The Ishikawa Diagram From the Perspective of the Fish

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The Ishikawa Diagram From the Perspective of the
Fish

• Celeste Chamberlain, BSN, MS
• Director, Clinical Quality Improvement
• St. Christophers Hospital for Children
• February 23, 2011

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This Evenings Journey

• Review shared professional experiences
• Apply a quality methodology to my professional
  growth and development
• Offer insights for application to help you
  develop a personal strategy for accessorizing
  your fish

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Professional Experience
Education
Leadership
Teaching
Quality Training
Certifications
Attitude/Philosophy
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What if the Ishikawa fish could speak? What
would she say about you. about your company?
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In my world..
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www.hospitalcompare.gov
IBC Pay for Performance
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Back to the Future
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Little Known Quality Formula
SC3
Self-Confidence
Content Competence
Keep this in mind as you accessorize your fish
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0
B.A. A.D. B.S.N. M.S.
4 degrees below zero
PhD (2012)
5 degrees below zero!!!
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Education

• B.A. Liberal Arts Boston University 1971
• French teacher
• No jobs (worked in ED as ward clerk)
• A.D. Nursing Lasell Jr. College 1975
• Aspiration Emergency Department nursing
• No jobs
• Moved to Baltimore to work at Johns Hopkins
  Hospital (they had jobs!)

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Education

• B.S. Nursing University of Maryland 1979
• This one was a gotta
• M.S. Emergency Health Services University of
  Maryland 1986
• Found this in the white pages
• Hows that for a thoughtful decision?!
• PhD. Candidate, Management Walden University
  (online) 2008 - ??

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Clinical Experience

• Staff nurse 1975 - 1986
• Emergency department
• Level 1 trauma center
• Critical care
• Intensive care, coronary care
• Cardiothoracic surgery intensive care
• Post anesthesia care (recovery room)
• Clinical Nurse Specialist (1986 1989)
• Emergency and Critical Care nursing

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Leadership Experience

• Nurse manager, Emergency Department (1977 1979)
• Director Emergency Department/Level 1 Trauma
  Center (1990 1998)
• AHERF system bankruptcy, 1997
• 8 hospitals on the auction block
• Tenet purchase/rescue of the Philadelphia health
  system
• Opportunity in quality language

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Leadership Experience

• Director Quality Improvement (1999 2011)
• Major change
• Adrenalin driven ED to desk job
• Quality experience ED process data/analysis
• Able to stay at MCP
• Challenges
• IS systems gone (with bankruptcy)
• Needed to rebuild the program
• New to the formal quality role (low on SC3)

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Leadership Experience

• More opportunities
• Reorganizations and staff reductions
• Assumed other organizational responsibilities
• Director Medical Staff Office (2001 2007 2009
  - 2011)
• Director Regulatory and Accreditation Compliance
  (2003 2011)

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Leadership Experience

• Still more opportunities
• Hospital closure announcement 2003
• Hospital changed hands, 2004, then closed for
  good, March, 2005
• Director Risk Management (2004 2007)
• Enough opportunity already
• Reorganizations and staff reductions
• Hospital sold

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Strike Rat, 2003
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Teaching 1986 - 2011

• CPR, ACLS, PALS, NALS
• Provider and Instructor courses
• Affiliate faculty, American Heart Association
• Critical Care Course (developed and taught)
• Adjunct Faculty
• Thomas Jefferson University
• Hahnemann University

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Teaching 1984 - 2011

• Guest Speaker
• Holy Family University
• Acadia University
• National and Local Lectures
• American Healthcare Institute
• American Association of Critical Care Nurses
• American Association of Post Anesthesia Care
  Nurses

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Related Experience

• Medical/legal expert witness (1995 2011)
• Textbook reviewer Emergency Nursing
• Article publication case study Tetanus
• All measures of SC3

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Certifications

• Emergency Nursing (1980)
• Critical Care Nursing (1990.)
• Six Sigma (2007)
• Certified Professional in Healthcare Quality
  (2008)

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Awards/Recognition

• Nurse Manager of the Year, 1996
• Emergency Nurses Association
• Instructor Excellence, Advanced Cardiac Life
  Support
• National Institute of Emergency Care
• Meritorious Service
• Second Alarmers Association and Rescue Squad
• Volunteer of the Year
• Medical Education Care Associates
• Honor Society of Nursing
• Hahnemann University Hospital

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Role Models/Mentors

• When you are young align yourself with older,
  smarter people
• When you are old associate yourself with young,
  smart, motivated people
• Energy
• New ways, perspectives
• Be a mentor for others

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Thomas Jefferson University School of General
Studies Emerging Alumni Award, 2010
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Mentor
Colleague
Sounding Board
Gentle Critic
Oh yeahHusband!
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Mom and Dad
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Thanks to my Mentors for

• Mom and Dad paying for a college degree I never
  used
• Cheryl Learn from the Hamster of Happiness
• Susan Always know the name of the person that
  cleans your office
• John SC3 The technique of tact
• They are all ceiling dwellers

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So..How To Accessorize Your Fish
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Its About Decisions

• Prospect theory of decision making
• VS(IIi vi)
• V The overall value
• II Decision weights
• v Consequence values
• i Outcomes

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Shared Decision Challenges

• Which graduate degree is right for me?
• Strategic career decisions
• Professional goals and personal philosophy
• Promote quality
• Drive social change
• Expand your scope of influence

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Decision Points

• Initial aspiration ED nurse save lives!
• Reasons for change/graduate school
• Burnout
• Shift work, weekends, holidays
• Narrow focus versus expanding experience
• Expanded clinical/organizational scope
• Retirement jobs

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Develop a Personal Methodology/Strategy

• Create your personal Ishikawa diagram
• Accessorize your fish with experiences that will
  help you achieve your goals
• Develop your own SC3 factor
• Conduct a personal SWOT, PEST
• Plan for contingencies
• What ifs, now what?

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Recognize Signs of Opportunity

• Those within your control
• Current trajectory
• Ceiling of growth
• Possible stagnation
• Possible burnout
• Those beyond your control
• Layoffs, closures, restructuring, etc.
• Better to be the one left behind?

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Final Thoughts

• Accessorize your fish
• Influence your own future even if your cannot
  always control it
• Be ready for unsolicited opportunities
• Take advantage of great resources like ASQ
• Professional support network
• Expand your horizons and

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Soar to New Heights!!
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Thank You!