Cleveland Clinic Akron General's professional practice model represents a unique integration of our core values and beliefs; vision and guiding principles that embrace professional practice as a means to achieve quality care that is grounded in evidence-based caring practices. The model encourages and facilitates nurses' contributions to FLOURISH and achieve excellent empirical outcomes.
The image of our professional practice model depicts components of essential domains of nursing practices. Our model is purposefully circular. A circle has no beginning and no end, which is symbolic of the dynamic and fluid therapeutic support professional nurses give in their everyday practice. Each element in the model strengthens all other components, promoting the enrichment of the whole. It is designed as an integrated system which supports efficient, effective, productive, data- driven and value-driven methods and serves to direct decisions regarding priorities and strategies.
The model depicts the Patient/Family/Community as the core, with nurse practices providing compassion and respect for an individuals' uniqueness while ensuring that Safety and Comfort are afforded.
The core is surrounded and intersected by the essential components of Caring and Healing Environment, Competency & Professional Development, Shared Decision-Making & Governance, and Evidence-Based Practice, Performance Improvement, Innovation & Research. The areas of influence encircling the center capture the professional elements, structure, processes and relationships that define the complex role of the nurse at Cleveland Clinic Akron General.
The essential components are enveloped by Relationship-Based Care which provides a unifying philosophical and operational framework for the practice of nursing and which is underpinned by Caring Theory. The focus of the program is caring across three vital relationships: the clinician's relationship with self, with colleagues, and with patients and their families and our community.
FLOURISH describes how our patients, colleagues, profession, and nurses as individuals, optimally experience excellence, as represented by personal dignity, harmony, autonomy and contentedness and sense of purpose in life; and which is cultivated by:
- Foster the values of be nice, work hard, accommodate and communicate
- Leadership is transformational
- Ownership of outcomes and excellence
- Utilize Evidence-Based Research
- Relationship-Based Care as a philosophical and operational framework
- Involved in Shared Decision-Making
- Safety, Quality & Efficiency
- Health and wellness promotion of our community
Patient/Family/Community - Exceptional patient experience of care is mutually valued by patients, family and community and the fundamental aim of the provision of our nursing care. Care is provided based on the identification and prioritization of the patients' needs to enhance a healthy balance of mind, body and spirit; as well as the commitment to improve the health of our community. Patient-centeredness is the approach utilized by the interprofessional health care team with the patient and family, as part of a mutually beneficial partnership to plan, deliver and evaluate healthcare. Our nurses' nurture personalized care by:
- Listening and honoring patient and family perspectives and choices
- Demonstrating kindness, respect, and being “present” with patients
- Encouraging and supporting patients and families to participate in care and decision-making
- Preserving the identification of patient’s family to be respectfully defined by the patient
- Offering information, communication and education in a way meaningful to the patient and family
- Ensuring equitable and effective access, transition and continuity
- Assessing community healthcare needs and assets, and collaborating with community partners to prioritize and promote the health and welfare of identified populations
Safety & Comfort
Safety and Comfort are desired states that every nurse wants and expects for patients. Our nurses advocate for and mobilize resources to provide a patient care environment which is free from harm, proactively targets a low risk of error, and is comfortable as substantiated by:
- Secure, uncluttered, clean, quiet, and private surroundings
- Evidence-based individualized pain management strategies
- Nurses, patients and family are involved in therapeutic self-care by collaborating to meet self-care needs and regulating self-care capabilities (hygiene, nutrition, mobility)
- Skillful and thoughtful use of touch to perform clinical tasks, communicate caring, and ensure comfort
Caring & Healing Environment
Caring and Healing Environment is where the essence of nursing practice is personified. Our nurses exemplify patients first by:
- Considering it a privilege to serve our patients and all they bring to their individual care
- Providing holistic and compassionate care
- Honoring individual beliefs and values through cultural congruency
- Establishing a contract of trust
- Developing relationships during the most vulnerable times
- Incorporating patients and their family members as true collaborative partners, in education and care planning
- Empowering patients to participate fully in order to improve healing and reduce complications
Competency & Professional Development
Competency and Professional Development is an avenue in which our professional nurses embrace their practice with the responsibilities and privileges it brings by:
- Accepting responsibility for achieving and maintaining a current level of competency in nursing practice
- Being accountable for our actions and judgments
- Demonstrating competency in nursing practice including proficiency in technological skills, evidence-based practice and interpersonal skills
- Continually assessing, planning, implementing, and evaluating care based on evidence, sound clinical judgment and critical thinking skills
- Valuing, encouraging, supporting and recognizing professional development and believing it is part of the foundation of nursing’s commitment to continued excellence
- Continuing to evolve his/her professional potential/growth and commit to professional development through life -long learning ensuring a competent nursing workforce.
- Ensuring a professional practice environment that attracts and retains highly qualified professional nurses.
- Developing expertise and advancement in nursing practice by embracing both roles of a teacher and student and to take ownership of changing practice
- Exhibiting integrity in nursing practice through self-knowing, nurturing students, and mentoring colleagues to provide exemplary professional practice
- Providing informal and formal professional recognition of nursing, as well as other disciplines, accomplishments whether with our recognition ceremonies or from patients, families, peers or leaders
- Cultivating an environment that promotes professional growth, learning and development, that supports the mission, ensures high quality care and enhances patient safety and outcomes
- Maintaining a Clinical Ladder Program recognizes and rewards the bedside clinician for participation in activities and education that provide evidence based knowledge that benefits their patient population, unit, hospital or community. These clinicians are seen as mentors and resource nurse to their peers.
- Caring for patients by delivery of expert and specialized care, attainment of specialty expertise.
Share Decision-Making & Governance
Share Decision-Making & Governance is an avenue that provides autonomy, empowerment, authority and collaboration to advocate and impact the professional nursing practice by:
- Actively participating in councils to influence decision making that impacts profession nursing practice, improving the quality of care, enhancing patient and family satisfaction, and contributing to overall nursing satisfaction
- Providing empowerment to make decisions at all levels and which are accountable for clinical outcomes
- Promoting nursing autonomy and decision making giving legitimate influence of nursing practice.
- Collaborating to influence and improve nursing practice and patient outcomes
- Integrating core values and beliefs that professional practice embraces to achieve quality care, improve nurse environment, nurse satisfaction, and retention
- This domain speaking to leadership throughout the organization by nurses at every level and in every setting. One of the underlying tenets of the model is that nurses in every position spend time in each domain. At Cleveland Clinic Akron General, every nurse is a leader. They are influential and are involved in policy development. Working internally to create an environment where nurses can practice at their peak, or externally to create vibrant communities which can support patients at home, leaders communicate and achieve their vision. Whether at the bedside or in the boardroom, Cleveland Clinic Akron General nurses model excellence.
- This domain including the clinical practice of all nurses throughout the organization, whether directly caring for patients or providing support for patient care. The nurse’s role and responsibilities delineate clinical decision-making and results in superior patient outcomes.
Evidence-Based Practice, Performance Improvement, Innovation & Research cultivate a spirit of inquiry using applied science to impact profession nursing practice and empirical outcomes by:
- Using Evidence-Based Practice (EBP) as a problem-solving approach for clinical decision-making within a health care organization. It integrates the best available scientific evidence with the best available experimental (patient and practitioner) evidence. EBP considers internal and external influences on practice and encourages critical thinking in the judicious application of such evidence to the care of individual patients, a patient population, or a system (Newhouse, Dearholt, Poe, Pugh, & White, 2007.)
- This domain including cultivating a spirit of inquiry and generating new knowledge to improve patient care outcomes. Nurses are encouraged to examine their practices and the practice of others and apply knowledge in order to improve patient care/outcomes. They are empowered to make decisions at all levels to promote quality care, to search for and critically appraise most relevant evidence to guide clinical nursing practice and are accountable for the clinical outcomes achieved.
- Committing to continual improvement and incorporating evidence-based practice into best practice.
- Gathering and sharing of data and problem-solving to improve patient care and outcomes.
- Advancing nursing practice through inspiration, creativity, translation, discovery, and caring practices using partnerships and resources.