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The Premier Primary Nursing Hospital in the United States July 23, 2013

Posted by mariemanthey in Creative Health Care Management.
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In early May I had the privilege of visiting The James Cancer Center, a division of Ohio State University Hospital. My colleagues at CHCM, particularly Susan Wessel and Janet Weaver, have been working with them for some time and had been telling me of the great progress in developing a highly professional practice model the James had been achieving.

What I saw was like a dream come true for me. I saw staff nurses free and motivated to creatively solve patient’s care problems! This isn’t about unusual staff nurses; they are basically the same as staff nurses everywhere. It is about leadership based on common sense and a cultural infrastructure of safety for the risk-taking of creative problem solving. It thoroughly convinced me that Primary Nursing can be done….and MUST be done. Our patients deserve this level of care and our nurses deserve this kind of high-trust, high-integrity institutional environment.

Here is an email I received today from Jamie Ezekeilian at the James (addressed to Susan Wessel and myself):

Dear Susan and Marie,

We did indeed complete our three-day Magnet site visit last Friday, and I couldn’t help thinking that you would have been so proud.  At the checkout session with our three appraisers they said that they wanted to share what they thought were our “double-WOWs,” and the first thing they listed was our Professional Practice Model, Care Delivery System, and Relationship-Based Care!  Some of their observations:

  • We are living all aspects of RBC throughout the organization
  • They were amazed that professionals beyond nursing (including physicians) could speak articulately about our PPM and RBC
  • That Primary Nursing was so enculturated in all practice settings— they thought it unheard of for surgical services (periop) to be practicing Primary Nursing
  • They were quite impressed with our communication across the continuum of care and of our care coordination
  • They said that staff clearly felt cared for by each other and that is how they continue to do the difficult work of oncology nursing
  • That all were focused on patients!
  • That we have “clearly done this right”
  • That staff throughout the organization are so excited to attend the RBC Symposium in September—”we heard about it everywhere we went”

I wanted to share this with you as an affirmation of your professional work and your passion for Relationship-Based Care. I am so grateful to you for your wisdom and so thankful that we have had the opportunity to work together.

With heartfelt gratitude,


It’s About Safety…..not maintaining ‘margin’ July 14, 2013

Posted by mariemanthey in Leadership, Professional Practice, Thought for today.
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Good crew supervisors do not focus on safety (what?) but rather on good supervision, crew cohesion, and work ethics.   Safety is the result.   Supervisors who constantly talk about safety have more accidents than those who focus on working relationships.  ….safety has to be built into the system and is a byproduct of deeper personal and organizational commitments.

These comments are from an article re. safety for forest firemen.   The current healthcare system obsession with bureaucratic mechanisms to ensure patient safety are adding complexity and chaos to an already chaotic system…..thereby  actually increasing the incidence of errors.    We need to use good supervision (not fear-based control), healthy staff teamwork and strong work ethics in health care just as they do with their firefighting crews.