Becker's Hospital Review

15 THOUGHT LEADERSHIP How nurse 'change agents' saved hospitals $84M By Bari Faye Dean T he American Association of Criti- cal-Care Nurses' Clinical Scene Inves- tigator Academy has provided more than a 600 percent return on investment; the 97 participating hospitals realized a fiscal sav- ings of $84.2 million, Marian Altman, PhD, RN, clinical practice specialist and supervisor of the AACN's CSI Academy, told Becker's. is isn't about detectives working together to solve a crime like on TV's popular CSI shows. However, AACN's CSI is focused on enabling nurses to work together to take on innovative in-hospital projects that "give nurses a seat at the table" when it comes to leadership and de- cision-making, explained Dr. Altman, while also recognizing hospital nurses as "change agents." "Nurses have innovation intelligence. ey have insights into the problems in hospitals because they're there — 24/7/365," she said. "When it comes to problems in hospitals, nurses have seen it all from the top down. But no one is asking them, 'How would you solve this problem?''' What is the CSI Academy? A hospital-based nursing leadership and in- novation program, the CSI Academy not only encourages hospital leaders to ask nurses for input on challenges but also provides partici- pating nurses with the skills and tools to solve problems that improve hospital operations and energize their hospital's nursing work- force. Once a hospital chooses to participate in the program, a team of two to four direct care nurses will identify a challenge in their unit to work through. It could be an issue related to patient care, with the families of patients or something in their work environment. en, they seek the solutions through the skills they learn in the 12-month CSI program and lead all efforts to make the changes they seek to improve as part of the project. CSI Academy is delivered via a combina- tion of in-person and virtual sessions over a 12-month period. Typically, five sessions are in-person ( months one, two, six, eight and 12) while others are held virtually. In-person sessions are a full day; virtual sessions are three hours. e program is designed with flexibility, with a schedule that can be tailored to meet the needs of the hospitals and nurse participants. Each session provides participants with con- tent delivered by the CSI faculty of experi- enced nurse leaders, team consultation and dedicated time for the team to meet and work on their projects. e teams report on their progress, share ideas and get feedback from each other and the faculty to help them work through any problems they may be encoun- tering. e nurses will, of course, work on their projects outside of the class session. Here's an example: One cohort at a hospital wanted to focus on getting nurses to truly collaborate to improve their work environ- ment which, in turn, would decrease nurse turnover in the hospital. e year before they participated in the CSI Academy, 44 nurses le that hospital. While they were doing the project, only 12 nurses le. e program is a full 12 months long because research shows that it takes between three and six months to truly embed change in a work environment. Aer 12 months, the changes are completely embedded but are also able to be sustained for the long term, Dr. Altman said. e numbers tell the story ere have been 486 nurses to date who have completed CSI Academy programs, but the effects of participation spread much further throughout nursing units and entire hospi- tals. Dr. Altman estimates that 6,820 nurses have reaped the benefits of their hospital's participation in a CSI Academy project. Of the 97 hospitals that have engaged with the CSI Academy, there have been 142 projects completed in 160 patient care units. Further, according to feedback from partici- pating chief nursing officers, more than 1.25 million patients have been positively impact- ed by the hospitals' participation in the pro- gram. How do hospitals get involved in CSI? Some hospitals pay to participate in the CSI Academy, but others get involved thanks to grants. For example, Edwards Lifesciences Foundation is funding three cardiac-focused cohorts of the CSI program, allowing AACN to provide it without charge to several hospi- tals. e first cohort, which included nurses from nine hospitals around the U.S. in rural areas, completed the program in the fall of 2022. e second cohort of nurses in Southern Cal- ifornia is currently in process; it will wrap up summer 2023. e third cardiac-related cohort is gearing up to launch at 10 hospitals — two in New Jersey and eight in New York. In addition to on-site programs, the AACN offers online access to its collection of CSI Academy innovation projects ― including project plans, clinical interventions, data col- lection tools, outcomes and references. Becker's also spoke with two nursing execu- tives who have engaged their teams with the CSI Academy. Jane McCurley, DNP, RN, chief nurse exec- utive at Methodist Healthcare System in San Antonio, said the effect of engaging with the CSI Academy has exceeded her expectations. "It engaged my front-line nurses in quality improvement initiatives. e ingenuity of the teams in their projects was inspiring to others and the outcomes had an impact on practice and to financial goals, as well." Launette Woolforde, EdD, DNP, RN, is chief nursing officer at New York City-based Lenox Hill Hospital; Manhattan Eye, Ear & roat Hospital; and Lenox Health Greenwich Vil- lage. She is also the deputy chief nursing of- ficer at Northwell Health, based in New Hyde Park, N.Y. Dr. Woolforde has been involved with three CSI projects to date. "It has brought me great joy to see the growth of each nurse who has participated. Almost all have gone on to advance their education and engage in pro- fessional activities within and outside of the organization." "Nurses have innovation intelligence. ey have insights into the problems in hospitals because they're there — 24/7/365. When it comes to problems in hospitals, nurses have seen it all from the top down. But no one is asking them, 'How would you solve this problem?'" — Marian Altman, PhD, RN

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