2011 Varnum Award Recipients
Bella, along with members of her family were just a few of the supporters who came to support Roebuck, a Staff RN Nurse in the NCCC Outpatient Oncology Infusion Suite at the fifth annual James W. Varnum Quality Health Care Awards ceremony. Roebuck was honored along with fellow recipients Richard Fedorchak, RN, Nurse Coordinator, Pediatric Hematology/Oncology; Amy Moore Certified Medical Assistant, Dartmouth-Hitchcock Concord Orthopaedics; and James Tracy, Support Service and Education Manager, Department of Pathology.
The Trustees of Mary Hitchcock Memorial Hospital established the James W. Varnum Quality Health Care Endowment upon Varnum's retirement as president of the organization in 2006. This award is meant to recognize employees, physicians or volunteers whose work embodies a deep commitment to creating and sustaining an environment of high-quality, patient- and family-centered care.
Here are some excerpts from the recipients' nomination letters:
Richard "Rich" Fedorchak, RN
Rich has always taken the time necessary to ensure that our patient's families are educated about their child's cancer diagnosis, treatment needs, medications, side effects and prepared to take them home during what may be the most stressful points in their families' experience. Rich tirelessly fields phone calls addressing not only the medical needs of our patients, but the psycho-social needs of their parents and family members as they call to have anxiety and fears alleviated.
Rich works closely with the inpatient Clinical Resource Coordinators on Pediatrics to ensure that all discharge needs are arranged in a timely manner to ensure patient safety. Once patients leave Rich facilitates contact with school nurses to ensure that patient's medical needs are met in their school environment as it is important that these children live as normal lives as possible. He regularly interfaces with the regional VNA's locating lab results for patients, educating VNA nurses about the unique needs of the pediatric oncology population and ensuring that all orders are arranged.
Rich is a strong advocate for patients with insurance companies relieving parents of one stressful burden. He ensures that prior authorizations are completed and therefore the institution reimbursed for services.
He has participated in many DHMC initiatives including a Quality Assurance project looking at the safety of central flushing and helped develop the new policy on central line flushes, which was implemented hospital wide. He has been actively involved in a patient education initiative working with the adult oncology program to improve their patient education process.
The term "legendary" has been used to describe the kind of nurse he is. His calm, positive manner always shines through even on the most challenging of days. He is devoted to his job, his coworkers and to our patients even when it means sacrificing his own personal time to do so. When he retires it is safe to say that his absence will be felt by each and every one of us in Pediatric Hematology/Oncology. There will be no other "Rich" – he cannot be replaced. He truly is a class act.
Amy Moore, MA
Her colleagues credit her with making orthopaedics in Concord what it is. Earlier this year the orthopeadic department was informed that they have the highest patient satisfaction scores of any of the southern orthopeadic practices. Her colleagues believe that Amy is one of the main reasons for these results.
As a certified medical assistant she is responsible for a wide range of activities including rooming patients, collecting information, assisting the providers in procedures in the office, removing sutures and staples, applying casts and splints, preparing medical records for patient appointments, patient phone calls, and much more.
Amy always gives 110%. She anticipates what needs to be done and just does it. She doesn't just stay in the comfort of her own job duties, as she is eager to learn new things and strives to make each day run as smoothly as it can.
She treats each and every patient with the utmost respect, finding ways to make their visit as comfortable as possible. A surgical office can heighten anxiety or fear, as patients are thinking about "what comes next''. Amy makes that experience for people just a little bit easier. And it all starts with just an introduction and a smile … very simple gestures that make all the difference. Patients remember her, ask for her, and speak of her when they talk about the great care they have been given.
One of the greatest things about her is her selflessness. She gives and gives, and doesn't ever look to take any credit for the things she has done. She is not a person who needs recognition to continue to achieve excellence, but she sure deserves it.
Sara Roebeck, RN
Sara volunteered to participate in NCCC Quality 101, a daylong course focused on quality improvement methodology. Because of her expressed interest in quality and her desire to improve the conditions within the infusion suite, Sara was selected as the only registered nurse to attend the first Value Institute Greenbelt certification course in March 2011. After this training, Sara initiated and led a project in the infusion suite that addressed the assignment of patients to nurses.
When Sara started her project the nursing staff received a patient assignment each day that had been designed the day before. This assignment was intended to be equitable based on patient numbers and complexity. However, the assignments were rarely fair or manageable because of factors that were beyond the control of the charge nurse creating the schedule. Sara changed all of this when she took the notion of a pre-assigned schedule and challenged it with her work on level loading of patient assignments. This work culminated in the ongoing method of assigning a patient to a nurse as the patient arrives. This method allows the nurse to see the patient in a timely manner, does not overwhelm the nurse with multiple patients arriving at once, and accommodates the variable arrival times of patients (despite their scheduled appointment time).
While this project has resulted in a streamlined approach to the assignment of patients to the nursing staff, the other benefits of this work are not so straightforward or easily apparent. This project created greater capacity within the infusion suite, improved patient and staff morale, decreased incidence of code initiations and created a more stable work environment. This project remains ongoing and evolves through use and staff suggestion.
Sara's work has had such an enormous positive impact that she has been asked to share the project experience at our departmental faculty meeting, at Nursing Grand Rounds, at the hematology/oncology Quarterly Quality Improvement Conference, at the NCI Nurse Executive Conference this fall and via an article in a nationally recognized nursing journal. The work has been so professionally satisfying to Sara that she has decided to tailor her graduate education toward quality improvement within the field of nursing.
James Tracey
One of James' responsibilities is to monitor the day-to-day wait times in four Outpatient Lab areas and he posts them each day so they are visible to staff. The program that he created allows the department to "monitor" the areas and if they see an increase in patient wait times they are able to send additional staff to that area. As a result the wait times for the Outpatient Labs went from a 20-25 minutes to current 3-5 wait time. This change has increased Patient Satisfaction scores.
James was also instrumental with the Southern New Hampshire Lab Project. He was the lead in Phlebotomy training and actively participated in the hiring process as well as recruiting staff for cleaning and moving supplies for the Southern New Hampshire transitions as well as working out extended Lebanon support for the initial transition. He created the same scorecards for their Labs as well and continues to monitor Patient Wait times and constantly looks at ways for improvement.
He has represented the Organization's vision for instituting a patient- and family-centered culture both in Outpatient Phlebotomy Area and Inpatient Phlebotomy area. James has worked very hard on the Specimen Rejection Policy for the Department of Pathology and has introduced this new policy to many different organizations within DHMC as well as to Senior Leadership. Also, he was a key player with the training of staff for the transition from CIS to eD-H and plays an active role in the Clinical Transformation Initiative.
For his staff, he has been able to develop mechanisms where internal Continuing Education attendance can be tracked to provide assistance to members of the Phlebotomy staff in educational resources. Because of his perseverance, 16 staff members have sat for their ASCP National Certification and have passed. James has been working very hard on developing a career ladder for Support Services and has re-written job descriptions within the Department to reflect this career ladder.
