Raising the Bar on Poster Presentations at Shared Governance Day Fair

Since 2007, Cleveland Clinic has hosted a Shared Governance (SG) Day Fair to showcase the work done by unit-level shared governance councils throughout the healthcare system. An important component of the SG Day Fair, held annually at Cleveland Clinic’s main campus and one of the eight regional hospitals, are poster presentations by nurses. In 2014, the 25-member Shared Governance Day Planning Committee raised the standards for poster presentations, hoping to garner submissions of the same caliber as those displayed at national nursing conferences.

Early posters offer room for improvement

The inaugural SG Day Fair on main campus in 2007 attracted 300 participants from across the health system. Each year since, there has been greater participation and more structure to the poster presentations. For several years the criteria for posters focused on nurse sensitive quality indicators, patient-focused indicators or hospital quality indicators. Posters were submitted online and included the poster names as well as a brief description of the quality improvement project. No outcomes were required during the submission process. Nurses submitted projects on hourly rounds, hand washing, falls, heart failure and readmissions among other quality improvement initiatives.

Typically, the posters had few references and outcome measures were vague or “to be determined.” It was often difficult to discern the connection between the interventions, outcomes and evidence. The SG Day Planning Committee judged the posters using a standardized tool and presented several awards, including an overall winner and three runners-up. Winners then presented their posters to the Cleveland Clinic Health System Chief Nursing Officers.

Setting higher standards yields stronger submissions

After several years, the poster presentations were demonstrating increasing maturity, but were not quite ready for submission to national conferences. In addition, the Shared Governance Day Planning Committee felt tasked by the Institute of Medicine’s 2011 call to elevate nursing to its fullest potential. “Nurses need to develop and use their scholarly strength in developing their shared governance projects,” says Deborah Solomon, MSN, RN, ACNS-BC, Clinical Nurse Specialist and Chair of the SG Day Planning Committee.

To help the committee devise more stringent requirements, Mark McClelland, DNP, RN, from the Cleveland Clinic Nursing Research and Innovation Department, joined the team in 2014. The committee instituted the following poster requirements:

• Completion of a mandatory online module on evidence-based practice.
• Addition of nurse safety as a submission category along with nurse sensitive clinical indicators, other hospital quality indicators, patient satisfaction and nurse satisfaction/engagement.
• Inclusion of a well-constructed abstract, including a review of literature, outcome measures and references.

The committee accepted abstracts based on a scoring rubric that matched the new requirements. To help nurses meet those requirements, the committee posted the new scoring rubric as well as an article on how to write an abstract. Committee members, unit-based clinical nurse specialists and staff from the Nursing Quality Department served as mentors through the new process.

Last year, 138 posters were submitted: Approximately 26 percent were not accepted due to lack of outcomes. The four winning poster teams utilized a literature review for background information and developed their shared governance projects with an evidence-based approach. The winning posters covered the following topics:

• Improving the Float Experience for the Cross-Unit Float with the Float Ally Model
• Decreasing Restraint Usage in Adult ICU
• Increasing Proper Ergonomics Awareness and Safe Use of the Workstation on Wheels
• Reduction of Primary Cesarean Deliveries

Winners displayed their posters at a local quality conference, and the projects are being disseminated as best practices across the health system. Several nurses have since submitted the posters to national conferences.

“Giving nurses a voice through shared governance involves raising the level of inquiry in their practice as evidenced by the winning posters,” says Monica Weber, MSN, RN, CNS-BC, FAHA, Director of Professional Nursing Practice and Magnet Program Manager for Main Campus. “Raising the level of inquiry supports quality patient care outcomes and the dissemination of best practices.” She and Solomon added that nursing leadership can influence outcomes and quality by increasing scholarly expectations and supporting and rewarding unit-based shared governance projects.