By Steven Brittain Special to NurseWeek Seton Hospital Nursing Congress As healthcare facilities across the country struggle to find

and retain the most highly qualified nurses, the shared governance model practiced at the Seton Family of Hospitals in Central Texas continues to provide a distinct advantage over the competition and serve as an invaluable recruitment resource. When current chief nursing officer Joyce Batcheller, RN, MSN, CNAA, arrived at Seton nearly 13 years ago, she found an intricate system of hospitals with a nursing staff that was in desperate need of organization and voice. The Seton Family of Hospitals, centered in Austin, TX and the surrounding areas, includes five urban acute care hospitals, two rural hospitals, a mental health hospital, several strategically located health facilities that provide medical care for well patients and three primary care clinics for the uninsured. The Seton Family of Hospitals is the leading provider of healthcare services in Central Texas, serving an 11-county population of 1.4 million. Four out of every ten overnight patients in the region receive their care at a Seton facility. It was imperative that a nursing staff so large be allowed to work together in a true shared governance environment so that decision-making and collaboration included nurses at all levels. Batcheller was the perfect person for the job. Having implemented a full shared governance model at her previous leadership role at Inova Fairfax Hospital in Virginia, Batcheller, who has worked in nursing for more than 30 years, hoped to instill the same philosophy at Seton. “I wanted to bring the same principles we had implemented in Virginia to Seton,” she said. “I wanted staff input in developing hospital-wide solutions. I wanted a way to bring the best of the best together from each site within the Seton Family of Hospitals so that we could standardize policies, procedures, equipment and anything else pertaining to our nursing staff across the spectrum of our institutions.” A governing body is born In May 1996, Batcheller’s brain child became a reality when the first meeting of the Seton Nursing Congress took place. More than ten years later, the Nursing Congress is as strong as ever and is a vital component of hospital operations, Batcheller said. “We have staff members who were involved with the Congress on the very first day who are still as involved as ever,” she said. Seton's Nursing Congress, which can have anywhere between 55 and 60 members at a given time, offers the nursing staff a monthly forum to talk about professional and clinical issues, provides a mechanism for their input and feedback and helps generate opportunities for the nursing staff to develop leadership skills. According to Batcheller, the Congress evaluates and advances nursing practice with the goal of meeting or exceeding patient-care expectations, and achieving successful patient outcomes. It is sponsored by the Nursing Executive Council, and also includes eight specialty-nursing councils and two support councils, which work together to

address clinical and professional practice issues; network-wide consistency of nursing practice; research and regulatory compliance; standardization and cost efficiencies; and nursing quality assessment and improvement. The Nursing Executive Council - chaired by the chief nursing officer - is comprised of lead nursing directors, and the chair and vice-chair of the Nursing Congress. The Council is responsible for the strategic planning and oversight of the Congress, and holds an annual retreat to establish goals and develop improvement strategies for the nursing division. Through the Nursing Congress, staff and leaders work together to continuously improve communication, work environment, patient safety, orientation and professional development. Free exchange of ideas Pamela Novak, RN, has been a nurse for the past 27 years and currently works in the Endoscopy department at Seton Medical Center in Austin. She also serves as the current chair of the Nursing Congress. The most engaging aspect of the Nursing Congress, Novak says, is the environment of open communication and the free exchange of ideas that it has created. “Obviously the Congress has been a huge resource to the nursing staff, but I think it’s become just as much of a resource for our administration,” Novak said. “All lines of communication are open and it has led to our nursing staff having no fear of management. They know that people are listening, and though every idea might not get acted upon, at least there a forum in which to express them.” Novak added it’s not uncommon for the chief executive or the chief financial officers to attend the monthly forum. In addition to the regular CNO update at each meeting, the presence of additional executive leadership provides the nursing staff insight into what the administration deals with on a daily basis. “It’s further proof that the administration at Seton values our opinions and won’t hesitate to engage the staff members who work on the frontlines,” she said. Just as important as having access to executive leadership is simply having access to one another, says Courtney Payne, RN, CCRN, a critical care nurse at Brackenridge Hospital, Seton’s trauma-specific facility in Austin. In a hospital system as large as Seton, there are nurses who cover every specialty and who know the industry inside and out, she said. The Nursing Congress ensures that nurses from all of Seton’s hospitals are exposed to this expertise and can see how the decision-making process affects everyone. Attempting to establish a network-wide view of Seton instead of simply site-specific ones is vital to the success of the Congress, she said. “We have so many specialties working together that it’s impossible for you to not be in a mode where you are constantly learning something new from your colleagues,” said Payne, who served as chair of the Congress in 2005. “It allows us to make policies that benefit everyone and develop plans that are the best for the patients because we’ve considered the entire spectrum of care. We’re broadening the horizons of our nurses and giving them such considerable control of their own practice. Giving your staff resources, information and contacts with people from backgrounds they normally wouldn’t get to work with benefits everyone from the nurses themselves to the patients in the hospital.”

Recruitment and retention Perhaps the largest benefit Batcheller says she has seen from implementing the Nursing Congress is the positive effect it has had on nurse recruitment and retention. Seton has established relationships with several nursing schools to allow young professionals in training and prospective employees to come to sit in on some of the monthly Nursing Congress meetings. “We’re eager to get up and coming nurses familiar with the Congress as early as we can,” Batcheller said. “We want them to see what they can be a part of by joining the Seton Family of Hospitals. Once nurses are hired, we try to get them involved immediately. Most are required to attend if not a Congress meeting, then at least one of their unit council meetings. We want them to know that they are integral parts of the system and not just faces in the crowd.” The 2002 American Organization of Nurse Executives survey took an in-depth look at the current nursing shortage and found that 83 percent of those surveyed believed improved working environments would be helpful in curbing the shortage, more so even than better wages (79 percent). The survey also found that 70 percent of those asked agreed a higher status for nurses in the hospital organization would be effective in correcting the shortage. Batcheller believes the Nursing Congress addressed these issues at the source by empowering Seton’s nursing staff and by placing them in a conducive, academic-style setting that fosters growth. “We hold values and respect in very high regard at Seton and I think our culture is fully embraced in our nursing staff. This can be seen in our levels of employee retention, our ability to attach the best and brightest new nurses and through the recognition that several of the largest institutions in the Seton Family have received,” Batcheller said. The nursing services at Seton’s four urban acute care hospitals have received the coveted Magnet Award—the highest level of recognition that can be awarded to nursing services in healthcare organizations. The American Nurses Credentialing Center (ANCC) awarded Magnet designation to Brackenridge Hospital, Children’s Hospital of Austin, Seton Medical Center and Seton Northwest Hospital. These four Seton Healthcare Network hospitals became the 61st through 64th facilities to receive this award in the United States. “I’m extremely proud of the work we’ve accomplished via the Nursing Congress and the positive atmosphere it continues to bring to Seton,” Batcheller said. “The Nursing Congress will continue to grow and evolve as the hospital system itself continues to grow. I believe we’ve created model of leadership that future generations of Seton nurses will carry on for decades to come.”