An Epic go-live, the opioid crisis and more: Mass General's CNO weighs in

Jeanette Ives Erickson, DNP, RN, is the CNO and senior vice president of patient care services at Boston's Massachusetts General Hospital — one of the founding hospitals of Partner's HealthCare. Mass General has been on the front lines of many of the contemporary challenges facing healthcare today. The hospital recently went live on its Epic EHR and is currently dealing with a serious influx of patients overdosing on opioids. In the midst of these challenges, Mass General and its nursing staff continue to excel.

Dr. Ives Erickson has been the recipient of numerous awards including an American Organization of Nurse Executives prism award and the Boston Business Journal Champion in Healthcare award. In 2007, she was appointed to serve on the U.S. National Advisory Council on Nurse Education and Practice. At MGH, Dr. Ives Erickson oversees a nursing program regularly recognized for excellence.

She recently spoke with Becker's about excellence in nursing, industry challenges, MGH's response to the opioid abuse crisis, MGH's Epic go-live and more.

Note: Responses have been lightly edited for length and clarity.

Question: Massachusetts General Hospital has been recognized repeatedly for excellence in nursing — what makes nursing at Mass General different?

Jeanette Ives Erickson: I work with the finest nurses on the planet. We work with nurses who practice with the well-being of patients at the center of everything they do. Nurses here have a breadth of knowledge. At MGH, we adhere to a collaborative process. We are very well known for our intraprofessional teamwork between nurses and physicians. Nurses here have a fire in their belly. Excellence is an expectation.

Q: What is the biggest challenge you're dealing with currently as a CNO?

JIE: Because of the excellence, this hospital is extremely busy in both inpatient and ambulatory settings. We experience maximum capacity and emergency department overcrowding every day. Our hospital's president has brought teams of people together to really look at the patient journey to how to be more effective and how to care for patients in lower acuity settings. This is a challenge for the whole hospital.

Q: Massachusetts, like much of the country, has seen a spike in opioid overdoses. How has the opioid epidemic impacted nursing at MGH?

JIE: One of the things I'm extremely proud of is the hospital's response to this problem. Nurses, MDs and social workers have all come together to develop best practices regarding care of patients in emergency centers and outpatient settings. Partners just brought together an opioid abuse committee collaborating to identify best practices. There is a significant amount of work going into this. We are making strides in this work in assuring that care delivery is equitable and delivered in a caring way to this vulnerable patient population. Efforts across MGH are being made to address prescriptions, making sure patients understand what [the medication] is supposed to do and educating patients about what is actually in their medicine.

Q: How has the new Massachusetts nurse staffing law impacted nursing in the ICU at Mass General?

JIE: It really hasn't impacted us. We've had a robust patient acuity-based system for 30 years. We address the patient's need for nursing care and nurses in this hospital are empowered to staff according to needs because several of our patients need more than one nurse. We meet and exceed the staffing ratio. It's really just been a bit of busy work.

Q: How does Mass General address burnout and work life balance among the nursing staff?

JIE: There are a lot of wonderful programs for nurses and everyone at MGH. We offer complimentary therapies to patients and staff, we have a hospital gym and our cafeteria serves nutritious foods. We don't serve soda or desert at my meetings. We have a reception room for staff to go to. During our Epic go-live and during Nurse's Week we offered chair massages to our nurses. That was a big hit.

Q: How has the transition been to the Epic EHR system, and how did you help prepare the nursing staff for the shift?

JIE: This was a massive undertaking. All employees went through training including myself. Extra staff was present for months before and after our go-live. In July 2015, we began hiring new graduate nurses to put them through a six month residency program. We hired over 300 graduate nurses, so all staff could have the time to go through Epic training. Hiring resident nurses meant we didn't have to hire external nurses from other agencies for the go-live. All of our nurses were already MGH and Epic trained. For nursing this has been a wonderful success. This is a tribute to the excellence that is in this hospital. This was a major undertaking, but the dedicated clinicians and support staff in this hospital are making this work. It of course takes time to become accustomed to such a major change. I'm in awe of the wonderful work this community has done and the level of achievements being attained.

Q: What's one goal you're working to achieve this year as CNO?

JIE: It's always about the patient each and every day every second of the day. My goal is to make certain the environment of care is safe and there are sufficient resources to care for patients. I focus on the six aims of the IOM [Institute of Medicine] to ensure that patients receive safe, effective, efficient, timely, patient-centered and equitable care.

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