How Novant Health brought nursing back to patient rooms

Novant Health implemented several changes over the past four years that have drastically increased the time nurses spend in patient rooms to 72 percent, according to Becker's Hospital Review.

In 2010, the Winston-Salem, North Carolina-based organization analyzed how much time its nurses spent at the bedside during 12-hour shifts. "We discovered that we weren't that different from the rest of healthcare organizations," Chief Clinical Officer Sallye Liner, R.N., told Becker's. "They were spending two-and-a-half to three hours on direct care. They're working hard. They're just engaged in activities that didn't have them performing at the top of their license. "

Novant executives brought together nurses from throughout the system to find a solution; these nurses identified the four activities that occupied most of their time not spent with patients:

  • Retrieving medication 

  • Care planning

  • Admitting, including obtaining patient history paperwork and medications

  • Searching for/gathering supplies such as IV poles

After conducting this analysis, Liner said, Novant then set a new bedside goal: 70 percent of nurses' time spent in patients' rooms. To help achieve that goal, Novant recruited certified nursing assistants to handle many of the tasks keeping nurses from their patients, and implemented electronic medical records to free up the time medical unit secretaries were spending transcribing orders.

"Over the course of the last three years following that, we've worked on care team models that included having the nurse define what the top of their license performance would look like," Liner said. 

After initially implementing the reforms in 51 nursing units, Novant has expanded them to all 15 of its hospitals, with nurses now spending 72 percent of their shifts in patient rooms. Since then, patient falls, infection rates and nurse turnover are down, with patient satisfaction on the rise, Liner said.

A study last year found that involving patients in their own bedside nursing care, particularly during shift changes, also helps improve outcomes and reduce errors, FierceHealthcare previously reported.

To learn more:
- read the Becker's article