"take the lead": The Nursing/Midwifery Unit Manager Project
Video: "take the lead"
"take the lead" was originally established as a collaborative project between the Nursing and Midwifery Office (NaMO) and the Health Service Improvement Branch, NSW Health. This was in response to patient and carer feedback and anecdotal information about N/MUMs experiences.
Feedback from the NSW Health statewide Patient Survey in 2007 indicated areas for improvement. These include patients' needing:
- clear and comprehensible information
- attention to their physical and environmental needs
- continuity of care and smooth transition and
- timely access to reliable health care.
The aim of the project is to facilitate the role of the N/MUM in the provision of highly coordinated care at the ward/unit level and thereby improve the patient journey and the patient and carer experiences. In addition the project aims to identify and implement strategies to support N/MUMs in achieving this role, recognising the pivotal part the N/MUM has in coordinating patient care.
In the Final Report of the Special Commission of Inquiry Acute Care Services in NSW Hospitals, Commissioner Garling recognised the key role of the N/MUM.
The Special Commission of Inquiry into Actue Care Services in NSW Public Hospitals (SCI) identifies the "take the lead" project and its activities as a key strategy in addressing some of Commissioner Garling’s recommendations and in particular number 23 and 24.
This project is one way that NSW Health is working to better meet the needs of patients and carers. All nurses and midwives, including those in the N/MUM role, have a pivotal function in providing high quality and coordinated care for patients.
What do we hope to achieve?
- Clarity and standardisation around the purpose and core functions of the N/MUM role.
- N/MUMs have the appropriate capacity and capability in order to fulfill their role .
- N/MUMs are enabled and facilitate highly coordinated patient care reflective of their role, and patient and carer expectations.
Who is the project sponsor?
The project is sponsored by the Chief Nursing and Midwifery Officer (CNMO) of NSW. It is also engaging and being supported by the Local Hospital Districts Directors of Nursing and Midwifery and other key stakeholders across the state.
What has been done so far?
A series of workshops, focus groups and one on one interviews were conducted in 2008 to explore and understand the current experiences of N/MUMs and to hear the expectations that others have of the N/MUM role. Demographic information was also collected through a survey.
Key findings included:
- There is extensive breadth, depth and variability in the accountability, responsibilities and functions performed by N/MUMs.
- 60% of N/MUM activities involve general management tasks and tend to be predominantly transactional in nature. The remaining 40% of N/MUM activities include quality and safety, patient care activities and leadership.
- There are a variety of educational levels among N/MUMs with over 40% identifying their nursing entry level qualification as their highest level of education.
- The availability of appropriate professional development and education that specifically meets the needs of this role is variable and at times limited.
- Standardised reports and information to support the N/MUM in fulfilling their role were limited in their availability.
These findings have been published in "take the lead" Report Phase One.
Core workstreams of the project
As a result of the consultation processes and data analysis three work streams have been identified. These are:
- Defining and seeking agreement on the purpose and core functions of the N/MUM role across NSW.
- Identifying strategies to address the education and professional development required to support and strengthen the N/MUM role.
- Outlining strategies to address the number of transactional (administrative) tasks N/MUMs currently undertake that do not align with the purpose and core functions of the role.
Building a shared understanding of the purpose and core functions of the N/MUM role
A Conceptual Framework has been developed which will articulate the purpose and core functions of the N/MUM role.
The draft framework is being developed in consultation with key stakeholders, including N/MUMs, clinical and non clinical staff, health executives, the NSW Nurses Association and the NSW N/MUM Society.
Evaluation of "take the lead"
The University of New South Wales has completed a Report of Mid-Program Evaluation of 'take the lead'.
Professional development and education modules that support and strengthen the N/MUM role
A series of five professional development and education modules have been specifically designed and developed to meet the needs of N/MUMs:
- Facilitating Critical Communication
- Lean Thinking and Leadership
- Financial Management of the Nursing/Midwifery Unit
- Rostering for Patient Care
- Leadership – Making it Happen
Specific details related to each module can be found here.