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Innovations at an Austin hospital to improve patient care and job satisfaction nationwide come just in time to help a dwindling number of nurses treat a growing number of patients.

Seton Northwest was among three hospitals chosen for Phase 1 of a two-year, $1.4 million study funded by the Robert Wood Johnson Foundation and conducted by the Institute for Healthcare Improvement.

The study, “Nursing: Transforming Care at the Bedside,” is designed to improve patient care by making changes in systems of care delivery for hospital medical/surgical units. Seton Northwest also is participating in the second phase, which began in June.

“It’s been pretty incredible to watch,” said Joyce Batcheller, RN, MSN, CNAA, senior vice president and network chief nursing officer for Seton Healthcare Network.

“I’ve not seen this level of enthusiasm in nursing in a long time.”

Pat Rutherford, RN, MSN, vice president of the Institute for Healthcare Improvement, said Seton Northwest was chosen because it’s part of Ascension Health, which has a reputation for being a health care innovator. Seton Northwest, in turn, is seen by Ascension officials as an innovator within its system, Rutherford said.

Seton Northwest is one of four Seton Healthcare Network hospitals to achieve the Magnet award designation, the highest national honor awarded for nursing care. Seton Northwest is a nonprofit, acute and subacute care, 113-bed hospital with more than 5,500 inpatient visits per year. The hospital has 10 operating rooms. More than 7,000 inpatient and outpatient surgeries were performed last year.

Seton Northwest and the two other hospitals were asked to come up with and test innovations and ideas for change that contributed to a “detailed conceptual framework” and a package of ideas that would redesign patient care at the bedside.

The project comes three years after a 2001 report by the Institute of Medicine. Its authors, representing every major stakeholder in the health care industry, recommended a fundamental system redesign. They advised changes be made to improve safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity.

Batcheller, a 29-year nursing veteran, said the nursing staff began with a brainstorming session to come up with ideas for improvements without regard to cost. She said that within three to four hours the staff had come up with more than 300 ideas, which were then grouped based on how easy they would be to implement.

“The majority of the ideas were fairly easy to do and cost minimal dollars,” she said. “What the staff did was come up with a series of tests they wanted to do in terms of new ideas.”

They then tested them using the Institute for Healthcare Improvement’s “rapid cycle,” in which ideas are tested on a small group of patients and/or with a small number of staff members. The results are reported back to the main group and a decision is made about whether the idea should be abandoned, adopted, or adjusted.

Mary Viney, RN, MSN, director of patient care services for Seton Northwest, said some ideas worked so well they were immediately implemented and spread to other departments. Others still are being studied and several ideas were abandoned.

One idea that worked is a nurse status board where nurses declare their level of work using green, yellow, and red magnetic dots. They place the dots next to their names on a white board every two hours. Green means all is well, yellow indicates that they’re a little behind in their work, and red denotes that they’re swamped with work, Viney said.

“It turned out to be real teamwork tool,” she said.