a data driven approach to nurse engagement · introducing our national employee engagement database...

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Nursing Executive Center

Survey Solutions

A Data Driven Approach to

Nurse Engagement

Today's Presenters:

Sarah Strumwasser

Senior Director

Research and Insights

[email protected]

Key Insights and Best Practices from the Experts

Kendall Adler

Consultant

Research and Insights

[email protected]

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2

The Nursing Executive Center in Brief The Comprehensive Resource for Executing Health System Strategy

Performance

Assessments

• Competency diagnostics

• Benchmarking reports

• Customized quality

assessments

• Red flag audits

Executive-Level

Insights

• National meetings

• Executive briefings

• Strategic frameworks

Team

Education

• Onsite presentations

• Private webconferences

• Facilitated working

sessions

• Nursing Insights

• Journal Review

On-Call

Support

• Tactical solutions to unique

challenges

• On-demand phone

consultation with

senior advisors

• Facilitated networking

Setting Strategy Translating Strategy into Action

Percentage

Magnet Hospitals

62% Years supporting

nurse executives

13 Nurse leaders attending

Center sessions each year

15,500+ Institutions holding

membership

1,900+ Renewal

rate

>90%

Trusted Partner for Leading Nurse Executives

Best Practice

Recommendations

• Executive strategies

• Replicable, pressure-tested

best practices

• Manager toolkits

• Customizable templates

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Introducing Advisory Board Survey Solutions

3

Comprehensive Portfolio of Services for Executives

Creating the High-Performance Workforce

ABSS - Physician

Engagement (PE)

• Best-in-class survey platform

with Dedicated Advisor support

• Targeted survey questions for

employed, affiliated, and

independent physicians

ABSS - Employee

Engagement (EE)

• Real-time data query to

prescriptive results platform

• User-friendly change

management tools, expert

consultations, networking

ABSS - Culture of

Safety (CoS)

• AHRQ culture of safety survey

setup and administration

• Best-practice and action

planning support

ABSS - Nursing

Engagement (NE)

• Magnet-compliant survey

instrument with department and

unit-level drill-downs

• Hands-on nurse-leader training

and expert consultations

Strategic Action

Planning Tool

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Why Are We Here?

4

Source: Advisory Board Survey Solutions’ Employee Engagement National Database, 2013.

27.9 28.7

31.4 32.6

2010 2011 2012 2013

Percentage of RNs Engaged Nationally

27.9% 28.7%

31.4% 32.6%

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Introducing Our National Employee

Engagement Database

5


1) Includes psychology, children’s, and heart institute.

2) Includes research and corporate services.

8%

18% 73% Non-

Teaching

69% 31% 89% 11%

Magnet

Designation

Teaching Status

System

Participation

Magnet Non-

Magnet

Teaching

Academic

Medical

Center

Hospital Health

System

34%

5%

10%

29%

7%

10%

5%

Facility Type

Short-Term

Acute

Critical

Access

Non-

Clinical2

Outpatient

Post-Acute Care

Physician

Practice/ Clinic

Children’s and

Specialty1

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The Advisory Board’s Engagement Index

6

Source: Advisory Board’s Employee Engagement Survey

Setting a High Bar

To be considered "engaged" respondents must answer "Strongly Agree" to at least two

of the four items listed above, and no less than "Agree" to any item.

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A Deeply Disturbing Comparison

7

RN Engagement Lagging Behind Everyone Else

Source: Advisory Board Survey Solutions’

Employee Engagement National Database, 2013.

1) Includes administrative/executive assistant, associate/professional, social worker, and support services personnel.

2) Includes advanced practice nurse (NP, CNL, CNS, DNP), dietician, medical technologist, occupational therapist, pharmacist,

phlebotomist, physical therapist, radiologic technologist, respiratory therapist, speech pathologist, support services personnel.

Percent Engaged by Job Role

Percent

Disengaged

OtherFrontline

Non-Clinical¹

PCAs LPNs MDs OtherFrontlineClinical²

RNs

42.9% 42.3%

38.4%

32.6%

37.8% 37.4%

5.5% 5.8% 4.8% 6.1% 7.4% 6.3%

n=180,384

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Not Closing the Gap

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Percentage of Staff Engaged Nationally

RNs Versus All Other Frontline Roles

27.9 28.7

31.4 32.6

37.7 38.9

41.5 42.8

2010 2011 2012 2013

RNs All Other Frontline Roles

37.7% 38.9%

41.5% 42.8%

27.9% 28.7%

31.4% 32.6%

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What’s Possible?

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26.3

31.4

36.5

43.6

25thpercentile

50thpercentile

75thpercentile

90thpercentile

RN Engagement Level Within an Organization by Quartile

Percentage of RNs Engaged

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Still Searching for the Ceiling

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Considering the Benefits of a More Targeted Approach

Source: The Advisory Board Survey Solutions’ Employee Engagement National Database, 2013. 1) Preliminary analysis.

Average Percentage of Staff Engaged per Facility1

39.3%

43.2%

44.0%

36.7%

41.3%

47.2%

2011 2012 2013

First-Time Partners Multi-Year Partners

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Plotting a Principled Path Forward

11

Source: Nursing Executive Center interviews and analysis.

1 What are my best enterprise-wide opportunities?

2

What best practices should I implement to act on

those opportunities?

Are there critical “hotspots” where I need to do more?

3

Three Key Questions for Improving Engagement

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42 Proven Drivers

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Source: Advisory Board Survey Solutions interviews and analysis.

Communication and Input

1. I am kept informed of the organization's future plans and direction

2. My ideas and suggestions are valued by my organization

3. My manager communicates messages that my coworkers need to hear, even when the information is unpleasant

4. My manager is open and responsive to staff input

5. My manager stands up for the interests of my unit/department

Employee Support

6. My manager helps me balance my job and personal life

7. My organization does a good job of selecting and implementing new technologies to support my work

8. My organization helps me deal with stress and burnout

9. My organization supplies me with the equipment I need

10. My unit/department has enough staff

Feedback and Recognition

11. Executives at my organization respect the contributions of my unit/department

12. I have helpful discussion with my manager about my career

13. I know what is required to perform well in my job

14. I receive regular feedback from my manager on my performance

15. My organization recognized employees for excellent work

Professional Growth

16. I am interested in promotion opportunities in my unit/department

17. I have the right amount of independence in my work

18. I receive effective on the job training

19. My current job is a good match for my skills

20. My manager helps me explore other jobs within my organization

21. My manager helps me learn new skills

22. My most recent performance review helped me to improve

23. Training and development opportunities within my organization have helped me to improve

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42 Proven Drivers

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31. Abusive behavior is not tolerated at my organization

32. Conflicts are resolved fairly in my unit/department

33. I have good personal relationships with coworkers in my unit/department

34. I receive the necessary support from employees in my unit/department to help me succeed in my work

35. I receive the necessary support from employees in other units/departments to help me succeed in my work

36. My coworkers do a good job

37. I have job security

38. I have a manageable workload

39. My organization pays me fairly for my job

40. My organization supports employee safety

41. My organization understands and respects differences among employees

42. The benefits provided by my organization meet my needs

Mission and Values

24. I believe in my organization’s mission

25. I understand how my daily work contributes to the organization’s mission

26. My organization gives back to the community

27. My organization provides excellent care to patients

28. My organization provides excellent customer service to patients

29. Over the past year I have never been asked to do something that compromises my values

30. The actions of executives in my organization reflect our mission and values

Baseline Satisfiers

Teamwork

Source: Advisory Board Survey Solutions interviews and analysis.

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Narrowing Our Focus

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Source: Advisory Board Survey Solutions’ Employee Engagement

National Database, 2013; Nursing Executive Center analysis.

Relative Impact on Engagement

Running Room

Baseline Performance Sufficient

Outsized Investment Required

42 Proven Drivers

7 Most Promising Drivers

1

2

3

4

Filters

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Some Drivers Have More Impact Than Others

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Filter #1: Relative Impact on Engagement

1) 2013 model contains 19 out of 42 drivers with an R2 of 0.65. All

drivers correlate with the engagement index in individual regressions.

Results from National Multivariate Regression1

Rank Driver

1 I believe in my organization’s mission.

2 My organization provides excellent care to patients.

3 My ideas and suggestions are valued by my organization.

4 The actions of executives in my organization reflect our mission and values.

5 My organization helps me deal with stress and burnout.

6 I am interested in promotion opportunities in my unit/department.

7 My current job is a good match for my skills.

8 My organization pays me fairly for my job.

9 My manager stands up for the interests of my unit/department.

10 Training and development opportunities offered by my organization have helped me to improve.

11 I understand how my daily work contributes to the organization’s mission.

12 My most recent performance review helped me to improve.

13 My organization recognizes employees for excellent work.

14 My organization supports employee safety.

15 I have job security.

16 Executives at my organization respect the contributions of my unit/department.

17 My organization provides excellent customer service to patients.

18 I have a manageable workload.

19 Over the past year I have never been asked to do something that compromises my values.

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Set Aside Areas of High Performance

16

Source: Nursing Executive Center analysis.

Filter #2: Running Room

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Sample Box and Whisker Plot

Box bottom and top

represent 25th and 75th

percentile

High performing drivers have small, high boxes with relatively short tails.

Filter Out the High Boxes with Short Tails

!

Top and bottom of tails

represent maximum and

minimum performance

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Highlighting the Running Room

17 Filter #2: Running Room

Percentage of RNs Agreeing or Strongly Agreeing per Organization

I believe in

mission

Organization

provides

excellent care

Ideas and

suggestions

valued

Executive

actions

reflect mission

and values

Organization

addresses

stress and

burnout

Interested

in promotion

opportunities

Job good

match

for skills

Organization

pays fairly

Manager

stands up

for unit

1 3 2 4 5 6 7 8 9



0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

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Highlighting the Running Room (cont.)

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Filter #2: Running Room

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Training and

development

helpful

My work

contributes

to mission

Performance

review

helped me

improve

Organization

recognizes

employees

Organization

supports

employee

safety

I have

job security

Executives

respect unit

contributions

Organization

has good

customer

service

Workload

manageable

Didn’t

compromise

values

10 11 12 13 14 15 16 17 18 19

Percentage of RNs Agreeing or Strongly Agreeing per Organization

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Identifying the Baseline Drivers

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Filter #3: Baseline Performance Sufficient

Attributes of Baseline Drivers

Reflect Basic

Employee Needs

Achieving Average

Performance Sufficient

Less Opportunity

for Improvement

To reflect the fact that baseline drivers require a different bar, analysis of baseline drivers

should include staff who respond “tend to agree” in addition to “agree” and “strongly agree.”

! Including “Tend to Agree”

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Applying a Different Bar for Baseline Drivers

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Filter #3: Baseline Performance Sufficient

Driver Agree,

Strongly Agree

Tend to Agree,

Agree,

Strongly Agree

“My organization pays me fairly for my job.” 46.8% 72.8%

“I have job security.” 54.7% 82.8%

“I have a manageable workload.” 52.1% 76.9%

National Performance on Baseline Drivers

70% threshold used

to assess baseline

driver performance

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Set Aside Drivers Requiring Outsized Investment

21

Source: Engaging the Nurse Workforce, 2007; Advisory Board

Talent Development; HR Investment Center, The Performance

Management Playbook, 2008; Nursing Executive Center analysis.

Filter #4: Outsized Investment Required

Driver Rationale Available Resource

“My manager stands up

for the interests of my

unit/department.”

Low-hanging fruit for managers

covered in Engaging the Nursing

Workforce; further improvement

likely requires heavy investment in

manager competency training

• Engaging the Nursing

Workforce

• Advisory Board Talent

Development

“My most recent

performance review

helped me to improve.”

Poor performance signals need for

comprehensive performance

management system overhaul

• The Performance

Management

Playbook1

Available Resources for Drivers Requiring Disproportionate Investment

1) Resources available through the HR Investment Center.

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Best National Opportunities to Improve Engagement

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• “My ideas and suggestions are valued by

my organization.”

• “The actions of executives in my organization

reflect our mission and values.”

• “My organization helps me deal with stress

and burnout.”

• “I am interested in promotion opportunities in

my unit/department.”

• “Training and development opportunities offered

by my organization have helped me to improve.”

• “My organization recognizes employees for

excellent work.”

• “Executives at my organization respect the

contributions of my unit/department.”

42 Drivers of

Employee

Engagement

Seven Drivers with Greatest

Opportunity for Improvement

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Translating Drivers into Pointed Action

23

Source: Nursing Executive Center interviews and analysis. 1) Based on 42 proven engagement drivers.

Developing a National Prescription for Nurse Engagement, 2014

Dimension Top Improvement

Opportunity1

Potential

Root Causes

Solvable

Challenge

Executive

Strategy

Recommended

Practices

I. Executive

Actions

Executive Actions Reflect

Mission and Values

II. Stress and

Burnout

Organization Addresses

Stress and Burnout

III. Staff Input Ideas and

Suggestions Valued

IV. Recognition

Organization

Recognizes Employees

Executives Respect

Unit Contributions

V. Training and

Development

Training and

Development Helped

Me Improve

Interested in Promotion

Opportunities

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All the Places We Looked

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Sub-Groups Analyzed for Identifying Potential Hotspots


National Database, 2013.; Nursing Executive Center analysis.

• Unit type/care setting

• Tenure

• Age

• Shift

• Region

• Employment status

(full time, part time, PRN)

• Union status

• System

• Standalone facility

• Academic Medical Center

RN Attributes Analyzed During Hotspot Analysis

Organizational Attributes

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Unit Type/

Care Setting Tenure Age Shift Region

Employment

Status

• < 1 Year

• 1-3 Years

• 4-6 Years

• 7-15 Years

• > 15 Years

• < 25

• 25-35

• 36-45

• 46-55

• > 55

• Day

• Evening

• Night

• Midwest

• Northeast

• South

• West

• Full-time

• Part-time

• Per Diem

The Two that Fell Below the Bottom Quartile

25


National Database, 2013.; Nursing Executive Center analysis.

RN Attributes

RN Sub-Groups Below the 25th Percentile for RN Engagement

• Cardiology

• Critical Care

• ED

• Float

Pool/PRN

• General

Telemetry

• Labor and

Delivery

• Med/Surg

• Nursery/NICU

• Nursing

Administration

• OB/GYN

• Oncology

• OR/

Perioperative

• Other Nursing

• Outpatient

• Peds/PICU

• Psychiatric

• Rehab

• Stepdown Unit

RN subgroups with engagement

levels lower than 25th percentile for

overall RN engagement automatically

categorized as hotspots

26

I. Executive Actions

Dimension

Top

Improvement

Opportunity1

Potential

Root Causes

Solvable

Challenge

Executive

Strategy

Recommended

Practices

I. Executive

Actions

Executive Actions

Reflect Mission

and Values

• Staff uncertain on

mission and value

• Executive actions

don’t reflect mission

and values

• Staff not aware of

executive actions

• Linkage between

executive actions

and mission

unclear

Staff don’t

fully appreciate

market rationale

for executive

actions

Translate Market

Forces into

Frontline Terms

#1 Mobile Town

Hall Forums

#2 Peer-to-Peer

Strategy

Liaisons

#3 Nurse Manager

“Doomsday”

Exercise

#4 Staff-Surfaced

Rumor Control

1) Based on analysis of 42 proven engagement drivers.

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Homing In on Potential Root Causes

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Executive Actions

One-Level Root Cause Tree

“The actions of executives within my organization reflect

our mission and values.”

Linkage between executive actions

and mission unclear

Executive actions don’t reflect mission

and values

Staff uncertain of mission and values

Staff not aware of

executive actions

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The Solvable Challenge

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Sending Frontline Staff a Mixed Message

“They keep saying patient safety is a top priority and we’re working with a smaller budget, but all

I see are staffing cuts and a new patient care facility being built. It doesn’t make any sense.”

Frontline Nurse

”

Executive Actions

Staff Don’t Fully Appreciate Market Rationale for Executive Actions

Representative Newsletter

Announcement

Nurse Perspective

Executive Perspective

“This is just another item on my already long to-do

list. Executives must not know how much I juggle.”

“Implementing bedside rounding will allow us

to maximize reimbursement by improving

performance on metrics tied to payment.”

Representative Perspectives

on Hourly Rounding

Nursing Buzz December 9, 2013

Hourly Rounding Update: Starting

January 1st, 2014, all nurses are required

to begin hourly rounding. Mandatory

training will be held across the week of

December 16th. If you have any questions,

please contact Edie Anderson at 123-456-

7890 or [email protected].

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Not Speaking Their Language

29

Source: CMS, available at: http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-

Instruments/hospital-value-based-purchasing/Downloads/FY-2013-Program-Frequently-Asked-Questions-about-

Hospital-VBP-3-9-12.pdf, accessed November 1st, 2013; Nursing Executive Center interviews and analysis.

Executive Actions

Sample Talking Points

Topic Talking Points

Value-Based

Purchasing

Overview

• The Hospital Value-Based Purchasing (VBP) Program is a Centers

for Medicare & Medicaid Services (CMS) initiative that rewards

acute-care hospitals with incentive payments for the quality of care

they provide to people with Medicare.

Measuring

Hospital

Performance

• CMS bases hospital performance on an approved set of measures

and dimensions, grouped into specific quality domains. Different

domains apply depending on the FY 2013 – 2015.

• In 2013, CMS bases performance on clinical process and patient

experience; in 2014, clinical process, patient experience, and

outcomes, and in 2014, clinical process, patient experience,

outcomes, and efficiency.

• CMS assesses each hospital’s performance by reviewing its

achievement and improvement scores for each applicable Hospital

VBP measure.

Reimbursement

• Reimbursement calculated by hospital’s base operating DRG during

that fiscal year and hospital’s value-based incentive payment

percentage during that fiscal year.

Staff may not

understand acronyms

or complex terms

Explanations assume

underlying knowledge

of market forces

Dense text; difficult

to pull out important

information

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Focusing on the Intended Audience

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Executive Actions

Key Characteristics of Effective Frontline Education Materials

Interactive

Format

Live, two-way

dialogue allows

staff to get real-

time answers

to questions

Captures Frontline

Perspective

Helps staff understand

how broad, organizational

changes impact their

daily work

Readily

Scannable

Ensures messaging

is clear, not

overwhelming

Brief

Makes complex

concepts easier

to digest

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Introducing Our Toolkit on Translating Market

Forces into

31

Sample Toolkit Resources

Customizable

Presentations

PowerPoint slides

and scripting for

leaders to brief

staff on tough

messages

Ready-to-

Use Videos

Short, easy-to-

digest videos for

frontline staff on

current market

forces

Manager

“Cheat sheets”

One-page primers

on market forces

impacting

organizational

strategy

Interactive

Exercises

Games for frontline

staff and managers

aimed at conveying

budget constraints

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Three Channels for Translating Market Forces

32


Communication Channels

Executive

Best positioned to discuss

organization-wide changes

Peer

Most relatable; staff may feel

more comfortable asking

questions when discussing

change with a peer

Manager

Can provide context for

how organizational changes

will impact the unit

Executive Actions

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Failing to Train the Trainers

33

Source: Baptist Health Lexington, Lexington, KY; Nursing Executive Center interviews and analysis.

Practice #3: Nurse Manager “Doomsday” Exercise

An Unrealistic Expectation

“We put people into leadership positions and assume they know

how to lead change. Most of the time, managers don’t really

understand the steps or process themselves. How can we expect

them to teach frontline staff when we don’t teach them first?”

Executive Director, Administrative Services

Baptist Health Lexington

”

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Demonstrating the Financial Impact of Adverse Events

34

Source: MedStar Montgomery Medical Center, Olney, MD; Nursing Executive Center interviews and analysis.


Overview of MedStar Montgomery’s Hypothetical “Doomsday” Exercise

Admitted to

observation unit

Central line

precautions missed;

develops 103º fever

Urinary catheter kept

in place longer than

necessary resulting in UTI

Develops pressure

ulcer after placed

on wrong surface

in OR and PACU

No bed alarm

used despite fall

risk; falls and

fractures femur

Clostridium difficile

spread to Mrs. Jones

after clinician forgets

to wash hands

$3,000 $10,000 $54,000 $3,000 $44,000 $7,000

Avoidable

Event:

Cost:

Observation

Unit

Admission

Patient

Fall

14 Day Hospital Stay

Central

Line

Infection

Pressure

Ulcer

Urinary

Tract

Infection

Clostridium

Difficile

Infection

Mrs. Jones

Arrives at

Emergency

Department

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Helping Managers Internalize Impact of Market Forces

35



1) Budget cuts include cuts from sequestration and Value-Based

Purchasing; calculated using publicly available data.

Overview of MedStar Montgomery’s Nurse Manager Budget Exercise

“Doomsday” Event Calculator

For complete “Doomsday” Event Calculator Tool, see Appendix.

Managers

Bring Their

Unit Budgets

Apply Across

the Board

Budget Cuts1 to

Unit Budgets

Deduct Impact

of “Doomsday”

Events

17% of

Managers Learn

Their Units

Would Close

Total Number of Patient

Falls, FY2013

Total Patient

Fall Cost

Average Cost per

Patient Fall

Number of Units

Total Patient

Fall Cost

Cost of Patient

Falls per Unit

=

=

X

÷

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What Would You Cut?

36

Bringing the “Doomsday” Scenario to the Front Line



For complete “Doomsday” Exercise Item Cost List, see Appendix.

“Doomsday” Exercise Item Cost List for Frontline Staff

Medical Surgical Division Item Cost List

Item

Foot/ankle pumps

Small copier

Office chairs

Wait room furniture

Nurses station computers

Bedside computers

Stretchers

IV pumps

Cost

$10,000

$3,500

$540

$6,000

$1,000

$5,000

$6,000

$3,000

Staff use cost list to

select items to cut

from representative

unit budget at each

avoidable event in

“doomsday” scenario

Staff receive list

of estimated costs of

commonly budgeted

unit items

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Visualizing the Impact of Avoidable Budget Cuts

37



“Doomsday” Magnetic Board Exercise for Frontline Staff

Magnetic board with

moveable, magnetic

pieces placed at front of

room during “Doomsday”

exercise for frontline staff

Staff asked to remove

items from board as they

cut them from

hypothetical unit budget

Board created in-house

using a camera, color

printer, laminator, and

magnetic tape

IMA

GE

CR

ED

IT: M

ED

ST

AR

MO

NT

GO

ME

RY

ME

DIC

AL C

EN

TE

R.

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Reducing Ad-Hoc Budget Requests

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April May June July August September October November

Ad-Hoc Manager Requests for Unbudgeted Items

Nurse Manager

“Doomsday” Exercise

2013

©2014 T

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Building a High-Value Care Team that Thrives

Our Newest National Meeting: Energizing the

Nursing Workforce

From Patient to Partner

Forces Shaping Provider Strategy in the New Health Care Economy

• Shifting market dynamics with most critical implications for nurse leaders

• Expanding access at all points along the continuum

• Redefining care delivery models within and beyond acute care

Building the High-Value Care Team

Strategies for Delivering Cost-Effective, Coordinated Care

• Unifying caregiver roles around shared goals

• Mobilizing the right staffing complement based on patient needs

• Comparison of highly effective care teams in different settings

Data-Driven Prescription for Advancing Frontline Engagement

How to Translate Survey Results into Meaningful Improvement

• Key trends and findings from The Advisory Board’s Employee Engagement

Database

• Identifying “hot spots” of staff with low engagement

• Targeting highest-impact engagement drivers

The Nurse Executive’s Role in Building a Highly Committed Workforce

Enfranchising Frontline Caregivers in Organizational Transformation

• Effectively communicating priorities to the front line

• Developing workforce resiliency in a changing environment

• Profiles of high-impact nurse executives

The Unit Manager’s Engagement Toolkit

Best Practices and Tools for Building Teams that Thrive

• Preempting key causes of staff burnout

• Integrating staff feedback into unit-level decisions

• Generating excitement about changing care delivery models

2013-2014 National Meeting Agenda

12 Meetings in 10 Cities

December 9-10

Washington, DC

January 16-17

Chicago, IL

February 10-11

San Francisco, CA

February 27-28

Atlanta, GA

March 6-7

New York, NY

April 24-25

Dallas, TX

CNO Roundtables

Leadership Team Summits

Two-day meeting in a small group setting

Audience: Senior nurse executives

Two-day meeting with an expanded agenda

Audience: Senior nurse executives and members of their nursing

leadership teams

February 18-19

Washington, DC

March 31-April 1

Chicago, IL

April 7-8

Laguna, CA

Regional Sessions

March 24

Denver, CO

May 9

Dearborn, MI

June 2

Seattle, WA

One-day meeting with a condensed agenda

Audience: Senior nurse executives and senior members of their

nursing leadership teams

2445 M Street NW I Washington DC 20037

P 202.266.5600 I F 202.266.5700 advisory.com

©2014 The Advisory Board Company advisory.com 1

Source: MedStar Montgomery Medical Center, Olney, MD.

MedStar Montgomery’s “Doomsday” Event Calculator

“Doomsday” Event Calculator

Observation Unit Admission:

Instructions: Use the equation below to calculate the impact of hypothetical adverse events on

nursing unit budgets.

Patient Fall:

Central Line Infection:

Pressure Ulcer:

Total Number of

Observation Unit

Admissions, FY2013

Total Observation

Unit Cost

Average Cost per

Observation Unit

Admission

Number of Units

Total Observation

Unit Cost

Cost of Observation

Admissions per Unit

=

=

$3,000 X

÷

Total Number of Patient

Falls, FY2013

Total Patient

Fall Cost

Average Cost per

Patient Fall

Number of Units

Total Patient

Fall Cost

Cost of Patient

Falls per Unit

=

=

$10,000 X

÷

Total Number of Central

Line Infections, FY2013

Total Central Line

Infection Cost

Average Cost per

Central Line Infection

Number of Units

Total Central Line

Infection Cost

Cost of Central Line

Infections per Unit

=

=

$54,000 X

÷

Total Number of

Pressure Ulcers, FY2013

Total Pressure

Ulcer Cost

Average Cost per

Pressure Ulcer

Number of Units

Total Pressure

Ulcer Cost

Cost of Pressure

Ulcers per Unit

=

=

$3,000 X

÷


Source: MedStar Montgomery Medical Center, Olney, MD.

MedStar Montgomery’s “Doomsday” Event Calculator

Urinary Tract Infection

Clostridium Difficile Infection:

Hypothetical “Doomsday” Scenario Unit Budget:

Total Number of Urinary

Tract Infections, FY2013

Total Urinary Tract

Infection Cost

Average Cost per

Urinary Tract Infection

Number of Units

Total Urinary Tract

Infection Cost

Cost of Urinary Tract

Infections per Unit

=

=

$44,000 X

÷

Total Number of

Clostridium Difficile

Infections, FY2013

Total Clostridium

Difficile Infection Cost

Average Cost

per Clostridium

Difficile Infection

Number of Units

Total Clostridium

Difficile Infection Cost

Cost of Clostridium

Difficile Infections per Unit

=

=

$7,000 X

÷

- 2014 Unit Budget Cost of Observation

Admissions per Unit

Cost of Patient

Falls per Unit

- -

Cost of Central Line

Infections per Unit

- Cost of Pressure

Ulcers per Unit

- Cost of Urinary Tract

Infections per Unit

-

Cost of Clostridium

Difficile Infections per Unit

= Hypothetical “Doomsday”

Scenario Unit Budget


Source: MedStar Montgomery Medical Center, Olney, MD. 1) Enables seat-to-seat transfers

MedStar Montgomery’s “Doomsday” Exercise Item Cost List

Medical Surgical Unit Cost List

Item Estimated Cost/ Each

Foot/ankle pumps $10,000

Small copier $3,500

Office chairs $540

Wait room furniture $6,000

Nurses station

computers $1,000

Bedside computers $5,000

Stretchers $6,000

IV pumps $3,000

Large printer $1,500+ $1,000

per year maintenance

Large copier $6,000

Cold therapy machines $3,800

Bedside commodes $100

Vital signs monitor $3,500

Steady1 $4,100

Recliners $1,800

Bladder scanner $17,000

Line cart $1,400

Isolation cart $100

Fax machine $250

Doppler $600

Thermometer $650

Vocera accessories

(replacing 1 per day) $525

a data driven approach to nurse engagement · introducing our national employee engagement database...

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