Page 23 - Hoag Orthopedic Institute 2018 Outcomes Report

“VALUE FOR OUR PATIENTS EMANATES FROM OUR MULTIDISCIPLINARY TEAM’S LASER FOCUS ON EXCELLENCE IN ORTHOPEDIC CARE. HOI UTILIZES A STANDARDIZED AND DISCIPLINED APPROACH TO PATIENT CARE, AND EMPOWERS ITS ALL-ORTHOPEDIC EXPERT STAFF TO BRING FORTH SUGGESTIONS FOR CONTINUAL INNOVATION AND IMPROVEMENT.”
KIM MIKES, MBA, BSN, RN, CNOR; VICE PRESIDENT, COO, CNO
HOI NURSE PRACTITIONERS: A VALUE-ADDED APPROACH TO CARE
Nurse Practitioners (NPs) have become a valuable asset to the orthopedic team at HOI. As an Advanced Practice Registered Nurse (APRN),
the NP can provide quality care to patients and provide leadership to the nursing staff. They provide the bridge between the surgeon, the hospital staff, hospitalist and the patients. Their purpose is to optimize the patient’s care and stay at HOI, and to prepare the patient and family for discharge. They are able to function in a fast- paced environment, while the needs of the patient are constantly changing.
NPs function under the Medical Staff department of the hospital and report to the chief nursing officer. They provide an added, necessary service to the surgeons at HOI. This unique “physician extender” role carries significant autonomy and
is similar to that of the hospitalist employed in other facilities. Functioning with NP and RN
state licenses, NPs progress through an initial privileging process and provide care within
their scope of practice. The NPs possess the strong assessment skills of a nurse. In addition to assessing patients, NPs are able to order tests, prescribe medications, diagnose, and treat patients in a timely manner. They can also refer patients to other specialists for consults.
While the surgeon is in the OR or in the office with patients, the NP is on the floor making rounds and answering nurses’ calls and questions. Having the NPs on hand daily to follow patients adds value to care in several ways:
• Improves continuity, comprehensiveness and standardization of care
• Ensures patient and family education is comprehensive and thorough
• Decreases medication errors such as omissions, duplications, dosing errors, or drug interactions via medication reconciliation with all new medications going home
• Increases timeliness in ordering and interventions
• Provides leaders and a teaching resource for floor nurses
• Enhances peace of mind for the patients’ physicians
When HOI opened in 2010, it employed one nurse practitioner. As of 2017, there were
four NPs who shared the responsibility for
HOI patients. Given the projected shortage of physicians, and the current pressing need to reform care for greater value, the utilization of NPs is likely to increase greatly, not only here at HOI but also in the community.
HOI Nurse Practitioners Junghee Lee, FNP-C; Marium Bhangda, FNP-C; Director of Allied Health Susanne Porter, FNP-BC;
Vice President, COO/CNO Kim Mikes; and Missra Rezvani, ANP-C. Not pictured: Elizabeth Kovacs, MSN, FNP-C.
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