Engaging the Frontline Staff and Identifying Peer Leaders

    • June 4, 2008

The Goal

Encourage nurses who provide direct care to patients to see themselves as the most important channels for developing and implementing quality improvements that will affect the care of patients throughout the hospital.

Why It's Important

True transformation on a medical/surgical unit begins and ends with the frontline staff, working in collaboration with a multidisciplinary team. It is also critical to have active participation from physicians who admit patients to the unit and leadership and support from senior management.

How To Do It

All team members should participate in early activities to generate ideas for transformation and be involved in testing for improvement in the four themes of TCAB: patient-centered care; care team vitality; reduction of waste; safety and reliability.

1. Identify a team that includes frontline professional nurses, nursing assistive personnel, unit clerical support, physicians and support personnel for the unit.

  • Consider including pharmacists, respiratory therapists, dietary staff, housekeeping staff, supply technicians, maintenance and engineering staff, social workers and others.

2. Begin engagement of frontline staff with registered nurses and other licensed and non-licensed nursing personnel.

  • Because nurses are the caregivers closest to the patient's bedside, efforts to engage frontline staff in redesign often start with the registered nurses and other licensed and nonlicensed nursing personnel.
  • Organizations that embrace the American Nursing Credentialing Center "forces of magnetism" and institute shared governance models will already have a model for enhancing nursing autonomy and engagement.

3. Empower multidisciplinary teams in redesign work by conducting brainstorming or "snorkeling" activities to promote innovation and idea generation.

  • Use storytelling to enhance personal connections to the transformation process.

4. Identify frontline staff nurses with a passion for transformation who will help engage other nurses. Peer leaders are a critical element to the TCAB process.

  • Successful TCAB units often identify key registered nurses, sometimes called "champions," to take the lead on each of the TCAB themes. These opportunities enhance their own professional development opportunities and promote vitality and energy within the unit.

5. Identify someone to help coach and mentor the TCAB team. Tap a project coordinator from outside the unit who is responsible for setting the agenda for weekly meetings.

  • The project coordinator can talk with the unit leader after each meeting and offer counsel on how progress is being made, troubleshoot any issues and provide general support to the program.