Continuous Quality Improvement at Memorial Hospital in Texas

The caregiver role includes those activities that assist the client physically, mentally, and emotionally, while still preserving the clients dignity. In order for a nurse to be an effective caregiver, the patient must be treated in a holistic manner. Patient advocacy is another role that the modern nurse assumes when providing quality care. Advocacy is the active support of an important cause, supporting others, or speaking on behalf of those who cannot speak for themselves (Kozier, Erb and Blais, 1997).

For the RNs to be more satisfied then, we need a new paradigm or process that is more inclusive, more active between management and staff, and provides more lines of open communication between the groups. Taking into account that the RNs job is hectic, hospital schedules are always frenzied, and there always seems to be a shortage of people, it will take considerable commitment and effort from management to sort out these details. The initial program recommendations are below:






Feedback Loop



Greater attention to providing regular positive feedback.

May require management participating in HR training; learn to find ways of verbally motivating employees

Tell charge nurse when observing excellent dedication, technique, or behavior



Management Communication

Monthly managerial meetings, nurse issues may be submitted in advance for agenda.

Could be as brief as daily briefing prior to shift; major issues submitted for departmental meetings specifically with nursing staff; will likely require 3 meetings (by shift).

Commitment to providing adequate and professional feedback to management about issues that focus directly upon quality improvement for the organization.

By shift or monthly, or both. Also, implement an electronic means to communicate questions and issues between groups.

Recognition Programs

RNs may be nominated by patients, colleagues, staff or management. Monthly “Nurse of the Month” with picture, plaque, and newsletter recognition. Gift Certificate from local restaurant or partner (could be donated)

Work with HR to provide ways for RNs to be nominated and rewarded; publicize with ward or unit pictures; perhaps button that says “Nurse of the month, ” etc. Whatever it takes to publically acknowledge excellence.

Commitment and participation in quality programs. Ability to help identify other RNs who deserve nomination.

Might be pilot program for RNs that could branch out and become a departmental measurement and hospital wide program. Monthly winners competing for larger awards, etc.

Reward Programs

Allocation of rewards ranging from 1/2-2 days off, extra vacation day, gift shop certificate, or other acknowledgement of success.

Work with HR and scheduling nurse to provide ways of small time rewards.

Be a team player and help take up “slack” when teammate is given time off as a benefit.

Must be scheduled in advance or banked. Should not negatively impact organization.

Conclusions and Further Research — Once we have approvals for the above program there will clearly be a period of adjustment necessary. The Human Resources Department should be willing to dedicate a person as liaison to help manage the implementation and ongoing procedural issues of the program, to answer questions management will have about implementation, and to help collect feedback on the programs. Once the 5th months awards are given, a new survey will be given, and a mew PDSA process team formed for further action. It is the hope that these small, but public, rewards will provide new vigor and motivation for RNs who receive, are nominated, or who strive for these rewards (Bowen, 2000).


Memorial Herman – About Us. (2010, January). Retrieved October 2010, from Memorial Herman Hospital:

Allen and Wilburn. (2002). Linking Customer and Employee Satisfaction. Milwaukee, WI: American Society for Quality Press.

Bowen, B. (2000). Recognizing and Rewarding Employees. New York: McGraw-Hill.

Corrigan, Greiner and Erickson. (2003). Fostering Rapid Advances in.

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