What's Happening?
Cleveland Clinic, a non-profit academic medical center, is standardizing nursing practice in its ambulatory care settings through the implementation of nine ambulatory affinity groups. These groups, each representing different healthcare specialties,
bring together nurses and leaders to review practices, identify variations, and drive excellence in nursing across the organization's more than 300 global outpatient locations. According to Sheila Miller, DNP, MBA, RN, NEA-BC, Executive Director and Associate Chief Nursing Officer, Ambulatory Services and Care Management at Cleveland Clinic, these groups ensure clarity for teams and excellent practices that help patients. The initiative supports Cleveland Clinic's recently restructured ambulatory operating model, which aims for greater consistency across geographic markets. Nurses, often the first point of contact for outpatients, play a critical role in managing chronic conditions, supporting care transitions, and improving clinical outcomes. The affinity groups are designed to empower nurses to shape how care is delivered, contributing to more efficient healthcare delivery, lower costs, reduced hospital admissions, and increased patient satisfaction.
Why It's Important?
This initiative by Cleveland Clinic is important for the U.S. healthcare landscape as it demonstrates a proactive approach to improving patient care and operational efficiency in ambulatory settings. By standardizing nursing practices across a vast network of outpatient facilities, Cleveland Clinic aims to reduce variations in care, enhance quality, and ensure consistent patient experiences. This model could serve as a blueprint for other large healthcare systems grappling with the challenges of delivering uniform, high-quality care across multiple locations and specialties. The emphasis on empowering frontline nurses in decision-making processes can lead to more practical and effective solutions, directly impacting patient outcomes and satisfaction. Furthermore, the potential for lower costs and reduced hospital admissions through improved outpatient care has significant implications for the broader healthcare economy, addressing key concerns about healthcare expenditure and resource utilization.
What's Next?
The work of Cleveland Clinic's ambulatory affinity groups is ongoing, with a structured review pathway for change recommendations from these groups to the Ambulatory Practice Review Committee and then to the Ambulatory Practice Council. New workflows created at the council level, with support from affinity group nurses, will be implemented by the affinity groups and supported by council members and local nurse leaders. This continuous feedback loop ensures that practices remain current and responsive to evolving patient needs and clinical advancements. The organization plans to continue leveraging these groups to identify enterprise-wide variations, develop standardized workflows, and improve consistency, compliance, operational efficiency, and revenue integrity across its ambulatory settings. This systematic approach suggests a sustained effort to refine and optimize outpatient care delivery.
Beyond the Headlines
Beyond the immediate improvements in patient care and operational efficiency, Cleveland Clinic's approach highlights a deeper shift towards shared governance and professional empowerment within nursing. By giving nurses a direct voice in shaping clinical guidelines and workflows, the organization is fostering a culture of ownership and continuous improvement. This model not only enhances the quality of care but also contributes to professional fulfillment among nurses, as noted by Stacey Russell, RN, Ambulatory Team Lead in Cleveland Clinic’s Glickman Urological Institute. The ability to promote consistency by leveraging the experience and expertise of caregivers, and ensuring nurses have a say in their work, can lead to a more engaged and satisfied nursing workforce. This, in turn, can have long-term positive effects on staff retention and the overall quality of healthcare delivery, addressing critical issues in the healthcare industry.
