K S Hitchings

Lehigh Valley Health Network, Allentown, Pennsylvania, United States

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Publications (17)11.53 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: More than 25 years ago, the name "Friends of Nursing" was adopted by an academic, community Magnet(®) hospital to signify a model for community support of nursing. From inception, the intent was to recruit philanthropic dollars to promote recognition of and excellence in nursing practice, education, and research. Although philanthropy in health care settings is common, what is unique about this program is the long-standing, dedicated conceptual framework for nursing philanthropy and the very significant number of philanthropic dollars from literally thousands of donors to support a diverse range of activities to affect and advance the professional excellence of nurses and the quality of patient care. This model has been successfully replicated within a wide variety of other health care organizations and nursing services throughout the United States and abroad.
    The Journal of Continuing Education in Nursing 02/2012; 43(5):211-7. · 0.71 Impact Factor
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    ABSTRACT: This article describes a study to devise an organization-specific professional practice model (PPM) assessment that reflects actual unit involvement. A secondary study goal is the development of a unit-based index that can be used to conduct comparative analyses in an efficient way. Each of the 5 elements of the organization's PPM was represented by 1 or more items on an author-developed instrument. The tool was structured so that item scores could be summed to achieve a single subscale for each PPM element and further aggregated into a total score. The instrument was administered to a 40% random sample of all regularly scheduled, full- and part-time registered nurses in an academic, community Magnet hospital in 2003 and 2005. Descriptive statistics were calculated for items, subscales, and summary scores for each patient care unit and overall. A weighted, unit-based index was developed to reflect each unit's score on a scale of 100. The 2003 assessment response rate was 51% (n = 200); the 2005 response rate was 48% (n = 193). Subscale scores and a total PPM score were calculated by summing the values of each individual item. Submissions enabled calculations of total scores by unit, mean scores by item, and the development of a unit-specific PPM index of performance. Beyond shared principles of empowerment, the specifics of each organization's PPM may differ in those key components of care delivery nurses are empowered to effect. Thus, fidelity to the organization-specific PPM is not well tested with generic decisional-involvement instruments. An organization-specific assessment such as this one can provide evidence of not only organizational PPM fidelity but a quantitative method to ensure that staff nurse decisional involvement is continuously evolving to an ever higher state.
    Nursing administration quarterly 01/2010; 34(1):61-71.
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    ABSTRACT: This manuscript describes a scholarly approach to peer case review that identifies and analyzes quality-of-care issues in response to a question about nursing care of a specific patient. The comprehensive method provides a structured format that critically examines untoward patient events, generates an awareness of gaps in care from a systems perspective, ensures action planning focused on legitimate root causes, stimulates performance improvement initiatives, and provides a forum to share learning throughout the organization.
    Journal of nursing care quality 07/2008; 23(4):296-304. · 0.77 Impact Factor
  • The Pennsylvania nurse 04/2008; 63(1):10-1.
  • Kim S Hitchings, Terry Ann Capuano
    Journal of nursing care quality 01/2008; 23(2):101-4. · 0.77 Impact Factor
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    JONA The Journal of Nursing Administration 03/2007; 37(2):61-3. · 1.33 Impact Factor
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    ABSTRACT: BACKGROUND: Lehigh Valley Hospital (LVH), a 623-bed tertiary care referral center, is one of two hospitals of the Lehigh Valley Hospital and Health Network. PATIENT AND FAMILY INVOLVEMENT: Improving patient safety requires active engagement. Many units have collaborative rounds, which family members may join. Family meetings often include multimedia sources to review patient conditions, results, and plans of care. LVH's advanced intensive care unit program allows virtual meetings with an off-site intensivist. USE OF INFORMATION TO SET AND EVALUATE QUALITY GOALS AND PRIORITIZE INITIATIVES: The Institute of Medicine (IOM) aims of care are addressed in terms of Donabedian's clinical outcomes (safety, effectiveness, and timeliness), financial outcomes (efficiency), and service outcomes (patient-centeredness and equity). APPROACH TO ADDRESSING THE SIX IOM AIMS: Two strategies to address the IOM's six aims have been employed--patient engagement and an emphasis on technology. More than $30 million has been invested, thereby creating a digital hospital, which, in combination with evidence-based practice, uses advanced computerized and wireless systems to improve patient care and safety. CHALLENGES AND LESSONS LEARNED: New problems evident once process improvements are made are quickly addressed. Technology cannot fix bad processes; rather, process improvements should come first, with technology then added to enhance those improvements.
    Joint Commission journal on quality and patient safety / Joint Commission Resources 11/2005; 31(10):566-72.
  • The Pennsylvania nurse 10/2005; 60(4):22-3.
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    ABSTRACT: Using a structural model, we evaluated the impact of leadership, staff stability, resources, workload, work environment, and staff expertise on nurse-sensitive patient outcomes to determine elements that can be modified.
    Health care management review 01/2005; 30(3):229-36. · 1.30 Impact Factor
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    ABSTRACT: To evaluate the impact of implemented work environment changes on nursing and support staff roles. In 1999, the authors identified key drivers of unnecessary work associated with the day-to-day delivery of patient care in their institution and implemented changes based on their results. Both quantitative and qualitative methods were used. Work sampling and focus groups were used to evaluate work flow. Activity categories were identified and clearly defined by advanced practice nurses. All compiled data were subsequently synthesized and cross-checked with the information acquired through independent, multidisciplinary validation studies. There were significant changes (P <.0001) noted in overall distribution of observed activities for nurses and all support staff. The significant changes noted in overall distribution of observed activities reflect the important adjustments made in both job descriptions and the environment to eliminate key drivers of unnecessary work in the delivery of patient care.
    JONA The Journal of Nursing Administration 05/2004; 34(5):246-56. · 1.33 Impact Factor
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    ABSTRACT: Critical care has enjoyed unobstructed growth during the past two decades; however, to remain viable, process and role changes are pivotal to ensuring continued quality, cost-effective, and efficient care. In this article, the second in a two-part series, the authors describe restructuring efforts, inclusive of their measurement and evaluation strategies, within four critical care units at an acute care, tertiary institution. Special emphasis is placed on the process, the authors' observations, and lessons learned to date. Part 1 (September 1998) presented evaluation data of the effects of hospital restructuring on patient and nurse satisfaction, costs of care, and clinical quality in four medical-surgical units.
    JONA The Journal of Nursing Administration 11/1998; 28(10):13-9. · 1.33 Impact Factor
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    ABSTRACT: Increasingly, hospital restructuring is viewed with skepticism because of a lack of systematic and rigorous evaluation of its impact on quality of care. This first article in a two-part series describes comprehensive evaluation of the effects of hospital restructuring on patient satisfaction, nurse satisfaction, costs of care, and clinical quality on four medical-surgical units at a large tertiary hospital. In addition, early application of the model to critical care is described. A quasiexperimental pre- and post-design combined with concurrent control units for selected measures was the overall strategy. The authors conclude that comprehensive restructuring of hospital-based care can take place in a manner that preserves multiple dimensions of quality while decreasing costs. This only can be ascertained, however, through rigorous and systematic measurement and evaluation. Part 2 will detail application and evaluation of the restructuring model in the critical care environment.
    JONA The Journal of Nursing Administration 10/1998; 28(9):21-7. · 1.33 Impact Factor
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    ABSTRACT: This report describes restructuring on four critical care units at an acute, tertiary care hospital in South-east Pennsylvania. Utilizing a Patient Centered Care conceptual framework that had been successfully applied in the medical-surgical areas, restructuring involved three main areas: revamping of work processes, inclusive of redesigned staff roles; environmental and facility changes; and enhancement of telecommunication and information systems. Preliminary analyses six months post redesign revealed improvements and maintenance in four outcomes areas--satisfaction, quality and efficiency, and costs of care.
    Nursing administration quarterly 02/1998; 23(1):1-14.
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    ABSTRACT: This article reports on study evaluating the effects of hospital restructuring on patient satisfaction, nurse satisfaction, cost of care, and clinical quality. The restructuring involved facility redesign, telecommunications enhancement, and implementation of patient care processes incorporating multiskilled personnel and case facilitation systems. The results indicate improved patient and nurse satisfaction, decreased length of stay and variable cost per patient day, and good clinical outcomes.
    Quality management in health care 02/1998; 6(3):22-34.
  • JONA The Journal of Nursing Administration 01/1998; 28(10):13-19. · 1.33 Impact Factor
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    ABSTRACT: Organizations have expended enormous resources to restructure care delivery Despite the growing literature describing these organizational innovations there is a paucity of credible data that reflects systematic measurement and evaluation of such changes. This report not only describes a comprehensive research based restructuring effort in a 720 bed acute care hospital, but it also describes an outcomes evaluation strategy and associated findings that may serve as a model and a guide for other healthcare institutions.
    JONA The Journal of Nursing Administration 06/1997; 27(7-8):33-41. · 1.33 Impact Factor
  • K S Hitchings, M T Kinneman
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    ABSTRACT: This article proposes that professional development be a core principle within an organization to equip staff members with the resources to adapt to change. Multiple examples of professional development activities are identified. Four absolutes to create an environment to support professional development are discussed. A successful professional development model at Lehigh Valley Hospital, Allentown, PA, is detailed, including examples of funding sources. Finally, the investigators furnish examples of how an environment rich in professional development activities fosters staff members' abilities to cope with change.
    Seminars for nurse managers 01/1995; 2(4):229-33.