First as a nurse in her home country of South Africa, then later as a nurse educator working in a regional North Carolina health system, Deonni Stolldorf saw innovations come and go.
“I saw how the hospital would implement an innovation, but we were not always able to see its benefits,” she said. “An implemented but unused innovation is like a book on a shelf. We need to do something to make innovations useful and beneficial. And if it’s not making sense, we need to de-implement it.”
Stolldorf’s research focuses on determining how innovations in health care can be sustained to enhance organizational performance related to patient safety and the quality and effectiveness of care. Her postdoctoral work at Vanderbilt focused on the sustainability of rapid response teams, or “SWAT teams,” that provide lifesaving care. Working with Vanderbilt University School of Nursing Senior Associate Dean for Research Ann Minnick, Stolldorf is researching the efficacy of nurse residency programs.
National organizations often promote nurse residency programs—one-year structured programs that include clinical and didactic education for recently graduated baccalaureate-prepared nurses. Some of these programs have been developed by individual hospital systems for their own use, while others follow national models.
“We know these programs improve nurse retention, and that retention improves direct outcomes,” she said. “[rquote]Ultimately, I hope we can show that nurse residency programs improve patient outcomes so that we can guide health care policy.”[/rquote]
Stolldorf is surveying nurse executives from 2,008 hospitals to ascertain the sustainability of nurse residency programs and the specific contexts that may affect their sustainability. Variables to those contexts include the role of leadership, goal alignment and the use of incentives or disincentives. Process variables include the use of a program advocate, or champion, and training. The study also will examine if any hospitals have closed their nurse residency programs and why.
“We know nurse residency programs improve a new graduate’s communication, prioritization and organization skills,” Stolldorf said. “My hope is that if we find contextual and process factors improving sustainability, we can provide guidelines on what hospitals need to have in place.”
In the next stage of her study, Stolldorf will conduct qualitative research to look at the experiences of residency program personnel and experienced nurses who are or are not participating as mentors in the program, and to tie nurse residency outcomes with quality outcomes.
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