Driving Organizational Change From the Bedside: The AACN Clinical Scene Investigator Academy

Abstract

Background Staff nurses are pivotal in leading change related to quality improvement efforts, although many lack skills to steer change from the bedside. The American Association of Critical-Care Nurses (AACN) staff nurse leadership program, Clinical Scene Investigator (CSI) Academy, teaches and empowers staff nurses in leadership skills and change concepts to translate evidence into practice affecting patient outcomes. Objectives To describe the curriculum of the AACN CSI Academy that provides staff nurses with the leadership skills required to create unit-based change projects that positively impact patient/family outcomes. Methods The curriculum of the Academy included leadership topics, communication, change concepts, quality improvement methods, project management, and data management and analysis. Each team of participants collected project data to show improvements in patient care. The program evaluation used many data sources to assess the program effectiveness, relating to the professional growth of the participant nurses. The participants assessed project patient outcomes, sustainability, and spread. Results The first cohort of CSI participants included 164 direct care nurses from 42 hospitals in 6 cities. They rated the Academy highly in the program evaluation, and they reported that the Academy contributed to their professional development. The individual hospital quality improvement projects resulted in positive patient and estimated fiscal outcomes that were generally sustained 1 year after the program. Conclusion With the skills, tools, and support obtained from participation in the CSI Academy, staff nurses can make substantial contributions to their organizations in clinical and possibly fiscal outcomes. (Critical Care Nurse. 2017;37[4]:e12-e25)

Thought leadership

“…Twenty-eight direct care nurses from seven Boston area hospitals were hand selected by their nursing leaders to participate in the American Association of Critical-Care Nurses (AACN) Clinical Scene Investigator (CSI) Academy. The AACN CSI Academy aims to provide direct care nurses with the knowledge, skills, and support to lead their peers in creating unit-based change that's easily scaled for maximum impact 7. At the conclusion of the 18-month program, the direct care nurse-led initiatives in the seven Boston-area hospitals measurably improved patient outcomes and demonstrated a combined impact of nearly $8 million in anticipated annual savings to the organizations involved 8.…”

“…The AACN CSI Academy aims to provide direct care nurses with the knowledge, skills, and support to lead their peers in creating unit-based change that's easily scaled for maximum impact. 7 At the conclusion of the 18-month program, the direct care nurse-led initiatives in the seven Boston-area hospitals measurably improved patient outcomes and demonstrated a combined impact of nearly $8 million in anticipated annual savings to the organizations involved. 8 This example shines a powerful light on the role of direct care nurses and demonstrates their ability to be bold thought leaders.…”

Alternative Approaches to Mentoring

“…33 The Clinical Scene Investigator program's national faculty mentor nursing teams as they conduct projects to improve outcomes among critical care patients, such as reducing the incidence of hospital-acquired infections, pressure ulcers, or delirium. 34 Mentoring by research scholars who are employed by the hospital or an affiliated university has facilitated the implementation of research projects by critical care staff within their units. 24,25 Mentoring has also been recognized as a strategy to help experienced staff increase competency in advanced practice roles such as clinical nurse specialist or nurse practitioner.…”

Predicting medical-surgical nurses' work satisfaction and intent to stay

“…Nurses expect their managers to be effective at the unit level and communicate information that affects their work. 7,10,19,20 In a descriptive qualitative study, what nurses expected from their manager differed. Nurses early in their careers had high expectations of leadership and expressed disappointment and felt stranded when their concerns weren't valued.…”