BEST PRACTICE

Implementation of the Stroke (Nurse) Champions

This quality program increasedcompliance and consistency with all indicators of care and provided opportunities for clinical and leadership growth.

Hospital: / SwedishMedicalCenter, Seattle, WA (Stroke module)
  • Several campuses
  • 600 beds; 70 strokes/month (all campuses)
  • Tele-stroke program
  • A shared governance hospital: organization has moved to shared leadership and nursing councils

Key Stakeholder / Stroke / Tele-stroke Program Manager
Overview: / Desiring representation for the stroke team on all patient floors, the Stroke Floor Champion position was developed to act as the floor/unit’s first-line “go-to” liaison with the stroke team, with the objective of bringing the stroke team “one layer closer” to the staff nurses.
  • A group of about 10 “robust” champions are in place covering: all neuro ICUs, all EDs, other neurology units, telemetry unit
The development of this position has enabled the hospital to deliver consistent and compliant stroke care across all its campuses, regardless of patient placement.
Responsibilities: / Floor champions provide a conduit for stroke education and ensure appropriate patient care:
  • Answer stroke related questions from floor managers as well as staff /nurses
  • Post dashboard data on unit; review floor data and fall-outs, noting need for additional education; provide training /education to floor staff/nurses as needed
  • Communicate stroke related news/updates to floor
  • Ensure only stroke trained nurses do dysphagia screen
  • Help resolve process issues

Implementation: / Evolved informally from the stroke managers’ experience as a charge nurse whose stroke knowledge/advice was often sought. Now have a charter outlining responsibilities of the position.
Identify and approach candidates with
  • Strong stroke skills
  • A desire to advance on the clinical ladder
  • Leadership qualities
Incentive is the honor/appreciation associated with the role; and opportunity to advance clinically.
Education: / Nurse champions have received basic stroke training, and feel strongly comfortably with their stroke skill set.
  • Refreshers provided as needed
  • Monthly meetings serve as a learning/teaching tool

Communication: / Monthly meetings include a review of dashboard data as well as a “report out” wherein concerns from each unit can be addressed and feedback obtained.
  • Managers provide time off to attend meetings
  • Meetings last 1½ to 2 hours; making it worth their while to come in if it falls on a day off

Impact: / Has contributed to compliance with consistency across campuses.
Also facilitates their ability to maintain gains through earlier identification of education needs and process change needs
Advice: / Advocate for Administration to value role and support thetime required for floor champions to attend meetings and obtain basic stroke education.