Interprofessional Teamwork Innovation Model (ITIM) to promote communication and patient-centred, coordinated care.

Background: Despite recommendations and the need to accelerate redesign of delivery models to be team-based and patient-centred, professional silos and cultural and structural barriers that inhibit working together and communicating effectively still predominate in the hospital setting. Aiming to improve team-based rounding, we developed, implemented and evaluated the Interprofessional Teamwork Innovation Model (ITIM).

Methods: This quality improvement (QI) study was conducted at an academic medical centre.

Building a Culture of Authentic Partnership: One Academic Health Center Model for Nursing Leadership.

Senior nursing leaders from the University of Kentucky (UK) College of Nursing and UK HealthCare have explored the meaning of an authentic partnership. This article quantifies the tangible benefits and outcomes from this maturing academic nursing and clinical practice partnership. Benefits include inaugural academic nursing participation in health system governance, expanded integration of nursing research programs both in the college and in the health science center, and the development of collaborative strategies to address nursing workforce needs.

Developing Governance Structures in Health Care System Consolidation: A Framework for Nurse Leaders.

Given the acceleration and increasing complexity of integrative care models across health systems, the question how governance and management structure(s) should be operationalized and evolved to achieve peak system performance is paramount. In a recent evaluation of partnerships with the University of Kentucky HealthCare (UK HealthCare), the conceptualization of the integration management model was explored. It was recognized that nursing leadership, governance structure, and relationships are vital for successful movement and migration of appropriate care models.

"SWARMing" to Improve Patient Care: A Novel Approach to Root Cause Analysis.

Background: When errors occur with adverse events or near misses, root cause analysis (RCA) is the standard approach to investigate the "how" and "why" of system vulnerabilities. However, even for facilities experienced in conducting RCAs, the process can be fraught with inconsistencies; provoke discomfort for participants; and fail to lead to meaningful, focused discussions of system issues that may have contributed to events. In 2009 University of Kentucky HealthCare Lexington developed a novel rapid approach to RCAs-colloquially called "SWARMing"--to establish a consistent approach to investigate adverse or other undesirable events.

Recognition of clinical deterioration: a clinical leadership opportunity for nurse executive.

Recognition and avoidance of further clinical deterioration can be termed a critical success factor in every care delivery model. As care resources become more constrained and allocated to the most critical of patients, some patients are being shifted to less intense and costly care settings where continuous physiologic monitoring may not be an option. Nurse executives are facing these complex issues as they work with clinical experts to develop systems of safety in the patient care arena.