TL4a
Advocacy and Influence TL4
Provide one example, with supporting evidence, of a Nurse AVP’s/Nurse Director’s advocacy for resources to support an organizational goal.
Example a: Nurse Director’s Advocacy for New Hyperbaric Chambers
Organizational Goal
CommonSpirit Health (CSH) is the overarching organization for Catholic Health Initiatives (CHI) St. Vincent Hot Springs (SVHS). CSH’s Organizational Strategic Plan 2026 (developed in 2022) has three strategic pillars: Our People, Our Excellence, and Our Future. The Our Future pillar is defined as: “Be a trusted provider of integrated care across the CSH continuum that is easy to navigate, affordable, and understandable for all those we serve.” (Evidence TL4a-1, CSH 5 Year 2026 Organizational Strategic Plan pages 5 & 9)
As a health system, CHI SVHS is evaluated for achieving its strategic initiatives through key performance indicators. Revenue from Diversification (Non-Acute) Sources is the key performance indicator (goal) used to measure this strategic pillar. CHI SVHS provides services to patients and navigates them to the right care, at the right place, and at the right time. Providing integrated care to patients across the CSH continuum and generating revenue from diversified (non-acute) services is how SVHS achieves this goal.
Nurse Director Advocacy
CHI SVHS Wound Center needed hyperbaric chamber cylinder replacements with mechanic overhaul services to include gurney replacements. The current two chambers were at the end of life on March 3, 2023, and March 20, 2023, leaving a vulnerable patient population without care. The Wound Center is an SVHS clinic that extends care to patients beyond the walls of the acute hospital by providing hyperbaric chambers for wound healing.
Without the availability of this service to these patients for treating their wounds, the patients are at high risk of getting admitted to the hospital, related to inadequate wound healing. Renee Fechuch, MSN, BSN, RN, Clinical Director, began advocating for resources at the end of 2022 to get the Wound Center new hyperbaric chamber cylinders.
Obtain Quotes
Fechuch obtained a quote on December 12, 2022. (Evidence TL4a-2, Hyperbaric and Gurney quotes) The SVHS hyperbaric chambers were manufactured by Sechrist. For compatibility, the decision was made to stay with the same manufacturer.
Adam Jarrett R.T. (R) (T) (ARRT), Director of SVHS Hospital Based Clinics, is typically the SVHS point of contact for this company. However, as the clinical director, Fechuch assumed responsibility for obtaining the quote, and due to unforeseen personal circumstances for Jarrett, Fechuch was the primary point of contact for the vendor for this acquisition.
Develop and Present SBAR
Fechuch developed a Situation, Background, Action, Recommendation (SBAR) after receiving the Sechrist quote. She presented the completed SBAR to the Executive Team at SVHS on December 15, 2022. The executive team included Teresa Lambert, MBS, BSN, RN, Vice President of Patient Care Services/Assistant Chief Nursing Officer (role of CNO); Crystal Bohannan, Vice President of Operations; and Douglas Ross, MD, FACEP, President. (Evidence TL4a-3, Hyperbaric SBAR)
Obtain Approvals
On January 17, 2023, Fechuch received executive approval for $203,310 for the replacement cylinders, pending an updated quote as the current quote expired during the approval process. Fechuch reached out to Caryn Oldham, Senior Vice President, Hyperbaric Sales Sechrist, on January 23, 2023, to find out that the price for the replacement cylinders had increased after the first of the new year.
Fechuch asked Oldham to honor the previous quote as this was the maximum amount of funding that would be granted. An email was received on January 25, 2023, from Oldham stating that Sechirst would honor the previous quote. (Evidence TL4a-4, Emails Advocating for Original Quote)
Acquisition of Resources
Coordinate Delivery and Installation
On February 28, 2023, a conference call was scheduled for March 6, 2023, with Oldham; Fechuch; Libby Lynch, Customer Service Representative, Sechrist; Don Adams, Field Service Hyperbaric Specialist, Sechrist; Jarrett; and Michael Childress, RN, Clinical Supervisor, Wound Center. The conference call was to discuss the delivery of the new cylinders on March 24, 2023, with possible delivery on March 23 after the clinic closed.
Fechuch’s advocacy for acquiring the hyperbaric chamber cylinders supported the CSH CHI SVHS “Our Future Aspirational Goal,” as vulnerable patients who needed wound care through the CHI SVHS Wound Center would not have been able to receive this care outside of the acute hospital if these resources were not obtained. These patients would have to have been admitted as patients in the acute hospital. On March 25, 2023, the new 3200 hyperbaric chambers and gurneys were installed, and the onsite mechanical overhaul was completed.
Advocating for these resources helped these patients receive the right care, at the right place, and at the right time. By having the correct equipment in the CHI SVHS Wound Care Center, the patients needing this treatment could be treated as outpatients in the clinic, which is more affordable than being admitted into the acute care hospital where they would need to be cared for 24/7. In FY23, CHI SVHS generated a revenue of $201,709 from the hyperbaric chambers, to achieve “Our Future Aspiration Goal.” (Evidence TL4a-5, Hyperbaric Chamber Revenue)