OAKWOOD HEALTHCARE SYSTEM ROC AMBASSADOR PROGRAM Oakwood Healthcare System is the first healthcare system in southeast Michigan to implement Relationship Oriented Care (ROC) – “a philosophy and method of delivering care combining patient and family-centered communication with high-impact team practices to create positive health outcomes”  (Hansten) based on Hansten Healthcare’s RROHC program. As an extension to the Registered Nurse ROC Specialist certification, the ROC Ambassador Program was created for unit-based Nursing Assistants, ED Basics/Assistants and Mental Health Workers. Employees complete the application to participate and submit this to their unit manager for approval. The program’s purpose is to facilitate support of ROC, raise awareness and attention around ROC values, and educate these ambassadors about ROC fundamentals in order for them to become an example for their unit and beyond. This is a voluntary option for Nursing Assistants, ED Basics/Assistants and Mental Health Workers and includes two paid hours of ROC class, along with 4-6 hours of unpaid self-study, and 90 minutes paid time for participating in one of the ROC Site Advisory Meetings. Upon completion, the Nursing Assistant, ED Basic/Assistant or Mental Health Worker receives a ROC certificate and a badge identifier as a ROC Ambassador. The ROC Ambassador Program was developed through feedback received from an online ROC survey. A Nursing Assistant requested to be more involved in the ROC program through ROC certification. Since the ROC certification is limited to nurses, this idea sparked Oakwood’s pursuit of creating the ROC Ambassador Program for support staff. Approval from two unions was needed before moving forward. Each union received this request very positively and supported Oakwood’s initiative. A team of three ROC Specialists created the contents of the program addressing teamwork, communication, and delegation. The program is presented in two segments. The Overview Session gives the employee an understanding of ROC and the contents of the portfolio. Celebration is the second session discussing their learning’s as well as celebrating their accomplishments. A festive theme with balloons, cake, and a photographer make each celebration event special! Additionally, the support staff attend one ROC Site Advisory Meeting which now has both nurses and support staff at the table discussing ROC themes. A much richer conversation is occurring while recognizing the importance of all healthcare employees and their contribution to ROC implementation. Oakwood is offering three sessions annually (winter, spring and fall). In the first two sessions offered in 2010, Oakwood has graduated 35 support staff! One Nursing Assistant who is a recent ROC Ambassador graduate stated that this program changed her life. She feels much more valued and respected as a team member of her unit. Kudos to ROC!

In the article, Margaret describes a program that educates nurses to use the RROHC concepts to increase patient and staff satisfaction and decrease nurse turnover.

If you’re a JNSD subscriber, you can download a copy of Margaret’s article here.

Key: AMI:  Acute Myocardial Infarction, HF, Heart Failure, CAP, Community Acquired Pneumonia 

The Impact of Nursing Care on Patients:

1. As smoking cessation counselling rates increased for AMI, HF, and CAP, so did inpatient satisfaction. 
2. As pneumococcal vaccine rates improved, so did patient satisfaction. 

The Impact of Nurses on Organizational Performance:

1. As smoking cessation counselling rates increased, supply costs decreased for AMI patients.  Supply costs also correlated with shorter LOS (length of stay).  (attentive to patient’s actual individualized needs?)
2. For CAP patients, supply costs decreased as timing and appropriateness of blood cultures improved, and timing and activity levels for antibiotics improved (p. 38)

The Effect of Organizational Success on Nurses:

1. As labor costs fell, nurse satisfaction improved.  (Could this be due to more confusing, inefficient environments mean less satisfaction and more overtime?)
2. Financially healthy organizations experienced less nursing associate turnover.  (Is this because the organization is spending fewer hours on hiring, firing, retraining?)
3. As average LOS decreased, perceptions of attention to the needs of associates improved.  The author intuits that “improvements in care processes and standardization of care result in shorter LOS; predict greater associate engagement,  involvement, and ownership; and reflect higher perception of the associates needs being met.” (p 38)

The Effects of Organizations Financial Health on Patient Satisfaction

1. As paid hours of nursing increased, inpatient satisfaction improved.
2. Nursing productivity correlated with patient satisfaction.  (Busy and attentive nurses perhaps?)
3. Lower supply costs predicted better patient satisfaction.

“Nursing Makes a Significant Difference: A Multihospital Correlational Study”

From Janice Simmons, December 17, 2009 Healthleaders Media, Recognizing Patient Spirituality Could Improve Quality of Care.

Thank you! Ruth Hansten and the RROHC faculty