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Virginia Mason Launches New Model of Nursing Care
Kristen Swanson, RN, PhD, FAAN, Named First Distinguished Nursing Scholar
SEATTLE – (Aug. 14, 2012) – Virginia Mason Medical Center is launching a new model of nursing care that uses the tools of the Virginia Mason Production System (VMPS) to implement the Swanson Theory of Caring.
Kristen Swanson, RN, PhD, FAAN, developed the theory. She is the dean and alumni distinguished professor at the University of North Carolina at Chapel Hill School of Nursing, where she has served since 2009. Prior to her tenure at UNC, Dr. Swanson was chair of the Department of Family and Child Nursing at the University of Washington, in Seattle, where she was a faculty member for more than 20 years.
Driven by almost three decades of research focused on caring and early pregnancy loss, Dr. Swanson developed a highly-regarded theory of caring for others (e.g., patients, families, co-workers). The Swanson Theory of Caring is built on five foundational elements:
- Knowing and understanding the experience of the patient and their family
- Being with and in the moment with the patient
- Doing for patients as they would do for themselves if it were at all possible
- Enabling the capacity of the patient to care for themselves and their family
- Maintaining belief and sustaining faith that the patient can face a transition and move forward with their lives.
Beginning in early 2011, Dr. Swanson began meeting with Virginia Mason nursing teams to help them embed the caring theory into their nursing practice standards. Some of the innovations they developed include:
- Caring huddles focused on the nursing team and ensuring optimal care is delivered to patients and families
- A caring concierge cart stocked with everyday items to assure that patients and families have access to many of the comforts of home
- Specific quiet hours on each floor to ensure a caring, healing and respectful environment
- Caring "andons" (visual signals) to ensure patient and staff needs are addressed quickly
- Online sharing of caring wisdom and strategies on the Virginia Mason intranet, including a discussion forum, newsletter and nursing recognition
In recognition of her contributions to nursing and the Virginia Mason Nursing Model of Care, Dr. Swanson has been appointed as Virginia Mason’s first Distinguished Nursing Scholar.
"There are still people who think you can either be caring, or efficient, but you can’t be both," says Charleen Tachibana, RN, MN, senior vice president, hospital administrator and chief nursing officer. "The tools of VMPS have helped us eliminate waste and non-nursing activities that took nurses away from direct patient care. Our nurses spend more than 90 percent of their time at the bedside, compared with a national average of less than 50 percent. The Swanson Theory of Caring gives us the right context at the bedside to deliver the best care possible."
The collaboration between Dr. Swanson and Virginia Mason is not something Dr. Swanson thought was even remotely possible when she first heard about the Virginia Mason Production System. The year was 2005, and Dr. Swanson found herself at a conference listening to Tachibana talk about applying the principles of Toyota’s production system to provide better, safer and more affordable care to patients.
"I thought, ‘that’s a stretch’," Dr. Swanson recalls. "Can you treat a patient like a car? I could not understand the connection between automobile production and patient-centered caring."
But the more she listened to Charleen, and the more they talked, the more she realized that the Virginia Mason Production System and the Swanson Theory of Caring are made for each other.
"Caring is predominately about sustaining faith that people can come through challenging times and find meaning," says Dr. Swanson. "Our job as care providers is to understand, value, care for and explain, so that patients and families can find their own inner capacity for hope and healing. Caring is compromised if nurses are spending most of their time fetching supplies or away from the bedside. What I have discovered through this collaboration is that the Virginia Mason Production System has all of the tools necessary to take my Theory of Caring and make it the Practice of Caring. I could not be more thrilled to have been chosen as Virginia Mason’s first Distinguished Nursing Scholar."
About Virginia Mason Medical Center
Virginia Mason Medical Center, founded in 1920, is a nonprofit regional health care system in Seattle that serves the Pacific Northwest. Virginia Mason employs more than 5,300 people and includes a 336-bed acute-care hospital, a primary and specialty care group practice of nearly 460 physicians, satellite locations throughout the Puget Sound area and Bailey-Boushay House, the first skilled-nursing and outpatient chronic care management program in the U.S. designed and built specifically to meet the needs of people with HIV/AIDS. Benaroya Research Institute at Virginia Mason is internationally recognized for its breakthrough autoimmune disease research. Virginia Mason was the first health system to apply lean manufacturing principles to health care delivery to eliminate waste and improve quality and pa tient safety.
Awards and distinctions include Top Hospital of the Decade by The Leapfrog Group, 2012 Top Hospital (for the sixth consecutive year) and grade "A" patient safety rating by The Leapfrog Group, 2012 Distinguished Hospital for Clinical Excellence and Patient Safety Excellence Award from HealthGrades®, and 2012 America’s 100 Best Specialty Excellence Award for Overall Cardiac and Gastrointestinal Care from HealthGrades.
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