Enterprise-wide Nursing Councils Positively Impact Care Delivery

Cleveland Clinic comprises an expansive network of medical hospitals, institutes and services operating in many geographic locations. And our 12,000 nurses care for patients in a variety of settings, including inpatient, outpatient and ambulatory.

Patient-centered care has always been at the core of Cleveland Clinic; however, in recent years, our Nursing Institute has worked hard to ensure standardization of the care we provide. Our diligent effort to better integrate and standardize care and practice really took hold in 2010 and was led by the development of Nursing Institute enterprise councils. Each council created holds a specific role in guiding nursing practice and, collectively, providing insight, guidance and direction for our nurses and nursing staff members through better collaboration, communication and networking.

Over the course of the past five years, we have made some enhancements to our councils, but our general council structure and outlined goals to integrate and standardize best practices in nursing care throughout the health system remain the same.

Six primary councils guide, standardize nursing practice

Cleveland Clinic’s Nursing Institute enterprise council structure includes six primary councils:

• Nursing Practice Council
• Nursing Informatics and Technology Council
• Nursing Quality Council
• Nursing Education and Professional Development Council
• Nursing Research Council
• Affinity Groups (specific to specialty practices)

Councils are nurse-led with a chief nursing officer or associate chief nursing officer serving as a liaison or council advisor. The councils all report to the Nursing Institute Council, which is the primary governing body for Cleveland Clinic nursing, and encompasses all of Cleveland Clinic’s executive nurse leaders and other key nursing leadership personnel. The Nursing Institute Council provides oversight of the collaborative council model by approving initiatives or recommended practice changes and disseminating key information and updates through the enterprise-wide intranet, newsletters, nurse huddles and meetings, and a variety of other communications to ensure education and adoption.

Specially focused to drive standardization

Each of the six primary councils is unique and specially focused to drive uniform standardization throughout the most important facets of Cleveland Clinic’s nursing practice – covering the spectrum of our nursing practice model. Below is a quick council overview.

Nursing Practice Council
Providing guidance, support and oversight to the Policy and Procedure Committee, the Nursing Practice Council is the overarching collaborative group that devises and approves standards in nursing practice prior to final approval by the executive nurse leadership team. The council functions as a decision-making group on practice issues presented by collaborating disciplines, such as pharmacy. Council chairpersons represent each of Cleveland Clinic’s regional hospitals, main campus and family health centers and are responsible for sharing best practices and approved changes with their respective health system areas by providing monthly updates on council activities.

Nursing Informatics and Technology Council
This council is charged with completing needs assessments for communication strategies, establishing directions for next generation communication devices, participating in nurse-specific and multi-disciplinary device validation trials to evaluate clinical impact, and more. This council also provides recommendations on ITD/telecommunications and improvements in nursing documentation workflows to support practice.

Nursing Quality Council
The Nursing Quality Council is responsible for ensuring that the Nursing Institute performance improvement plan aligns with the Cleveland Clinic health system plan. The council works with Cleveland Clinic’s information technology team to develop dashboards that support improvements in the quality of care. It provides education to frontline nurses on nurse-sensitive quality measures that have led to improvements in patient safety, and it spearheads the implementation of numerous evidence-based practice projects.

Nursing Education and Professional Development Council

Among other important initiatives within education and professional development, this council has been instrumental in Cleveland Clinic Nursing Institute’s recently launched nurse residency program for medical-surgical and critical-care areas, which is recognized as a best practice in nursing education. This council has also provided oversight to the professional development career ladder and partnerships with affiliate schools of nursing, which have both grown since their inceptions.

Nursing Research Council

Through the work of the Nursing Research Council, the Nursing Institute has developed a successful platform for integrating the strength and levels of evidence into nursing standards. The council has created evidence-based practice educational modules for all nurses interested in conducting a research study and provides mentorship and guidance in research proposal development and compliance. The council also reviews all nursing research proposals prior to submission to the internal review board.

Affinity Groups
Specialty affinity groups are key to positively impacting patient populations through standardization of practice and implementation of best practices. Specialty areas include emergency services, wound care, oncology, surgical services, ambulatory, pediatrics, behavioral health, medical/surgical and critical care nursing. Because of the work being done through these affinity groups, Cleveland Clinic nursing has implemented best practices across multiple locations and patient care areas, such as an emergency services plan of care that provide patients and families with information on all aspects of care; a standardized approach to chemotherapy administration; and a standardized perioperative education program and annual competencies for surgical services staff.