Description: Nursing Peer Case Review? The thing to do? – Clinical Improvement/Innovation Poster
Key Contact: Ashlee Perreault BSN RN CNOR Team: Catherine Gabster MSN RN CNL CNS, Tara Goldberg MSN RN CAPA, Michele Maines MSN MSG RN CNL, Kimberly Ternavan MS/MBA RN CPHQ NE-BC Ronald Reagan UCLA Medical Center, UCLA Health, Los Angeles, California
Description of Team: The Nursing Peer Case Review (NPCR) Committee includes clinical nurses from seven perioperative and interventional units (Operating Room, Cardiac Catheterization Lab, Pre-op Unit, Post-Anesthesia Care Unit, Medical Procedures Unit, Interventional Radiology, and Transitional Recovery Unit). The NPCR Committee also includes mentors from nursing leadership, a Clinical Nurse Specialist, a Nurse Informaticist, Risk Management and Quality representatives.
Preparation and Planning: Peer review provides a framework for identifying opportunities to enhance patient safety and improve the quality of care. The NPCR structure and processes we adopted were developed at another hospital within our health system. Building upon their work and with the mentorship of founding committee members, we elected to form a population-focused NPCR Committee.
Assessment: The units represented in our perioperative NPCR Committee engage in thousands of hand-offs and overlapping processes each day. In an effort to strengthen organizational culture of safety and advance Just Culture, these units needed a forum for nurses to collaboratively review system process issues, identify opportunities for improvement, and advance the quality of care.Implementation: The NPCR Committee meets monthly to review a case and invites the involved nurses to participate in a non-punitive discussion. The Committee makes recommendations which are disseminated to involved department leadership and the greater health system nursing community via the shared governance structure.
Outcome: The NPCR Committee has promoted inter-unit collaboration by engaging clinical nurses and leadership from all seven of the perioperative and interventional units. The Committee has successfully sustained monthly meetings, identified opportunities for improvement, and disseminated recommendations. Outcomes monitored by the Committee include Culture of Safety survey results from involved units and feedback from clinical nurses who participate in NPCR.
Implications for Perioperative Nursing: The NPCR Committee empowers perioperative nurses to collaborate with their peers and participate in quality improvement activities. Creating a perioperative NPCR Committee promotes a culture of safety by providing a forum for clinical nurses to have a focused discussion about nursing practice and patient safety in the perioperative setting