Advice From Your Peers

We asked our current clients some questions regarding advice they had for soon-to-be Nash enthusiasts. Click each individual’s name to see their insightful advice regarding their experience with the Nash Methodology.

What was one area that required the most attention while implementing the Nash methodology?

Ensuring the correct staffing grid was loaded into Nash Analytics. There were several versions for many floors so we had to keep validating the information.

How have you incorporated the Nash methodology into your daily operations at a unit and divisional level (Nash Analytics, patient placement, finances)?

I run many reports to provide information back to Nursing leadership. We have also created bi weekly staffing variance responses that incorporate the Nash methodology with our productivity system.

What, if any, operational changes were a result of the Nash methodology (staffing, patient placement)?

In the past, our departments were expected to manage to the same HPPD regardless of census. Nash allows them to adjust the HPPD based on the patients in the unit which is why it’s important to have the right number of patients in each unit to avoid incomplete care teams.

What qualities do you think a project leader should have to make the implementation successful?

The most important factor to make this process a success is the support of the executive team. We required a fair amount of new hires to have the right complement of staff. In addition, it’s important to have the physician leadership aware of the project and receive their buy in, which I’m not sure we did. As far as successful project leadership, you need to be assertive, organized and have a strong understanding of the process.

How have you incorporated the Nash methodology into your daily operations at a unit and divisional level (Nash Analytics, patient placement, finances)?

I run many reports to provide information back to Nursing leadership. We have also created bi weekly staffing variance responses that incorporate the Nash methodology with our productivity system.

What, if any, operational changes were a result of the Nash methodology (staffing, patient placement)?

In the past, our departments were expected to manage to the same HPPD regardless of census. Nash allows them to adjust the HPPD based on the patients in the unit which is why it’s important to have the right number of patients in each unit to avoid incomplete care teams.

What qualities do you think a project leader should have to make the implementation successful?

The most important factor to make this process a success is the support of the executive team. We required a fair amount of new hires to have the right complement of staff. In addition, it’s important to have the physician leadership aware of the project and receive their buy in, which I’m not sure we did. As far as successful project leadership, you need to be assertive, organized and have a strong understanding of the process.

What was one area that required the most attention while implementing the Nash methodology? I think the key item is frequent, consistent follow-up via daily monitoring of staffing variables and target census for the cost centers. After the initial education to Nash, making sure I was checking each cost center’s numbers daily was critical as I could quickly identify deviations and provide immediate re-education, etc. How were you successfully able to communicate the expectations to your leaders? Frequent meetings on Nash and then follow-up emails summarizing the meeting’s key points. Meetings were held both for all participants together and then by division which was more helpful looking at a unit’s specific needs in relation to their division. In addition, meeting 1:1 with each director/manager was essential to clarify information and allow opportunities for them to ask questions, etc. This was really an essential process as we discussed their cost center and looked at their deviations from Nash individually rather than in a general group meeting. I also met frequently with Bed Control to educate and re-educate on patient placement guidelines. How have you incorporated the Nash methodology into your daily operations at a unit and divisional level (Nash Analytics&trade, patient placement, finances)? Although I am only handling Toledo Children’s now, in the beginning I had Toledo and Wildwood. Directors/managers were integrating Nash into their daily operations via monitoring patient placement and staffing numbers. Directors/managers were responsible for looking at their Nash numbers every day and then educating their staff members as necessary. I met with the Administrative Supervisors several times to review Nash patient placement and staffing guidelines so they would be able to make better decisions based on Nash first to fill, etc. How was the Nash methodology introduced to support areas (HR, admitting, physicians)? During our general Nash meetings, I included bed control, finance, HR, etc. on the mailing list so that they were involved from the beginning. Additional staff members took the Nash Project to physician’s meetings. What, if any, operational changes were a result of the Nash methodology (staffing, patient placement)? The fill order was a significant change to operations. In the past, bed control filled a bed that had a patient discharged and divided up the admissions among various units. Also many times staff members were “held” with the presumption that they would eventually be needed for admissions. There was a major shift away from the “what ifs” type of thought. What qualities do you think a project leader should have to make the implementation successful? I think that a project leader must have the vision for the project and be engaged. It is critical to help establish direction and communicate information on the project including initial and ongoing education, updates, changes, etc. The project leader needs to be a problem solver by meeting with the stakeholders and fixing any issues that develop. As with any project, setting realistic and achievable goals is key. For instance, initially directors/managers needed to be looking at their staffing variance and target census every day and then we expanded from here. Individual targeted meetings with the directors/managers helped to deliver value to them with less waste and reduced time. A project leader has to be organized and keep track of what has to be done when and ensure follow-up on any problem areas.