e p o r t
7
Leadership
Leadership in Action
A
Developed by Hospital RNs Karen Safko, Amy
Mansfield, and Linda McIntosh (former Colleague),
the Journey takes the form of a 14-step board game that
records the amazing stories that happen every day at the
Hospital. Congratulations are in order for the Radiology
Department who was first to complete The Amazing
Journey in October 2009.
shared commitment and response to good
governance yields remarkable results in safety,
procedures, and overall patient satisfaction.
Sharing the Vision
The Shared Governance Model is a blueprint for effective
Colleague communication. Adopted in 2007, Shared
Governance has led to numerous improvements in
safety, methodology, patient care, and collaboration, and
continues to be an effective communications method for
all nursing Colleagues.
Tutorial Prepares Future Nurses
The Hospital Preceptor program, intended to facilitate the
licensure process for nurses, conducted three classes during
2009, and served 32 students. Full-day sessions included
generational differences, adult learning theory and
learning styles, personality conflict management, Benner’s
Novice to Expert Theory, and an enrichment day.
The Amazing Journey
The Amazing Journey debuted in 2008 as a way for all
Hospital Colleagues to identify and record examples of
the 14 Forces of Magnetism and Sources of Evidence.
n
it
-B
ed
s
a
ncils
Cou
&
Mag
ne
t
Ch
a
m
Nursing Education
Council
Council Chairs
io
Nursing Research &
Evidence-Based Practice
Council
S
Nursing Recruitment &
Retention Council
p
n
U
Shared Governance Model
PNC
Council Chairs
Nursing Quality &
Patient Safety Council
U
n
i
8
2 0 0 9
N
t
-B
a
u r s i n g
Nursing Informatics
Council
Nursing Clinical Ladder
Council
se
d
A
Co
unc
ils
nn u a l
R
e p o r t
&
t
Magne
am
Ch
o
pi
n
S
E d u c at i o n
Doing His Part for Healthcare
NPSGs
Colleagues
Come Together
2nd Annual Nursing Summit
October 23, 2009, was a day-long
conference for nurses and support
Colleagues to review nursing theory and
how it applies to bedside care and practice.
There were over one hundred participants,
including many direct care nurses, a
marked increase over 2008. Joanne R.
Duffy, RN, FAAN, PhD, and Kathy
Wyngarden, RN, BSN, MSN, FNP,
were featured speakers. The Summit was
supported by generous Foundation donors.
SimMan is a remarkable interactive
learning tool that simulates a living
patient – he speaks, breathes, and has
heart, lung, and bowel sounds – and is
useful in a variety of scenarios. He can
be programmed to simulate physical
trauma injuries such as burns, stabbings,
and amputations, as well as myocardial
René Bieganowski, RN, BSN, BBA,
infarctions (heart attack), respiratory
Clinical Education, (center) demonstrates
problems, and other conditions. Training SimMan to Maureen Ronquist, RN,
MSN, CCRC, Nisus Research, (left) and
exercises are limited only by the user’s
Kathy Smith, RN, CVU (right).
imagination. Additionally, SimMan is a
valuable reminder of the importance of regular safety measures: in keeping
with Hospital safety protocols, each SimMan program includes two patientidentifiers and hand hygiene. Since 2007, there have been 2,678 hands-on
SimMan demonstrations and educational contacts with local students,
Hospital employees, emergency workers, Board members, and pharmacists,
among others.
Institute of Nursing
Patty Walton, RN, MSN, Clinical
Liaison, presented “Crucial Conversations:
A Model for Creating a Culture of
Safety” at the Fall 2009 Institute of
Nursing Excellence retreat. The threeday conference was designed to reward
excellent direct-care nurses; encourage
them to remain in the profession and
attract others; increase their capacity for
leadership; and enhance their ability to
be role models. Walton discussed the
foundation of the Crucial Conversations
model as it relates to healthcare and a
culture of safety.
“Embracing caring
relationships as the basis for
practice offers professional
nursing a promising future that
will make a profound impact on
patient outcomes.”
– Joanne R. Duffy, Author of Quality Caring in
Nursing: Applying Theory to Clinical Practice,
Education, and Leadership, a guide for Northern
Michigan Regional Hospital nursing Colleagues.
Personal Achievment is the Hallmark of Nursing Colleagues
Continuing Education (CE) programs, professional development,
advanced degree status, and scholarship opportunities distinguish
nursing Colleagues at Northern Michigan Regional Hospital. Below, the
outstanding scholarship recipients of 2009:
Baiardi Scholarship
Ashley Brandt
Sarah Tanner
Sally Brown
S.T. Kutcipal
Scholarship
Sharon Bryant
Linda LeFevre
Diane Wren
Brenda Osterhout
Suzanne Duvall
Marcella Nuffer
Debbie Left
Janet Gentle
Karen’s Uniform
Scholarship
Lucinda Peebles
Orthopaedic
Education Fund
Scholarship
Faye Dubay
Anna Czarnecki
Judie Bricker
Heidi Brege
Jeannine Miller
Leanne Rasmussen
Patty Frederick
Lin McIntosh
Rose Schurig
Cardiac Cath Lab
Staff Education
Scholarship
Eileen Butler
Ruby Pettenger
Bruce Kumfer
Donna Pastorius
Pam Ulvund
Randall Reed
2 0 0 9
N
Level 3 RN’s
Scholarship
Alicia Duarte
Karen Hadley
Brenda Balogh
Mary Howard
Barb Pluister
Sarah Henning
Emilee Kennedy
Adam Brege
Level 3 Staff
Education
– Haupricht
Scholarship
Gwen Sangeorzan
Mindy Shock
Maria Candela
Alicia Duarte
Theresa Kilpatrick
u r s i n g
A
Continuing
Education
Scholarship
Lee Ruemenapp
Emily Cochran
Kim Westrick
Patricia Dallaire
Tina Aown
Jennifer Woods
Lacey Nursing
Scholarship
Alicia Beebe
Sally Brown
Rebecca Stanley
Emily Cochran
Susan Shore
Joann Haderer
Shelly Bellmer
Susan Nuorala
nn u a l
R
e p o r t
9
Community
Recruitment and Retention
Career Satisfaction
Moving Up NDNQI
The Nursing Clinical Ladder, Novice (I) to Expert (V), is a
five-level system of professional advancement for nurses.
In 2009, four nursing Colleagues attained Level IV.
Continuing Education
NPSGs
New in 2009, nurse graduates with less than one year of
experience can increase their knowledge and skills with
the RN-1 Program, a voluntary six-month internship
program aimed at increasing Colleague experience,
improving satisfaction, and strengthening the recruitment
and retention of nurses. Guest speakers, hands-on
SimMan crisis workshops, and classes on professionalism,
leadership, patient care issues, and caring and values are
the subjects of the eight-hour class sessions. Following
the six-month internship, participants choose a mentor
who will support and guide them for one year. Nine nurse
graduates completed the program in 2009.
A Healthy Work Climate
NPSGs
NDNQI
New action plans have been implemented as the result
of the 2009 PRC nursing Colleague job satisfaction
survey findings. Almost 600 respondents indicated the
importance of open communication between staff and
superiors. Initiatives include methods for event reporting,
problem solving, and error reduction.
Direct Care RN Vacancy Rate NDNQI
• 2 009 Average – 3.5% (National Median 4.8%)
• 2008 Average – 6.7%*
• 2007 Average – 5.3%*
Direct Care RN Turnover Rate NDNQI
• 2009
Average – 9.9% (National Median 10.2%)
• 2008 Average – 6.8%*
• 2007 Average – 9%*
Purchased Labor NDNQI
• 2 009 Contract/Temp – 4,190 hours
(A 92% reduction due to discontinuation of
contract labor in February, 2009)
• 2008 Contract/Temp – 53,549 hours
* Statistics for 2007 and 2008 include inpatient units
only and do not include areas such as Operating Room
and Emergency Department.
I Care
“I care about my community and all of its members. As a
medical professional, I am invested in the health and the overall
quality of life here, in the towns where we live.” – Elaine Siwiec, RN, BSN
Neurology Nurse Clinician
1 0
2 0 0 9
N
u r s i n g
A
nn u a l
R
e p o r t
Community Commitment
Moving Beyond Expectations
Education is Prevention:
Stopping Suicide in Time
Marilyn Cleary, RN,
knows something about
keeping children safe.
This Hospital pediatric
nurse and mother of
three is also a suicide
survivor: Cleary lost
Marilyn Cleary, RN,
Certified in Pediatric
her eighteen-year-old
Advanced Life Support and
daughter to “wellNeonatal Resuscitation
hidden, untreated
depression.” Cleary turned her personal pain
into action through her involvement with the
Charlevoix and Emmet County Suicide Prevention
Committee. “Suicide is a significant public
health concern,” she says. “Programs about
awareness and sensitivity to depression and
mood disorders will help erase the silence and
stigma of suicide.”
In the spirit of community, nursing Colleagues accumulated more than
1,500 volunteer hours.
Volunteering in the Community
• E mployee Health & Wellness Fair at
Bay Mills Indian Community, Brimley:
1 volunteer
• Cancer Survivors Day: 38 volunteers
• Gaylord VitalCare Expo: 1 volunteer
• Women & Wellness at Bay Harbor:
46 volunteers
• Cheboygan Senior Expo: 2 volunteers
• Cancer Services Clothing Swap/Drive:
20 volunteers
• Newberry Open House: 3 volunteers
• B oyne 2 Boyne: 1 volunteer
• Blue Jean Day: 11 volunteers
• Gaylord Business Showcase:
3 volunteers
• Petoskey Charlevoix Senior Health Fair:
1 volunteer
• Mercy Hospital Grayling Specialty
Clinic Open House: 3 volunteers
• Lewiston Health Fair: 2 volunteers
• Family Fun & Fitness Day – North
Central Michigan College: 2 volunteers
Seeing an Opportunity, Meeting a Need
NPSGs
NPSGs
Hospital Oncology Nurse, Rita Miller, RN, MSN, OCN, pilots the first
Nurse Navigator program at the Hospital Breast Health Center. Recognizing
the special needs of cancer survivors – 10 million strong and
rising in the United States alone – Miller wanted to help
bridge the information gap between patients, oncologists,
and primary care physicians. During the early phases of
cancer, the focus is on treatment and the overwhelming
physical and emotional effects that accompany it. But
after treatment, with the cancer under control, or even in
remission, the patient must still cope with a range of medical
Rita Miller, RN, MSN, OCN needs. The program guides women with breast cancer
through screening, diagnosis, surgery, therapy, recovery, and into survivorship.
“We educate and support the patients,” Miller says, “empowering them to
make informed treatment decisions throughout the cancer journey.”
Through her work with the committee, Cleary
strives to educate area residents about
the warning signs, the risk factors, and the
prevention of suicide. “Education is prevention,”
says Cleary. The committee is made up of
“gatekeepers,” a well-rounded representation of
mental health professionals, law enforcement
officers, school counselors, superintendents, and
tribal leaders. The committee helps school staff
and students recognize the signs of potential
suicide, including depression, other mental
health issues, and bullying. “We strive to create
an open door to understanding,” Cleary says.
“We want people to know about the danger
signs, the available resources, and how to
respond quickly.”
NPSGs
Nursing Research: Food for Thought
The Nursing Research and Evidence-Based Practice Council has partnered with
the Little Traverse Bay Bands of Odawa Indians in an innovative health study
called “The Happy Odawa Family Kitchen.” Funded by the Blue Cross Blue Shield
Foundation, the study targets underserved cultural groups within local populations.
Nursing Research Coordinator, Linda Schofield, RN, BSN, MSN, PhD, initiated
the study. “This population has a high degree of diet-related conditions such as
diabetes, hypertension, and heart disease,” Schofield says. “Through nutrition,
exercise, and health monitoring, we hope to achieve positive outcomes for the
members of the tribe.” Native traditions are incorporated into the program: exercise
includes tribal dancing as well as yoga and walking; native recipes are also
included, but are made with healthy alternatives. In 2009, five families participated
in the 8-week sessions; 24 families are scheduled to participate in 2010.
Linda Schofield, RN, PhD, and Robin Holt, RN and ICU
Teamleader and APACHE Coordinator
2 0 0 9
N
u r s i n g
A
nn u a l
R
e p o r t
1 1
C o m m u n i t y M e ss a g e
Doing Our Part
T
he job of the caregiver does not stop at the Hospital
door. Hospital nurses strive to make the community
and the world a healthier place.
Self
In Recognition
Nursing Colleagues rightly share the 2009 accolades given
to Northern Michigan Regional Hospital. Their efforts
were crucial to the overall record of the Hospital.
• R
ecycler of the Year: For extensive Hospital-wide
efforts to recycle.
• Building Michigan’s Healthcare Workforce:
For innovative and successful strategies in
healthcare recruitment.
• Most Wired: For exemplary use of technology,
including PowerChart®, Bridge Bar Coding,
and Web site quality.
• A
ARP Best Employer for Workers
over 50: In honor of recruitment, retention,
and promotion of over-50 employees.
• M
edal of Honor for Organ Donation: For
maintaining a 75% or better rate of eligible
organ donors for a 22-month period.
• Stroke Awards for Outstanding
Performance: For t-PA and stroke
education, defect-free care, and timeliness
of case entering.
• S
troke Performance Achievement Award:
For demonstrating 85% adherence to
the American Stroke Association’s
key measurements of nationallyaccepted standards.
• HealthGrades Outstanding Patient Experience
Award: Top 5% in the Nation for patient satisfaction.
• Cancer Program 3-Year Approval Award: For
the reduction of morbidity and mortality through
education, setting, and monitoring of quality care.
• Practice Greenhealth Environmental Leadership
Circle Award: For outstanding attention to providing
environmentally responsible healthcare.
• PRC 2009 Top Performer: Hospital Emergency
Department and Outpatient Services received 4-Star
Top 25% Overall Quality of Care, and the Radiology
Department received 5-Star Top 10% for radiation
therapy and EEG.
I Care
“I care about myself. I know that if I am at my best, my patients
will benefit. I take care of my health so that all my attention can
go to those who need me.”
– Roger Ostwald, RN, BSN
Intensive Care Unit
1 2
2 0 0 9
N
u r s i n g
A
nn u a l
R
e p o r t
Professionally Speaking
Nursing Statistics and Resource Utilization
Total Number of RNs: 482
• 2 009 Direct Care – 75%
• 2008 Direct Care – 80%
Gender
• F
emale – 430 (89%)
• Male – 52 (11%)
Status
• F
ull Time – 358 (74% of RNs)
• Part Time – 68 (14% of RNs)
• Per Diem and Temporary – 56 (12% of RNs)
Nursing Specialty Certifications Held NDNQI
• 2 009 – 75
• 2008 – 53
• 2007 – 43
are represented by
men and women with
varied backgrounds and
experiences, diverse
professional achievements,
and a wealth of specialized
training and degrees.
M e m o r y
Average Age – 45
•
•
•
•
•
3 0 and younger – 69
31-40 – 102
41-50 – 150
51-60 – 136
60+ – 25
Thomas C. Mroczkowski
President & CEO
2003 – 2009
Northern Michigan
Regional Health System
2009 Nursing Education Levels NDNQI
Doctorate Degree
Hospital nursing Colleagues
In
Masters Prepared
.4%
.4%
2009
7.3%
4.7%
30.3%
22.1%
Bachelors Prepared
60.2%
72.9%
Associates Degree
LPN
2008
1.9%
1.8%
Nursing Education Hours NDNQI
• N
ursing CE Hours – 4,292
• Mosby CE Hours – 1,516
• Nursing Inservice Hours
(not including PowerChart® hours) – 4,601.8
• Total for 2009 – 10,409.8**
• Total for 2008 – 12,523**
• Total for 2007 – 3,621
PowerChart® Inservice NDNQI
Hours for Nurses
• 2009 – 1,008
• 2008 – 3,932
** Includes nursing CE, Mosby CE, and
Nursing Inservice Hours.
In memory of our Colleague and
friend, Tom Mroczkowski, whose
vision and passion radiated to every
level of the Hospital. We carry on
in his honor.
“I am just so proud and pleased,
words cannot express how I feel
personally about the work being
done here at Northern Michigan
Regional Hospital.”
– Thomas C. Mroczkowski
at the 2009 Annual Nursing Summit
a
Nu r sing a
nd
Structural
Empowerments
He
al
t
h
c
a
r
G
l
o
b
l
in
s
ue
s
Is
e
Empirical
Outcomes
Transformational
Leadership
G
l
o
b
a
Exemplary Professional
Practice
New Knowledge
l
Is
su
es
in
Nurs i n g and
h
lt
a
He
c
a
r
e
416 Connable Avenue
Petoskey, MI 49770
231.487.4000
northernhealth.org
On The Cover: Top Right (L to R) – Lisa Krause, RN, Two South, and Sarah Tanner, RN, Two South; Bottom Left – Dixie Cosier, RN,
House Manager; Bottom Center (L to R) – Heather Rice, RN, CVU, and Lisa Carlson, RN, CVU; Bottom Right – Alicia Duarte, RN, Level 3