National Recognition for Quality and Safety: The nursing teams, along with all providers at CMH, understand that patient safety is our highest priority, regardless of where patients receive care. Central Maine Medical Center has received multiple annual A grades from the Leapfrog Group, an independent national watchdog organization. The Leapfrog Group has named Bridgton Hospital and Rumford Hospital as Top Rural Hospitals, as well. The Leapfrog Group assesses hospital quality based on their performance in preventing medical errors, injuries, accidents, infections and other harms to patients in their care.

CMH also contributes to the National Database of Nursing Quality Indicators (NDNQI), a national database that collects data that are then used to improve the quality of nursing care. This partnership allows us to continually improve the quality of care throughout all CMH facilities.

EMR: Ensuring Continuity of Care: Information technology (IT) plays a crucial role in health care, and CMH has received HealthCare’s Most Wired award, which recognizes excellence and patient safety and outcomes in healthcare IT. Our investments in IT include implementing electronic medical records (EMR), which allow CMH to maintain accurate, up-to-date information about patients in our facilities. We use the Cerner® EMR at all three CMH acute care hospitals and have individualized the system to suit the needs of our nurses and other healthcare providers. Our teams now have the ability to access real-time information about inpatient care, emergency care, medical imaging, pharmacy and computerized provider order entry for each of our patients.

Not only does our EMR enable us to standardize care for patients, it also reduces stress on providers concerned about making errors and improves the efficiency with which they are able to provide care to patients.

Rapid Response Teams Improve Outcomes: An offshoot of our investments in EMR is the rapid response team (RRT). When a provider identifies physiological abnormalities in a patient that increase the risk of adverse clinical events, such as unexpected breathing problems or chest pain, the provider can call for an RRT from anywhere in the hospital 24 hours a day, seven days a week.
RRTs include a variety of providers, such as intensive care unit nurses and respiratory therapists, who:

• Respond to team member concerns about a patient experiencing early warning signs of decline
• Initiate or assist with interventions to stabilize the patient
• Make recommendations to the healthcare team as needed
• Expedite transfer of the patient to appropriate higher level of care

Early recognition improves the safety and effectiveness of medical care and helps assure optimal outcomes.

Prioritizing Communication: Teamwork and communication are critical to keeping patients safe and improving quality of care. CMH nurses use the four-part Situation-Background-Assessment-Recommendation (SBAR) communication system to keep fellow team members up to speed about patients’ conditions and alert fellow providers about problems that need immediate attention. The SBAR technique helps CMH nurses:

• Organize information in preparation for communicating with a provider about a patient
• Give a report to another caregiver in an organized, focused format
• Provide information to an emergency team responding to a critical situation

TeamSTEPPS: Healthcare is most efficient and effective when professionals work together toward a common goal. As part of our commitment to quality care, Central Maine Healthcare offers TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) to new and existing nurses. The program allows nurses to gain the confidence they need to make decisions quickly and accurately with the support of their teams.

Created by the Agency for Healthcare Research and Quality and the Department of Defense, TeamSTEPPS is a set of teamwork tools proven to improve communication and collaboration between healthcare workers. By implementing this program, healthcare organizations optimize patient safety and minimize medical errors. Our healthcare professionals participating in TeamSTEPPS focus on four key skills to improve their competency where teamwork is concerned:

• Communication
• Mutual Support
• Leadership
• Situation Monitoring

They also understand how the four skills work together with the three Team Competency Outcomes:

• Attitudes
• Knowledge
• Performance

The skills learned through TeamSTEPPS are implemented during each patient’s treatment regimen. TeamSTEPPS principles may be applied when:

• Sharing the treatment plan with the team. During this event, the team is primarily concerned with assigning important roles and responsibilities, establishing expectations and anticipating outcomes.
• Huddling to monitor and modify the plan when necessary and debriefing to evaluate team performance. During a debriefing session, TeamSTEPPS graduates may apply the skills they have learned and developed to reinforce the positive behaviors necessary for exemplary patient care.Overall, Central Maine Healthcare nurses who participate in TeamSTEPPS have the confidence to ensure that mistakes or oversights are identified and remedied quickly.

Shared Governance Council: Central Maine Healthcare’s nursing program includes a Shared Governance Council, in which nurses and nurse leaders collaborate on decisions that affect and improve every aspect of the nursing profession at CMH. This collaboration benefits our nurses by helping them work as a team and creates a workplace culture of inclusion, engagement and compassion. Our Shared Governance Councils directly contribute to our vision of nurses providing holistic, high-quality care to our patients.

Our patients benefit from these Shared Governance Councils, as well. By sharing decision-making responsibilities between nurses and nurse leaders, our teams can work together to ensure safer, more effective patient care and more successful patient outcomes.

Our 6 Shared Governance Councils: Our six councils include nurses from across CHM. The councils meet regularly to create and develop work plans to meet goals in the following six areas.

• The System Nursing Education Council focuses on finding educational opportunities that allow nurses to not only advance their careers but also improve patient-centered care. The team works with partners both internally and externally to create a culture that supports lifelong learning.
• The Informatics Council maintains a close relationship with the information technology (IT) department to keep communications between departments smoothly, optimize and improve utilization of our electronic medical record system and advocate for other IT resources that allow nurses to provide safe, high-quality care.
• The Patient Experience Council focuses on meeting patients’ and families’ needs at all CMH facilities. The council works with nurses to improve patient and family satisfaction scores and develops ways to improve the CMH nursing culture such that high-quality patient and family care motivates all actions and decisions.
• The Professional Practice Council provides leadership strategies, encourages career development and helps nurses maintain a professional, compassionate relationship with patients and team members. Its efforts give nurses the resources necessary to provide superior patient care.
• The Quality & Patient Safety Council recommends improvements to nursing practices throughout our healthcare system for the comfort and safety of our patients. Goals include expanding efforts to standardize clinical practices and improve system-wide communication about quality initiatives and data.
• The Recruitment & Retention Council develops strategies to create a work environment where our nurses feel valued and supported and provides them with opportunities for career growth. For example, the council has implemented a Mentorship Program for nurses who have completed residency training and a Professional Advancement Program that rewards nurses who pursue clinical excellence.