Yale-New Haven Hospital has had around-the-clock coverage with a dedicated off-shift executive staff since 2010 and this coverage has expanded to the Saint Raphael Campus.
Off-shift executives and off-shift nurse leaders now oversee hospital operations on both campuses from 7 pm to 7 am each weekday and from 7 pm on Friday night to 7 am on Monday morning.
The off-shift represents two-thirds of the hospital's routine operational time. Each campus has an off-shift executive (OSE) to ensure a consistent, positive experience for patients and families and an off-shift nurse leader (OSNL) who manages clinical concerns.
A team of six OSEs and eight OSNLs is responsible for both campuses and members rotate between them.
Like their YSC and Yale-New Haven Psychiatric Hospital counterparts, SRC off-shift managers and department leaders now join — via conference call — the 8 pm and 12:15 am huddles. The team reviews the status of the hospital, alerting the OSE and OSNL to potential "hot spots" that might require attention.
The nightly huddles draw in leaders from throughout the hospital, including representatives from multiple nursing service lines; centralized staffing; Bed Management; Mechanical and Electrical Engineering; Food and Nutrition; the Emergency Department; Respiratory Therapy; Diagnostic Radiology; Environmental Services and Patient Transport.
In their 15-minute report-out, huddle participants are adept at quickly surfacing a brewing issue that can be addressed before it escalates. Challenges range from a full census requiring environmental services planning to an overflowing ED where patients are waiting to get into clean rooms. Emergency management/storm preparation might also be discussed at a huddle to assure that all are aware of the emergency management goal.
"Off-shift huddles are extremely successful in knitting departments together so we can help each other resolve issues," said Tahiry Sanchez, RN, director, Off-Shift Administration, who oversees the entire off-shift team. "Staff who work on the off-shift know that they have a team which will address their concerns in real time when they have an issue."
"Off-shift coverage on the Saint Raphael Campus is key to achieving a single standard of care throughout the hospital," said Sue Fitzsimons, RN, PhD, senior vice president, Patient Services. "Yale-New Haven is a destination hospital and patients expect and demand the same high quality of care and safety no matter what time it is and what campus they are on. Our staff rotates so they are totally familiar with the intricacies and staff of each campus, which further enhances standardized performance."
"Caring properly for patients is a 24-hour, interdisciplinary effort," noted Sanchez. "Having a leadership team dedicated to the night, evening and weekend shifts positively influences patient satisfaction. Leaders are on-site and can give immediate attention to an issue so the patient's or family's concern does not have to wait until the morning. This is how a destination hospital looks, sounds and feels to a patient."
Contact information for the off-shift executive is (203) 500-0491 on the SRC and (203) 430-9734 on the YSC. The off-shift nurse leader is at (203) 500-6627 on the SRC and at (203) 430-8204 on the YSC.