Transformational Leadership

A Year of Nursing Excellence

UT Southwestern Medical Center continues to take pride in nurses’ contributions by supporting transformational practice across the spectrum of health care services, including all nursing functions established by the American Nurses Credentialing Center (ANCC). UTSW has achieved ANCC Magnet Recognition Program® designation twice since 2016, each designation cycle lasting four years. Considered the ANCC’s highest honor and the gold standard in nursing, this recognition is bestowed to health care organizations that design nursing goals to improve patient outcomes. Attaining this designation means our nurses are nationally recognized for providing excellent, evidence-based patient care, advancing their practice through research and professional development, and earning the respect of their colleagues for the important role they play on the patient care team.

UTSW nurses have a strong voice and continue to enhance care throughout the health care system and North Texas. In 2023, U.S. News & World Report named UTSW the No. 1 hospital in Texas (tied) and nationally ranked 11 of our medical specialties. Also last year, two UTSW nursing leaders were inducted as Fellows in the American Academy of Nursing, and our nurses received many other honors and awards. Nurses are the lifeline within UTSW through their influence, compassion, and clinical excellence. Transformational leadership starts with our frontline nurses, who demonstrate vision and expertise and regularly share their work and insights through peer-reviewed articles and presentations delivered locally, nationally, and internationally. UTSW nurses continue to strive to set the pace and create a culture that supports patients, families, communities, and staff.

In 2023, UTSW nurses continued to be transformational servant leaders at every level through direct patient care and beyond. The guiding principle for UTSW nurses is that “excellence is our starting point, not our finish line.”

Accreditations Achieved

Accreditations reflect the professional expertise and facilities validation of UT Southwestern nurses in providing the highest-level care and treatment for patients.

William P. Clements Jr. University Hospital continues to rank in the 98th percentile in overall hospital patient experience (Vizient). In 2023, it also was ranked the No. 1 hospital in Texas (tied) by U.S. News & World Report.

Professional Development Mentorship Program Improves Employee Engagement, Prepares Future Leaders

The UT Southwestern Advanced Practice Provider (APP) Professional Development Mentorship Program began in 2016 following the results of an employee engagement survey, which voiced a desire for a mentorship program that would support the professional growth and development of APPs, encompassing advanced practice registered nurses and physician assistants.

The program was planned and executed by the Mentorship Committee, chaired, and staffed by APPs with the support and executive sponsorship of an assistant APP director within the Office of Advanced Practice Providers (OAPP). Mentees and mentors complete an application process and are matched based on the mentee’s desired area of professional growth and the mentor’s strengths. For example, if a mentee desires to learn how to publish an article, he or she is matched with a mentor who is skilled in publishing and experienced with the process. The yearlong program is centered around a SMART goal the mentee creates to achieve growth in a desired area. The mentor and mentee meet one-on-one monthly, where the mentor provides feedback and support toward the goal. Every other month, all program participants meet as a large group for advice and instruction on a variety of topics, such as:

• Leadership pathways and development
• Research and publication
• Effective communication
• Public speaking
• Poster development and presentation

The program concludes with an end-of-year celebratory event, where the mentees present their capstone SMART goal project during a moderated poster session.

Through the first five cohorts of the program, 68 mentees participated in the program. Eight of the 68 participated as a mentee for more than one year, either because they had not completed their SMART goal and wished to continue or because they were looking to advance in another professional area. To date, outcome data is complete for 67 of the participants.

Cardiothoracic Symposium

In late 2022, the patient volume and clinical teams in cardiac and thoracic surgery expanded. During this growth period, nursing, physician, and advanced practice leadership identified a chance to host a formal interprofessional symposium focused on the holistic care of cardiothoracic surgery patients. The inspiration for this event stemmed from a desire to unite the cardiac surgery and thoracic surgery specialties and provide a formalized professional development opportunity for nurses.

Prior to the pandemic, two annual symposiums focused solely on the care of thoracic surgery patients. These educational opportunities were well-received by nurses. In 2020, a third symposium was held, this time virtually, and it was less successful than the in-person events of previous years. After pausing for a few years, the symposium was revived and redesigned to expand beyond thoracic surgery and encompass cardiac surgery care. This formalized educational opportunity was focused on nursing professional development and growth by highlighting the multidisciplinary care model for the cardiothoracic patient population.

The goal of the newly revamped cardiothoracic nursing symposium was to enhance interprofessional collaboration and increase bedside nurses’ knowledge and comfort level in caring for postoperative cardiothoracic patients. A daylong in-person conference was thoughtfully planned based on the identified learning needs of nurses and included didactic, hands-on, interactive sessions. It was held at Clements University Hospital’s Education Center on April 14, 2023. Presenters reflected the multidisciplinary team, including advanced practice registered nurses, physician assistants, rehabilitation and respiratory therapists, physicians, and nutritionists. Topics ranged from drain management for chest tubes, NG tubes, and J-tubes to nutrition support, respiratory and pain management, and teachings on common cardiothoracic surgeries, including coronary artery bypass grafts and lobectomies.

The cardiothoracic nursing symposium was very well-received. In all, 115 participants enrolled, and there was standing room only in the auditorium. Nursing professional development credits (7.25 CNEs) were awarded to all participants. At the beginning of the symposium, a pre-test was administered to all participants. It included 10 multiple-choice questions related to the holistic care of cardiothoracic patients. Ninety-two pre-test responses were received, with 42.85% of questions answered correctly. The same 10 test questions were given to participants at the end of the symposium. Of the 93 post-test responses received, 69% of questions were answered correctly. This reflected a 61% increase in correct answers based on knowledge gained throughout the symposium.

ZL5 Leadership Facilitates Smooth Transition to CUH

In early 2023, discussions regarding the renovations at Zale Lipshy Pavilion prompted nurse leaders from Zale Lipshy 5 (ZL5) to collaborate on devising effective ways to ensure a seamless temporary relocation of staff and patients from ZL5 to three different units at Clements University Hospital (CUH) until the renovations were completed. Many arrangements were organized well before the official move, which took place in the last week of October and the first week of November. Plans included several critical components, such as competency development across units handling new patient populations, super-user training facilitated by therapy services focusing on mobilizing orthopedic and spine surgery patients, nurse manager handoff meetings with medical directors, nurse leader presentations during receiving units' staff meetings, and coordination with materials management for the required supplies at receiving units, among other considerations.

The initiative’s goal was to provide continuity of care during the transition.

ZL5 Assistant Nurse Managers Julie Varkey, M.S.N., RN, CMSRN, and Khoi Ngo, B.S.N., RN, PCCN, Nursing Director Cynthia Hill, M.S.N., B.S.N., RN, and Nurse Manager Nancy Palacios, D.N.P., APRN, FNP-BC, NE-BC, collaborated with CUH units 10 Green and 12 Orange, which had vacancies. The ZL5 staff team was supported during the transition, reducing staffing needs. Nurse Managers Stacey Henry, B.S.N., RN, NE-BC, and Annie Jojy, M.B.A., B.S.N., RN, along with Nurse Directors Deshonna Taylor, D.N.P., RN, CCRN-K, and Dawn Brown, M.S.-M.A.S., B.S.N., RN, NE-BC, actively backed the effort and engaged in planning. Leading up to the move, Henry and Jojy ensured the ZL5 team felt supported and informed by presenting updates at staff meetings. This was vital as the team shifted from caring for acute surgical patients to internal medicine patients. Prior to the official move, the units held a joint kickoff celebration, allowing everyone to connect, dine together, hear from leaders, and receive resources to ensure a successful transition. Support from HR, NOMAD (Navigating Our Multifaceted Acute Distress), staffing services, care coordinators, clinical informatics, and mobile Moxi robotic assistants further strengthened the teams.

The teams are grateful to their nursing directors and executive leaders for support during this planning and transition. As a result, the nursing units demonstrated resilience and maintained continuity of care across service-specific goals such as initiating postoperative ambulation within four hours and maintaining spine pathway compliance documentation.

• Therapy Services: Julie Buchl, PT, D.P.T., M.B.A., FACHE, Therapy Director; Homer Walag, PT, D.P.T., Therapy Manager; Jace Kerby, PT, D.P.T., Therapy UBE; Heather Paup, PT, D.P.T., Assistant Therapy Manager
• Nursing Directors: Cynthia Hill, M.S.N., RN; Shari Ann Dino Vu, M.S.N., RN, CCRN, NE-BC; Deshonna Taylor, D.N.P., RN, CCRN; Dawn Brown, M.S.-M.A.S., B.S.N., RN, NE-BC; Byron Carlisle, M.S.N., RN, CCRN, SCRN
• Nurse Managers: Annie Jojy, M.B.A., B.S.N., RN; Stacey Henry, B.S.N., RN, NE-BC; Nikarlo Rogers, M.H.A., B.S.N., RN; Christina Joe, B.S.N., RN, NE-BC; Beena Johnson, M.S.N., RN, RN-BC; Donald Stout, B.S.N., RN, RT(R), ARRT; Nancy Palacios, D.N.P., APRN, FNP-BC, NE-BC
• Assistant Nurse Managers: Julie Varkey, M.S.N., RN, CMSRN; Khoi Ngo, B.S.N., RN, PCCN; Neely Helton, B.S.N., RN
• Staffing Services: Jerry Hoang, B.S.N., RN, CCRN; Kaitlyn Gore, M.S.N., RN, CCRN; Jeremy Musil, B.S.N., RN, CCRN
• Rapid Response Team Manager: Ambrose Muchiri, B.S.N., RN, CCRN
• Care Coordination: Catherine Close, B.S.N., RN, OCN; Lynne Howsley, B.S.N., RN, CCM; Valerie Cabello, B.S.N., RN, ACM-RN
• Education: Brenda Pope, M.S.N.-Ed., NPD-BC; Danica Fuerte, M.S.N., RN, NPD-BC; Punitha Wilson, D.N.P., RN, GERO-BC; Autumn Spencer, M.B.A., B.S.N., RN, CCRN
• CRU: Teresa Eversole, CCRC, ACRP-PM
• Finance: Chris Thomas
• And many more

Emergency Department Workplace Violence Committee

Following the COVID-19 pandemic, the Clements University Hospital Emergency Department (ED) experienced an increase in its number of physical and verbal abuse events. ED nurse Erica Harris, B.S.N., RN, noticed this trend and decided to advocate on behalf of the staff by contacting ED leadership and the Patient Safety team for assistance. After conferring with Amie Swindle, M.S.N., RN, from Patient Safety, and Rachel Faidley, M.S.N., RN, from the ED management team, it was decided that a Workplace Violence (WPV) Committee should be introduced to help decrease violent events and help staff feel safe in their workplace. In August 2022, the WPV Committee was created, and its members have been working nonstop to create a safer workplace for those in the ED.

At each monthly WPV Committee meeting, members discuss workplace violence event reports and contribute to practical solutions. ED staff members and managers, the Patient Safety team, and representatives from Hospital Operations and the UTSW Police Department are present at each discussion. This collaborative approach allows for in-depth conversations and the development of novel solutions.

The first committee meeting in September 2022 focused on the trial of a new debriefing form used after a disruptive event. The form is designed to attach to a "workplace violence" event report and to assist leadership in forming solutions to decrease future events.

The WPV Committee also voiced a need for signage in the lobby to increase patient/visitor awareness of spreading nonviolence and triaging the waiting room. These signs explain the triage process and the reasoning behind wait times. With the UTSW marketing team's help and coordination, these signs were placed around the waiting room on April 28, 2023.

The following month, on May 24, in collaboration with the Patient Safety team and Informatics, the WPV Committee introduced, trialed, and released the Vocera Panic Button, which allows staff to get assistance immediately from any other ED staff member signed into the Vocera system. To date, this feature has helped protect the staff members involved in several high-risk scenarios.