Person-Centered Care - Saint Joseph Hospital

Person-Centered Care
Saint Joseph Health System
Nursing Annual Report • Fiscal Year 2010

“The needs of the spirit are as critical to health
as those individual organs which make up the body.”
— FLORENCE NIGHTINGALE
(1820-1910)

Our integration as one at Saint Joseph Health System continued even further this year with many
successful milestones along the way. Even though we are only two years old as an eight-facility system, our clinical teams are
sharing best practices across the state that ultimately improve patient care in each of our communities.
Our focus on improvement this year continued to elevate the standard of care from both a quality and satisfaction perspective. Our
Critical Success Metrics are not just a collection of statistics and numbers, but instead are tangible and deliverable methods to reach our
goal of person-centered care, which includes the categories of:
• People (Workforce Development, Nursing Leadership Institute)
• Quality (Service Excellence, Evidence-Based Practice)
• Stewardship (Technology and System Development; Care Coordination and Patient Self-Management)
• Growth (Access)
As you read this publication, you will be impressed not only by the volume of initiatives that all of our nurses have implemented and
accomplished, but also by their collective passion to deliver the best care possible to our patients.
I am pleased to share with you the 2010 Saint Joseph Health System Nursing Annual Report, which provides an overview of our nursing
team’s dedication to person-centered care, a comprehensive team approach that includes the nurse, patient, family and community.
Sincerely,
Gene Woods, FACHE
Chief Executive Officer
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ABBREVIATION KEY FOR DEGREES AND SPECIALTIES ABBREVIATION KEY FOR UNITS
CCH Continuing Care Hospital
CCU Coronary Care Unit
CTU Cardiac Thoracic Unit
CTVU Cardiac Thoracic Vascular Unit
HISSU Heart Institute Short Stay Unit
ICU Intensive Care Unit
L&D Labor and Delivery
NICU Neonatal Intensive Care Unit
PACU Post Anesthesia Care Unit
PASS Pre-Admission Screening Services
PRNU Prep-Recovery Nursing Unit
ACHPN Advanced Certified Hospice Palliative Care Nurse
ACLS-EP Advanced Cardiac Life Support - Experienced Provider
ACNP Acute Care Nurse Practitioner
ADN Associate Degree in Nursing
APRN, NP Advanced Practice Registered Nurse, Nurse Practitioner
ARNP Advanced Registered Nurse Practitioner
ASN Associate of Science in Nursing
BC Board Certified
BSIT Bachelor of Science in Information Technology
BSN Bachelor of Science in Nursing
CBPN-IC Certified Breast Patient Navigator
(Imaging and Cancer Care)
CCM Certified Case Manager
CCRN Critical Care Registered Nurse
CDE Certified Diabetes Educator
CDN Certified Dialysis Nurse
CEN Certified Emergency Nurse
CFRN Certified Flight Registered Nurse
CIC Certified in Infection Control
CMA Certified Medical Assistant
CMSRN Certified Med/Surg Registered Nurse
CNA Certified Nursing Assistant
CNAA Certified in Nursing Administration, Advanced
CNM Certified Nurse Midwife
CNN Certified Nephrology Nurse
CNOR Certified Nurse in Operating Room
COHN Certified Occupational Health Nurse
CPAN Certified Post Anesthesia Nurse
CPN Certified Pediatric Nurse
CPNP Certified Pediatric Nurse Practitioner
CPST Child Passenger Safety Technician
CRNA Certified Registered Nurse Anesthetist
CRRN Certified Rehabilitation Registered Nurse
CS Clinical Specialist
CSTFA Certified Surgical Technologist/First Assistant
CWOCN Certified Wound, Ostomy, Continence Nurse
FNP Family Nurse Practitioner
IBCLC International Board-Certified Lactation Consultant
LNC Legal Nurse Consultant
MBA Master’s in Business Administration
MHA Master’s in Health Administration
MSN Master’s of Science in Nursing
NA Nursing Assistant
NNP Neonatal Nurse Practitioner
OCN Oncology Certified Nurse
RCIS Registered Cardiac Invasive Specialist
RN Registered Nurse
RNC-NIC Registered Nurse Certified in Neonatal Intensive Care
RNC-OB Registered Nurse Certified in Obstetrics
RNFA Registered Nurse First Assistant
SANE Sexual Assault Nurse Examiner
SWAN Nursing Assistant/Ward Secretary
TNCC Trauma Nurse Core Certified
UM Unit Manager
US Unit Secretary
TABLE OF CONTENTS
Letter from Gene Woods, CEO 1
Abbreviation Key 2
Introduction 3
Saint Joseph - Berea 11
Saint Joseph - London 15
Saint Joseph - Martin 19
Saint Joseph - Mount Sterling 23
Flaget Memorial Hospital 27
Saint Joseph Hospital/Saint Joseph East/Saint Joseph - Jessamine 31
Living our Core Values 48
PRINCIPLES OF PERSON-CENTERED CARE
The ultimate goal of person-centered care is to create partnerships among health care practitioners, patients and
families that will lead to the best outcomes and enhance the quality and safety of health care.
The practice of person-centered care is guided by these principles:
• Respect and Dignity
• Information, Communication and Education
• Participation
• Collaboration
• Physical Comfort
• Emotional Support
• Involvement of Family and Friends
• Coordination and Integration of Care
—Adopted from the American Hospital Association

Fiscal year 2010 has been a great year for nursing at Saint Joseph Health System (SJHS).
INTRODUCTION
We would like to report on our progress toward the metrics described in our
Nursing Professional Practice Model & Care Delivery System.
PEOPLE
To keep care person-centered: hourly
rounding-nursing plan of care
Hand-off of care
Quality indicators
Core measures
Service excellence
Communication boards
Patient and family satisfaction
STEWARDSHIP
Respect for the individual patient
Coordination of care
Communication, information and education of care to
include patient’s cultural and lifespan needs
Comfort (emotional, physical and spiritual)
Emotional support
Family involvement (including significant others,
support persons, and life partners)
Care Coordination
and Patient
Self-Management
Workforce
Development
Recruit and retain a qualified
nursing workforce by
encouraging specialty
certification and
continued
education for our
nursing staff.
Technology and
System Development
Develop and enhance
clinical information systems
that support and contribute to
nursing’s role in the health care
delivery model.
Strengthen nursing practice for
the provision of safe, timely,
efficient, equitable, personcentered,
excuse-free,
sacred and transparent
care in all settings.
Person-
Centered
Care
Access
Nursing
Leadership
Institute
Advocate and implement
strategies for access to the
appropriate level of care for
all patient populations. Explore
use of current and future virtual
care models.
GROWTH
NURSE
PATIENT
FAMILY
COMMUNITY
Develop and implement a core
curriculum nursing leadership
formation program that
enhances the performance
development model for
all levels of nursing
personnel.
Service
Excellence
Exceed the patient, family and
caregivers’ expectations in the
provision of optimal patient care by
building a culture of professional,
courteous and respectful caregivers.
Evidence-Based
Practice
Implement and measure key
indicators to support Evidence-
Based Practice through the
Clinical Covenant enhancing
the patient experience.
QUALITY
Accountability
Advocacy
Confidence
Competence
Enabling
Empowerment
Responsibility
Relationship
Stage 1: Novice
Stage 2: Advanced Beginner
Stage 3: Competent
Stage 4: Proficient
Stage 5: The Expert
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FY10 Critical Success
Metrics Results
PEOPLE
Core Competencies Developed: Completed
Achieve Voluntary RN Turnover less than 10%:
Finished at 6.88%
Eliminate Agency Use: As of June 30, all nursing
agency has been eliminated!
RNs: 1,789
LPNs: 120
ARNPs: 30
RN Voluntary
Turnover: 6.88%
Saint Joseph Health System
Nursing Facts
SJHS Nursing Degrees – October 2010
SJH/SJE/SJJ SJB SJL SJM SJMS Flaget TOTALS Percentage
Associate Degree/Nursing 488 44 231 21 72 139 995 56.25%
Bachelors Degree/Nursing 476 27 48 5 23 49 628 35.50%
Masters Degree/Nursing 45 2 3 0 5 14 69 3.90%
Other Masters Degrees 1 1 0 2 1 0 5 0.28%
Diploma 68 3 0 0 1 0 72 4.07%
TOTALS 1078 77 282 28 102 202 1769 100.00%
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QUALITY
IMPLEMENT EVIDENCE-BASED PRACTICES
All SJHS hospitals implemented Evidence-Based Practices (EBP) to include Pressure Ulcers, Surgical Never Events, Fall Prevention, Hospital-Acquired Infections, Catheter-
Associated Urinary Tract Infections, Central Line-Associated Bloodstream Infections, Pain, Venous Thrombo/Embolism Prevention, and Heart Failure. There are nine EBPs
with 27 bundles; all were implemented.
ACHIEVE 50% REDUCTION IN HOSPITAL-ACQUIRED CONDITIONS (HAC) FOR CORE EBP
This proved to be a very difficult goal. As a system, we decreased the HAC in total, but did not reach the 50% goal.
DEVELOP AND IMPLEMENT THE CLINICAL COVENANT
During FY10, we implemented the Clinical Covenant with three patient types: Pneumonia and Heart Failure, Orthopedic, and Critical Care. Saint Joseph - Berea developed the
Pneumonia and Heart Failure team, Flaget Memorial Hospital developed the Orthopedic team and Saint Joseph Hospital developed the Critical Care team. The goal is to spread
the newfound knowledge to all SJHS hospitals.
The Clinical Covenant is a promise we will make to each patient that we will always do certain things and always not do certain things. The Covenant is not a guarantee but
a promise to the patient that we will do all we can to give the patient the best opportunity to have a good outcome. The concept is that care at the bedside would be changed
through the formation of a transactional relationship between the patient and the caregiver. The charter for all teams was to create an environment where the patient receives
highly reliable, patient-centered, seamless, transparent care. This care would be evidence-based and include core measure components and safe practices from the National
Quality Forum.
SAINT JOSEPH HEALTH SYSTEM NURSING CERTIFICATIONS:
We have 174 nationally certified nurses for SJHS, representing 10% of our RN workforce.
Critical Care Registered Nurse: 27
Trauma Nurse Course Certified: 21
Certified Emergency Nurse: 20
Sexual Assault Nurse Examiner: 14
Certified Ambulatory Perianesthesia Nurse: 7
Board Certified Registered Nurse: 5
Certified Case Managers: 5
Certified Nurse Operating Room: 5
Family Nurse Practitioner, Board Certified: 5
Registered Nurse Certified, Inpatient Obstetric: 5
Certified Breast Navigator: 4
Certified Pediatric Nurse: 4
Certified Wound Ostomy Nurse: 4
Adult Nurse Practitioner, Board Certified: 3
Certified Bariatric Nurse: 3
Certified Pediatric Emergency Nurse: 3
Certified Post Anesthesia Nurse: 3
Certified Hospice & Palliative Care Nurse: 2
Certified Lactation Counselor: 2
Certified Med/Surg Registered Nurse: 2
Certified Rehabilitation Registered Nurse: 2
Certified Respiratory Therapist: 2
International Board Certified Lactation Consultant: 2
Oncology Certified Nurse: 2
Adult Nurse Specialist-Board Certified: 1
Advanced Certified Hospice & Palliative Nurse: 1
Board Certified Holistic Nurse: 1
Certified Clinical Document Specialist: 1
Certified Diabetes Educator: 1
Certified Infection Control Nurse: 1
Certified Nurse Administrator: 1
Certified Occupational Health Nurse, Case Mgmt.: 1
Certified Professional Healthcare Quality: 1
Certified Radiology Nurse: 1
Critical Care Registered Nurse with Cardiac Medicine Specialty: 1
Fellow of the American College of Healthcare Executives: 1
Gerontological Clinical Nurse Specialist-Board Certified: 1
International Certified Childbirth Educator: 1
Lamaze Certified Childbirth Educator: 1
Legal Nurse Consultant Certified: 1
Nurse Executive, Advanced Board Certified: 1
Registered Cardiovascular Invasive Specialist: 1
Registered Nurse Certified, Low Risk Neonatal Nursing: 1
Registered Nurse Certified, Neonatal Intensive Care: 1
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All teams utilized a multidisciplinary approach to include physicians, leaders,
executives, nursing and line level staff. Each of our pilot projects began their journey
with a unit profile, which studied the patient population by age, diagnosis, staff
composition, patient flow in the unit and patient satisfaction scores. Simultaneously,
each team studied the patient flow process. These studies identified each step in
detail, from the time the patient entered the system to the time of discharge, whether
admitted from the Emergency Department, surgery or a medical admission. During
this review, process variation and delays were identified.
The teams realized some redundancy and opportunity for improvement by simply
putting on paper the way “we thought” things were done on a daily basis. We also
had some important “just do its” during flow charting. This was the time the rest of
the hospital began to see what the group was doing, as we placed our charts on the
walls and sent them on a hospital tour on display boards. With this collaboration
between the Clinical Covenant teams and other stakeholders, perspectives have been
broadened. This is allowing us to realize the importance of consistency in the way we
work and in the way we work together, to ensure our patients’ experiences are seamless
and highly reliable.
CLINICAL OUTCOMES FOR CLINICAL COVENANT TEAMS
Saint Joseph - Berea Pneumonia and Heart Failure Team (Pegasus)
• Identified the need for education on EBP standards, NQF standards and process
improvement tools, such as AIM/PDSA and Gantt Charts
• Physicians were not getting timely results for the direct-admit patient for
laboratory and radiology results. The orders were written routinely and as a
routine many were not available in a timely manner for the physician to review on
the day of admission. All laboratory and radiology orders for direct-admit patients
are now ordered stat and the results are ready for the physician to review on the
day of admission.
• Scripting for our patients utilizing Healthy People 2010 recommendations as well
as Teach Back Method
• Consolidation of direct-admit process for physicians. A letter was sent to all
physicians, giving them one central number to call for any direct admission.
• Earlier implementation of Respiratory Bundle. The Respiratory Bundle standing
orders are implemented as a bundle when patients are admitted to prevent delays
in discharge.
• Revised Medication Reconciliation process. Pharmacy worked with a
MEDITECH resource person to revamp and streamline the process and delete
redundant processes for physicians and nurses.
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• Change in admission process to prevent unwanted test results going to physicians and
critical results from being missed. Patients with no primary care physician were being
assigned a primary care physician in MEDITECH for the attending physician, and test
results were going to that physician post-discharge.
• Saint Joseph - Martin participated in this team and has taken this information and
quickly spread it to its campus.
Flaget Memorial Orthopedic Team (Hercules)
• Identified improvement opportunity for pain management.
• Developed an increased awareness of when the next dose of medication is due for the
patient and the caregiver, by placing the last dose of pain medication given on the
patient communication board and by adding communication boards for caregivers in
discreet locations on the nursing unit with information as to when the next dose of pain
medication is due for patients. The intent is to provide a system where any caregiver could
let the nurse know, through a written message, that a patient was in pain without having
to leave the area to find someone to notify.
• Developed a method of communication that has common language and understanding
between sender and receiver by scripting a consistent message being delivered to the
patient regarding how to manage their pain.
• Reviewed patient handbook regarding pain management to ensure scripting and written
material matched.
• Dedicated orthopedic rooms have been supplied with the necessary equipment so it is
always in the room, to prevent delays in care when the patient arrives.
• Variation with pre-op orders is being addressed by the surgeons through the development
of a standard set of orthopedic admission protocols.
• Pharmacy and the Post-Anesthesia Care Unit (PACU) worked together to find a way
the patient’s location could be changed in the computer so orders could be faxed to
pharmacy from PACU. This expedited the care of the patient on arrival to the floor by
eliminating the wait time for orders to be processed by pharmacy and medication to be
delivered to the unit.
Saint Joseph Hospital Critical Care Team (Leo)
• Availability of Rapid Sequence Induction (RSI) drugs. Numerous drugs were available
in the AccuDose medication cabinet, but delay occurred in obtaining each separately. An
RSI kit was placed in the AccuDose to ensure a more rapid drug procurement process for
emergent intubations in the unit.
• Time delay in locating patient care supplies in the unit stock room. As a result, the stock
system was better organized to group and categorize supplies, utilizing a color-coding
system: respiratory supplies have orange tabs; urinary supplies have yellow tabs, etc.
The area of search can thus be narrowed down at a glance based on the color coding.
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• Facilitate case management for the critical care areas. The current case
manager serviced two areas of the hospital: ICU South and a step-down
unit. As a result, the case manager was reassigned to oversee care in
two sister units: ICU South and ICU North.
• Reduce the time spent in obtaining line placements,
particularly deep lines, and feeding tubes. Capital money was
appropriated, and an ultrasound machine was purchased for
placement of lines at the bedside. The equipment is now
in place and training on the machine has occurred. The
critical care nurse practitioners are currently working
on the development of expertise with equipment
utilization during line placements. The end result in
this process will be a safer line placement process,
through a reduction in trips off the unit for the
patient and the critical care nurse, as well as
concurrent visualization during line placement.
• Variability in the delivery of patient
medications to ICU South. With three
methods of delivery—carrier, tube system,
dumbwaiter—the need to arrive at consistency
was seen as a time-saving measure. The
implementation of the newest PharmNet
ordering system has led to the need to stabilize
the changes arising from this system before
suggesting changes to the delivery system.
A subcommittee consisting of pharmacy,
maintenance, nursing and quality has been
empowered to review the existing process.
• Currently developing scripting around the delivery
of care, and the safe practices that they employ on
a daily basis to ensure excellent patient outcomes.
The areas of scripting focus are centered on the safe
practices developed by the National Quality Forum
(NQF). The end result of the process improvement
project will be to increase the time the critical care nurse has
available to spend with the patient at the bedside. This will
allow the nurse to have crucial conversations with the patients
and family members centered on the care that will always be
delivered to the patient.

STEWARDSHIP
A Case Management model of nursing has been piloted in the Lexington market.
The Case Management Department has been undergoing changes over the past
year to better serve our patients. The department’s name has been changed to Care
Coordination in order to better reflect our body of work.
The changes in the care delivery model are driven by the complexity of the health
care system of today. These changes are designed to assist patients on their
journey across the care continuum. They support an environment of healing
and wellness by focusing on excellence in patient care delivery and quality
outcomes. The vision for the department is one in which the individual
patient’s health care needs are met through the coordination of the many
health care disciplines.
The coordination of care enables us to meet the patient’s physical,
mental and spiritual needs as they journey across the care continuum.
In the new Care Coordination model, the care coordinators and
social workers support an environment of healing grounded in our
core values of reverence, integrity, compassion and excellence.
In order to fulfill the vision and meet the goals of the department,
the roles of the RN case managers and the social workers have to
change. The care coordinator’s role has transformed by focusing on
excellence in order to provide the patient with a smooth transition
on to the next level of care. This excellence and transition is
accomplished through the coordination and collaboration among the
health care team, the patient and the patient’s family.
REDUCE HEART FAILURE READMISSIONS
Extensive efforts and discussion have centered on heart failure management with
core measures and reduction in readmissions. In defining the problem of heart failure
readmission it has been noted if the patient does not understand the discharge
instruction, this leads to poor compliance with fluid and medication management.
A concentrated effort with a nursing and physician committee has focused on core
compliance to reduce readmissions, which includes understanding of medications.
Unless contraindicated, beta blocker and ACE/ARB are indicated on discharge and
long-term management. Review of readmission notes a few patients are frequently
readmitted, indicating a need for a long-term non-acute program, such as a cardiac
rehab or Heart Failure Clinic. Although timely retrospective review has improved
core measure results, improving toward top deciles will require concurrent review. A
multidisciplinary team was organized to develop a plan. Case management is focusing
on length of stay; nursing is essential to improving results; an admission packet was
created to collect all needed resources in one place, including the recommendation for
an Evidence-Based Practice order set.
It has been noted by the Institute for Healthcare Improvement that readmission occurs
within seven days of discharge and post-discharge phone calls improve a patient’s
understanding of patient management needs. As a pilot, Saint Joseph - London
employed ARNPs as disease management leaders. The ARNP calls each patient postdischarge,
and is the first contact for patients who have concerns. (Most readmission
occurs within seven days of discharge.) It is expected that the discharge instructions,
which consists of six indicators, will improve discharge medication management.
The social worker’s role has evolved, becoming more focused and
covering a broader population in order to meet the needs of our patients
and their families. The social workers coordinate services for the patients
as well as act as a resource to physicians, staff, patients and families for the
psychosocial aspect of the patient’s care plan. They continue to serve as a
bridge linking our patients and their families with community and may also
provide crisis intervention and/or counseling in special situations.
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GROWTH
Implemented a Med/Surg team to spread Transforming Care at the Bedside (TCAB)
throughout the system. Led by Billie Turner, this team implemented bedside report on
at least one unit at each site and is now spreading this to include all inpatient units.
The group has collaborated with the service excellence council to design patient
communication boards for patient rooms. Boards will be installed during the month
of October. Patients will see consistent information on all inpatient units throughout
SJHS. The team has also collaborated with the education department to offer medical/
surgical specific continuing education for nurses. A two-day certification prep course
and a one-day CE course are now scheduled.
IMPLEMENT ED REINVENTION STRATEGIES
A team was formed in January 2009, led by Kathy Stumbo and team leaders Laura
LaRue, Emergency Department Director for Flaget Memorial Hospital and Marilyn
Swinford, Emergency Department Director for Saint Joseph Hospital and Saint Joseph
- Jessamine. The team’s focus has been on sharing information, developing best practices
and standardizing the ED patient experience throughout SJHS.
The team has a major goal of reducing unnecessary waits and delays in the Emergency
Department. Our targets are five-minute “Care Begins” and 30-minute “See a Provider”
(marketed as “No Wait ER”). The initial
pilot began at Saint Joseph Hospital
(SJH), Saint Joseph East (SJE) and
Saint Joseph - Jessamine (SJJ) with key
successes due in part to the leadership of
Kelly Ray at SJH, Patti Creed at SJE and
Dan Andrews at SJJ. The pilot will be
spread to all Kentucky facilities.
satisfaction and increased ED volumes by 12% from the previous year for SJH/SJE/SJJ
Emergency Departments.
Patient satisfaction is a strong focus of the team. Our providers received standardized
customer satisfaction training from the Physician Team Health vice president and to
date our facilities have some of the highest satisfaction scores among Catholic Health
Initiatives facilities, with three facilities reaching the 99th percentile. Satisfaction
and spirituality of seeing the F.A.C. E. of God rings true in every ED visit (F.A.C.E.
stands for Formation, Accountability, Communication and Evaluation—our service
excellence best practices fall under these categories).
Standardization of orientation, protocols and education are an ongoing process (led by
Melinda Stumbo, Saint Joseph - Martin; Mary Lou Young, Saint Joseph - London; and
Patty Sturt, Saint Joseph - Berea). The RN new graduate program is an intense fourmonth
process that has resulted in successful integration of the newest members of our
team into our fast-paced tertiary environment.
Achieving the recognition of excellence, the SJHS Inaugural Certification in Emergency
Nursing (CEN) review course was offered this year at Saint Joseph - Jessamine. Seven
nurses now proudly are recognized after successfully earning the CEN.
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After only four short months, “Care
Begins in 5 Minutes” is being met 65% of
the time, with an average of four minutes
for SJH, four minutes for SJJ and eight
minutes for SJE. “See a Provider Within
30 Minutes” is being met 60% of the time,
with an average of 35 minutes for SJH,
22 minutes for SJJ and 35 minutes for
SJE. Our slogan “Be Safe, Be Nice, Be
Quick” has resulted in high patient

The state of nursing at Saint Joseph - Berea is strong.
Nurses have been heavily involved this past year in not only patient care but in community
care. Recently, we recruited six pediatricians to our campus. This was a new skill set for
our nurses and they took it on with great enthusiasm. Our nurses are now able to care
for the whole family, from infant to senior adult.
This past year also brought new Evidence-Based Practices (EBP) the nurses implemented. Huge
successes were seen as the rate of hospital-acquired conditions decreased by 50%. The quality of care
at Saint Joseph - Berea has been noticed and our nurses have been asked to be involved in more and
more community activities, as you will see in the coming pages.
Nurses are at the core of our development of a person-centered environment. As always, none of
this would have happened without the dedication and commitment of all departments in the
hospital. One thing we do well at Saint Joseph - Berea is work together as a family of caregivers,
whether we are in nursing, the lab, radiology, respiratory, rehab, housekeeping, dietary or the
many other departments that provide care to our patients either directly or indirectly every day.
Each and every day is a day we come to work and fulfill our calling as nurses. This we do with
our CHI and SJHS mission, vision and values in mind.
With gratitude,
Pat Patton, RN, MSN
Chief Operating Officer/Chief Nursing Officer
SAINT JOSEPH - BEREA
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Transformational Leadership
During this last fiscal year, all nursing staff, rehab staff and pharmacy staff at Saint Joseph - Berea (SJB) were educated on Health Literacy and its effects on readmissions. During this
two-hour class, staffs were educated on exactly what Health Literacy is, how it affects our patients and nursing staff, as well as the effect it has on readmissions. Working closely
with the Madison County Health Department, the CNO taught these classes. Also during these classes, participants learned the use of the “teach back” method. In this
teaching style, patients are taught certain content and then asked to repeat back or “teach back” what they have learned.
The pain clinic was started in Surgery this past year. Victor McCane, RN, BSN, started this service in collaboration with Mary Turner, RN, from Saint Joseph -
London. Dr. Siddiqi, board-certified in interventional pain management, comes to Berea once every two weeks to see patients and do procedures. This new
service line was started effectively and efficiently due to Victor’s leadership. Frances McKeehan, RN; Clarissa Ramsay, RN; and Brenda Marcum, RN, were
instrumental in making sure this service was up and running by obtaining procedural sedation classes. Victor and his nursing staff worked closely with Dr.
Siddiqi and his staff to make sure patient expectations as well as quality expectations were met.
Structural Empowerment
In FY10 SJB received approval to move forward with our MEDITECH Clinical Documentation System. Amy Hedglin, RN, CEN,
nurse informaticist, has taken the lead for this initiative. By moving forward with this initiative it will help provide better patient care in
the following ways:
• Improved customer satisfaction through better coordinated care and service. Information flows with fewer repetitive questions.
• Increased clinician and provider satisfaction as nursing documentation will be available in real time to clinicians through the Primary
Care Informatics (PCI) module.
• Increased efficiency with the chart being available to all appropriate users as permitted by system availability.
• Clear, concise documentation and patient history that is easily accessible in the continuation of care from department to department
and visit to visit.
• Mechanisms to facilitate compliance with all applicable regulations.
• Assistance in the tracking of performance improvement initiatives with greater ease, and decrease in potential errors that may be
caused by illegible handwriting.
TOUCHING THE COMMUNITY: BEYOND OUR DOORS
SJB nursing reaches out to the community through many outreach programs. These included a Go Red for Women event where blood pressures
were taken; Berea Chamber of Commerce Golf Tournament at Battlefield Golf Course, where sunscreen was handed out; Berea Craft Festival at
Indian Fort Theatre, where first aid was provided and health promotion and injury prevention material were provided; Berea Community School
Health Fair, where information was provided regarding childhood diabetes and obesity, blood pressure checks, financial counseling, as well as
other health information; Spoonbread Festival, where first aid was provided; the Kentucky Guild of Artists and Craftsman Fall Fair at Indian Fort
Theatre, where first aid was provided. Our SJB nurses are in the community on a continual basis, letting the community know the benefits of using
their local hometown hospital. Nurses, as well as
other staff members, participated in the secondannual
Get Healthy Berea event, where health
promotion and injury prevention material were
available for all who attended.
Hospital educator Elena Baker, RN, BSN,
partnered with Saint Mark Catholic School
to provide monthly health-related educational
presentations to children in preschool through
third grade. This helped instill healthy
habits in the children.
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NURSING FACTS:
NUMBER OF NURSES
RNs: 77
LPNs: 2
ARNP: 1
MSNs: 2
Exemplary Professional Practice
The Professional Nursing Practice Model is a method for nurses who are practicing direct patient care
to advance professionally. It is based on Patricia Benner’s Novice to Expert practice model and is one of
patient-centered care. SJB Emergency Department is the first and only department at the hospital to
have 100% staff on the Professional Nursing Practice Model.
Elena Baker, RN, BSN, was instrumental in arranging pediatric in-services provided by the pediatricians
for our staff nurses and respiratory therapists. By doing this, the nurses and respiratory therapists were
able to ask questions directly of the pediatricians and get a better sense of how the nurses were to care
for their patients.
AVERAGE YEARS OF SERVICE
0-5 years:
48.71%
6+ years:
51.28%
AVERAGE AGE OF NURSES
21-40 years:
33.33%
41+ years:
66.66%
The ED staff and other departments were successful in SJB’s annual Chemical Stockpile Emergency
Preparedness Program (CSEPP) drill. FY10 was the first year that federal investigators gave zero
deficiencies to Saint Joseph - Berea’s team.
BOOKS/ARTICLES
Sheehy’s Emergency Nursing: Principles
and Practice, chapter 42 “Toxicologic
Emergencies”
Author: Patty Sturt,
RN, MSN, MBA, CPEN
ENA: Sheehy’s Emergency Nursing,
6 th edition, 2009
TRIFOLD POSTERS
Nurse Manager’s Review of Budget and
Information and Use in Decision Making
Rose Patrick, RN, MSN
Patty Sturt, RN, MSN, MBA, CPEN
Impact of the Clinical Ladder on Staff
Satisfaction in a Community Hospital
Diane Bowling, RN, CEN
Patty Sturt, RN, MSN, MBA, CPEN
FURTHERING EDUCATION
Heather Agee
Beth Alcorn
Elena Baker
Janis Carpenter
Leslie Crawford
Holly Fort
Amy Hedglin
Charles King
Teresa King
Mike Miller
Pat Patton
Patty Sturt
TURNOVER
RN:
6.67%
Voluntary RN:
2.67%
Vacancy:
3.60%
Implementation of a Competency-Based
Training Program: Impact on Staff
Performance and Confidence During a
Chemical Incident Drill
Darcy Maupin, RN, BSN, CEN
Patty Sturt, RN, MSN, MBA, CPEN
13

New Knowledge Innovations and Improvements
INNOVATION IN ACTION
Hunter Purdy, RN, HNB-BC, was hired to create a Person-Centered Healing Environment. She
worked closely with the president and CNO/COO to develop a plan to transform Saint Joseph - Berea
into an Optimal Healing Environment that was person-centered. During this process we defined
person-centered to include the patient and the employees, volunteers, physicians and everyone who
contributes to the mission at Saint Joseph - Berea. In FY10 we began a healing therapies program,
obtained funding for local art throughout the facility, and have given the inside of the facility a
facelift. This work has also included involving local high school students to paint murals in two patient
rooms to make them more pediatric friendly. Hunter has also worked closely with community art
organizations, artists, the local farmers market and Berea College in creation of this Optimal Healing
Environment. Current activities include implementing a room for renewal for all caregivers, providing
therapeutic massage on-site for employees, and other self-care opportunities.
In an effort to broaden the range of available programs and make more services accessible to more
patients, Saint Joseph - Berea now has the availability of a Sexual Assault Nurse Examiner (SANE)
service. Elena Baker, RN, BSN, SANE, is certified in forensic evidence collection and is now able
to provide the service for the residents of Berea, as well as those from surrounding counties and
communities. The SANE program at SJB seeks also to play an active role in the health and wellness
of the local student population and would like to provide training and awareness to Berea College
students, the Berea College Safety and Security Department, as well as the college faculty on sexual
assault and domestic violence issues. Saint Joseph - Berea is dedicated to the healing mission of the
Church, emphasizing human dignity, social justice, and the creation and maintenance of healthier
communities. We are proud to continue that mission by offering this essential program to Berea and the
surrounding communities we serve.
CLINICAL COVENANT WORK
In January 2010 we formed Team Pegasus and started down the road to implementing the Clinical
Covenant at Saint Joseph - Berea. So much hard work has been done by so many dedicated and
talented folks to get us to where we are today. We have been blessed to have commitment from
physicians, leaders, executives, line level nursing staff, case managers, social workers, quality abstractors
and other managers. The group has been focused like a laser beam and each member has held the
others accountable in keeping the patient and family members at the center of every decision we made.
We knew this was something different—not a project or a program—it was the right thing to do to
integrate patients, caregivers and loved ones into the total care of the individual. We knew if we did this
right, we could improve outcomes, reduce costs and help patient satisfaction.
RESEARCH IN ACTION
At SJB 30 nurses participated in the collaborative research study conducted by Loyola University
Chicago and CHI that explored staff nurse perceptions in six areas of the professional practice
environment. While the results cannot be generalized to all staff nurses at SJB, they did reveal that the
hospital met or exceeded the CHI average in the areas of teamwork and leadership, and disagreement
and conflict. The remaining four areas of clinical practice, general relationships and communication,
internal work motivation, and cultural sensitivity are areas for examination by the nursing organization
at SJB, as results were below the CHI average. Saint Joseph - Berea continues to participate in this
research with the next step being managers’ awareness of employees’ perception of leadership.
NATIONAL CERTIFICATIONS
RECEIVED
Critical Care Registered Nurses:
Bernice Baird, RN
Diane Snyder, RN
Med/Surg Certified:
Laurie Faught
Certified Central Sterile Supply Tech:
Wilma Masters
Certified Emergency Nurses:
Dixie Bryant, RN
Vicki Hamilton, RN
Amy Hedglin, RN
Darcy Maupin, RN
Certified Pediatric
Emergency Nurses:
Vicki Hamilton, RN
Darcy Maupin, RN
Patty Sturt, RN
Board-Certified Holistic Nurse:
Hunter Purdy, RN, HNB-BC
SANE Registered Nurse:
Elena Baker, RN, BSN, SANE
ADVANCED DEGREES
RECEIVED
Pat Patton, RN, MSN: Master’s in
Nursing, specializing in nursing
administration, from University
of Kentucky.
Patty Sturt, RN, MSN: Master’s in
Business Administration from
Midway College.
AWARDS AND RECOGNITIONS
DAISY Award Recipients:
Julie Hamm, RN,
Med/Surg
Melissa Cosby,
RN, ED
Sharon Clark,
RN, OR
EDUCATIONAL
ACCOMPLISHMENTS
AND MENTORING
Clinical Ladder
August 2010
Level III
Diane Bowling
Melissa Cosby
Darcy Maupin
Mike Miller
Nancy Mowbray
Greta Thompson
LEVEL II
Vicki Hamilton
Amy Hedglin
Brenda Marcum
Frances McKeehan
Karen McKinney
Ruth Prewitt
LEVEL I
Heather Agee
Mitzi Alexander
Jami Belcher
Mildred Botkins
Sandra Bowling
Crystal Catron
Leslie Crawford
Laurie Faught
Julie Hamm
Rebekah Hamilton
Mona Hanna
Mary K. Johnson
Stephanie Kauer
Teresa King
Charlene Lamb
Samantha O’Neal
Clarissa Ramsay
Sarah Saylor
Emily Shaw
Diane Snyder
Lori Vickers
Sherry Wilson
LEADERSHIP IN NURSING
Pat Patton, RN, MSN: Cumberland
District Director for the Kentucky
Organization of Nurse Leaders
(KONL)
LEADERSHIP IN
PROFESSIONAL
ORGANIZATIONS
Pat Patton, RN, MSN: Cumberland
District Director for the Kentucky
Organization of Nurse Leaders
(KONL)
Empirical Quality Outcomes
• Saint Joseph - Berea maintains 100% on the AMI core measures.
• Quality data submitted to CMS has been validated at a 97% success rate with only two charts falling
out of the sample.
• In the past year, patients have received their pneumonia vaccine 100% of the time and flu vaccine
97.62% of time (one patient missed). This is a major improvement for SJB.
• SJB continues to perform well in the area of patient satisfaction. In FY10 we ended in the 82nd
percentile for patient satisfaction, with 78.8% of patients giving top scores for patient satisfaction.
• Implemented six Evidence-Based Practices for Saint Joseph - Berea. Reduced rate of hospitalacquired
conditions by 50%.
14

This past year has been a journey of dreams, designs, dedication
and discovery. We have been blessed to have recently opened our new facility. The talents of
our nursing team were true drivers of positive change in creating our new environment.
Our clinicians created our new “home” and it is phenomenal. We would be nothing
without the creativity and talent of our team. Our dedication to patient care remains
a driving force for us in all we do. Each of our groups is to be commended for their
untiring efforts and devotion. The building is filled with innovations that are user-designed. Our
team deserves kudos for continuing to give great care while juggling the demands at dual locations
over an extended time frame. The challenges eased slightly with a precision patient move that was
accomplished in mid-August. Yes, we really did move one patient every three minutes. Wow.
While we have different challenges now, be assured that we will meet each with the same sense
of care and compassion. I cannot tell you how proud I am to be on this team. The clinical staff
here in London is unparalleled, in my opinion. This new facility is quite a legacy to all who
created it. It is a gift and tribute to this community. We are thankful for the entire region’s
support and tolerance as we worked through the multiple demands.
We salute this group for their dedication in creating and transitioning into our new facility.
We are delivering world-class medicine with a true hometown commitment. Please join me
in congratulating the clinical team in London. We are proud to be a part of the good sisters’
legacy of caring for this community.
With gratitude,
Peggy Green, RN, MHA
Chief Operating Officer/Chief Nursing Officer
SAINT JOSEPH - LONDON
15

Transformational Leadership
Shalan Gibbs, RN, BSN, Heart Failure Outreach Nurse, helped to design and coordinate our Heart Failure Symposium held at the London Community Center in November 2009.
The Symposium featured Shalan as a speaker, as well as two of our physicians and one of our dietitians. The event also had vendors on site, prizes, a catered lunch and plenty of
education for the community and clinicians that attended. This event is planned to become an annual event, each year featuring a different focus topic of some aspect of the
cardiovascular system.
Saint Joseph - London (SJL) received the Mission and Ministry Grant for CHF last year. With that grant funding, Shalan intercepted
all heart failure patients admitted to the hospital. If the patient lived within 30 miles of the hospital, did not qualify for Home Health
assistance with their heart failure, and agreed, she began to visit them at their homes. She provided physical assessments, one-onone
heart failure education (or with a caregiver/family member), assistance with their medication administration, and self-care
education to prevent readmission to the hospital. Patients were provided with warning signs magnets, and even scales if they
needed them.
Shalan Gibbs
She worked in direct partnership with our Innovative Cardiac Solutions Team (who opened a patient rehabilitation
program last year for cardiac patients), front line nursing staff and case managers, who are enthusiastic in educating heart
failure patients about self-care and medication management of their condition. Through this collaborative effort, SJL
was able to meet a very important goal on our journey to Joint Commission Advanced Heart Failure Certification:
Reduce heart failure patient readmissions. We reduced them by 33%! This granted us the AHA Get with the
Guidelines Bronze Award.
Structural Empowerment
TOUCHING THE COMMUNITY: BEYOND OUR DOORS
In July, Saint Joseph - London’s Healthy Communities outreach program sponsored a Community Health Screening in Jackson County.
Several nurses volunteered from SJL and worked closely with the Jackson County Health Department, White House Clinic, Manchester
Memorial Hospital and volunteer cardiologists to provide blood pressure screenings, oxygen saturation measurements, finger stick
glucose checks, cholesterol and other blood work to members of the Jackson County public. The nurses were from all different disciplines
of health care.
The Healthy Communities program also participates in a monthly clinic for the Kentucky Homeplace program, a University of Kentucky
sponsored program designed to assist low-income families with their expenses of living. While these families attend this clinic, they also receive
health screenings and education from nurses and physicians who volunteer from Saint Joseph - London. At the Heart Failure Clinic, people
receive cholesterol screenings, vitals checks, medication assistance, detailed self-care instructions to prevent admission to the hospital, and even
free scales to weigh themselves if they don’t have any. At the Diabetes Clinic, people can get their glucose checked by a volunteer nurse, foot care
education, wound care education, and free testing
strips and glucometers.
Twice a year, our Obstetrics Department partners
with Healthy Communities to host Babyfest.
These events are open to the public and offer free
food, educational speakers about childbirth and
infant related topics, vendors, games and prizes.
In FY10, we had the opportunity to help Jackson
County host a Babyfest.
16

NURSING FACTS:
NUMBER OF NURSES
RNs: 282
LPNs: 27
ARNPs: 6
Exemplary Professional Practice
HOSPITAL AWARDS
2010 HealthGrades Pulmonary Care Excellence Award (5th year)
2010 HealthGrades Cardiac Care Excellence Award (2nd year)
2009 HealthStream Excellence Through Insight Award for
Overall Employee Satisfaction and Engagement
2009 HealthStream Excellence Through Insight Award for Highest Nurse Satisfaction
NURSES IN ACTION
Armed with education, our SANE nurses (Tracy Allen, Lori Coots, Connie Cope, Katrina Gray, Dawn
Kilby, Shana Sandifer, Jamie Trett) held a Domestic Violence Vigil on the courthouse steps in October
2009 to promote awareness of this too-often unnoticed killer.
AVERAGE YEARS OF SERVICE
0-5 years:
65%
6+ years:
35%
AVERAGE AGE OF NURSES
21-40 years:
62%
41+ years:
38%
Med/Surg Director Heather Morgan, RN,
BSN, was a presenter to the SJHS Medical/
Surgical Reinvention Team. She presented
information about bedside shift report (which
we implemented in 2008) and how it improves
staff communication, shortens report time, and
increases patient satisfaction by including them in
the health care team.
Duff Holcomb, RN, from SJL Birthing Center,
teaches Childbirth Classes every Tuesday and on weekends for expectant families of London. Her
classes include pregnancy, warning signs during pregnancy, labor and delivery, pain relief options,
Cesarean section education, post-partum and newborn care, as well as infant CPR. These classes are
free to those who plan to deliver at SJL.
MENTORS AND PRECEPTORS
Mentor: Shelby Collins, RN, M/S; mentee: Cheryl Paul, RN
Mentor: Mary Cryer, RN, M/S; mentee: Jamie Eversole, RN
Mentor: Heidi Davidson, RN, M/S; mentee: Cheryl Paul, RN
Mentor: Sarah Maggard, RN, M/S; mentee: Natasha Roberts, RN
Mentor: Ginger Smith, RN, M/S; mentee: Karin Mathis, RN, and Cherlynn Cheak, RN
CTVU preceptors: Pam Brown, RN, and Chris Griffin, RN, BSN, CCRN
TURNOVER
RN:
11.99%
Voluntary RN:
7.49%
17

New Knowledge Innovations and Improvements
Thousands of patients in the U.S. suffering
from heart attacks fail to receive critical
therapy in a timely fashion, and nearly 30
percent do not receive any reperfusion
treatment (opening of the blocked artery)
at all. As a result, the American Heart
Association (AHA) created the STEMI
Provider Manual. STEMI is an ST-Elevation
Myocardial Infarction, the most dangerous
form of a heart attack. The STEMI Provider
Manual is designed to educate providers in
the rapid recognition and early treatment
Cath Lab Staff Nurses are now AHA STEMI Certified at SJL.
strategies for patients who suffer from this
type of heart attack.
To ensure the Saint Joseph - London staff is trained in the recognition and treatment strategies for
STEMI, all staff within the Cardiac Cath Lab have completed the manual and passed the exam. The
American Heart Association recommends that patients suffering from STEMI receive reperfusion
treatment within 90 minutes of entering the hospital. With an average door-to-reperfusion time of 59
minutes, Saint Joseph - London consistently delivers quality care to the patients of central and eastern
Kentucky.
NATIONAL CERTIFICATIONS
RECEIVED
Cindy Angle, RN, ED: TNCC
Karen Anders, RN, Hospice: CHPCN
Chris Griffin, RN, CTVU: CCRN
Paula Marcum, OB: IBCLC
Cheryl Sasser, RN, Hospice: CHPCN
ADVANCED DEGREES
RECEIVED
Shalan Gibbs, RN, Innov. Cardiac
Solutions: BSN
Carla Gilbert, RN, Infusion Svcs: BSN
Paula Henson, OB CNA: ADN
Sonia Jackson, Coordinator ER/Obs:
BS, Management
Patricia Lewis, OB Ward Clerk: ADN
Leena Napier, RN, Observation: BSN
AWARDS AND RECOGNITIONS DAISY Award Recipients:
Karin
Blankenship,
RN, Med/Surg
Nellie Goodin,
RN, Observation
Chris Griffin,
RN, CTVU
Melissa Walters,
RN, Med/Surg
Recipients of SJL’s 2010 Ambassadors of Caring Award come from various units and each was chosen by their peers
who recognized their outstanding compassion shown to our patients, their families and visitors.
AHA STEMI providers at SJL are Chasity Cooper, RN; Stacey Faulkner, RN; Bruce Goodrich, RN;
Lena Hall, RN; Robin Harris, RN; Carmel Hensley, RN; Faith Holt, RN; Teresa Lewis, RN;
JJ Parsons, RN; and Shaunnah Sizemore, RN.
Empirical Quality Outcomes
• SJL successfully implemented all of the required, and optional, Evidence-Based Practices—a
collaborative effort among nursing, quality and leadership. We redesigned our computerized
medication reconciliation form, which led to improvements in the whole process of reconciling
medications and our core measures. We now have four admission/discharge nurses to help expedite
the admission and discharge processes for our patients.
• In June, nursing, pharmacy, materials management, education, biomedical services and IT banded
together to facilitate the successful adoption of “smart pump” infusion technology. These pumps
are capable of providing extra protection to patients and nurses through their “smart” technology
parameters. We hope to utilize the reporting capability of these pumps to provide even safer quality
care to patients.
• SJL successfully implemented the LEARN system for educational requirements and elective
opportunities for staff. The system contains hundreds of courses with continuing education
credits attached, tracks them, and a transcript can be printed by the student at anytime. It is fully
customizable and an asset to computer-based training scenarios.
• With the AHA’s focus for BLS/ACLS on quality CPR, we adopted two (one adult and one infant)
fully computerized BLS mannequins. They connect to a laptop loaded with specific software and can
check off staff on CPR skills faster and more efficiently than ever before. Because the computer is not
biased and set by internal parameters, it can ensure that CPR is done correctly every time. Learners
are required to perform CPR correctly or they do not receive a card. The computerized mannequins
can also be set up for “practice” mode, where someone can practice CPR with fully interactive
feedback from the software—telling them immediately to slow down or speed up, or that they are
giving too much breath or not enough air. Through this method, our staff will be consistently trained
and practiced on quality CPR and improve overall patient survival rates after a cardiac arrest.
18

I am pleased and honored to share the many accomplishments
of the nursing staff and all those involved in delivery of patient care throughout the past
year at Saint Joseph - Martin. Outcomes in patient care have been outstanding as we
have implemented 28 Evidence-Based Practices and refined our service excellence
program. Much activity also centered around expanding the continuum of care for
our community as we saw the opening of a diagnostic sleep center, Saint Joseph
Sleep Wellness Center, and Saint Joseph Senior Renewal Center, which provides outpatient geriatric
psychiatric services. We also grew our cardiology services with the addition of a full-time noninvasive
cardiologist who has greatly increased the number of diagnostic procedures provided for
our patients.
Guided by our core values of reverence, integrity, compassion and excellence, we remain
committed to achieving high quality outcomes and excellent customer satisfaction. This could
not be accomplished without the dedicated, caring employees who deliver quality care on
a daily basis. Our employees keep our customer satisfaction scores consistently higher than
other area hospitals, maintain top performance on core measures, and have successfully
implemented Evidence-Based Practices throughout the organization; but, most importantly,
our employees provide such compassionate care that we often hear patients say “God is present
here.” This is the impetus that inspires us daily to continue to grow our ministry at Saint
Joseph - Martin.
With gratitude,
Billie Turner, RN, MBA
Chief Operating Officer/Chief Nursing Officer
SAINT JOSEPH - MARTIN
19

Transformational Leadership
Transformational Leadership is about taking what you do well and continuing to improve upon it. Saint Joseph - Martin (SJM) always strives to deliver optimum patient care. Often
this calls for transforming how we provide that care.
Evidence-Based Practice (EBP) continues to be at the forefront at SJM. We were successful this year in implementing 28 EBPs as part of the CHI national initiative.
Implementation of these practices resulted in a greater than 50% reduction in hospital-acquired conditions.
The Med/Surg unit was restructured to include the charge nurse role. This restructuring was implemented with the goal of providing more time for direct
caregivers to be at the bedside. Designated charge nurses received education and development opportunities centered around leadership and team building
through change leadership training.
Mary Martin, RN, infection preventionist, participated with other infection prevention specialists throughout the region in an effort to address
community-acquired infection rates. The group consisted of infection control nurses and infectious
disease physicians throughout eastern Kentucky.
Structural Empowerment
Reaching out to the community has always been an important part of the ministry at SJM.
TOUCHING THE COMMUNITY: BEYOND OUR DOORS
Several nurses participated in SJM’s annual Senior Health Fest. The Senior Health Fest is a
community event offered to those 55 and older. Health information on numerous topics, health
screenings and flu shots are provided along with food and fun. Nurses participating were Teresa
Bailey, Neva Francis, Cathy Johnson, Mary Little, Mary Martin, Carol Jo May, Kim Sanders-Castle
and Melinda Stumbo.
160 foster children in Floyd County had a brighter Christmas due to the SJM Angel Tree sponsored
by employees.
All departments were involved in fundraising activities for the 2010 Relay for Life event, resulting in
a record-setting amount being raised for SJM as well as Floyd County.
Food and fun were had by all during the 2010
Nurses’ Week. During the celebrations several nurses
were recognized for perfect attendance during 2009.
Those recognized were Teresa Bailey, Sharon Bates,
Carol Bentley, Neva Francis, Susan Goble, Krystal Hall,
Theresa Hyden, Jessica Kidd, Tammy King, Carol Jo
May, Natashia Osborne, Cindy Patton, Tina Pinson, Angie
Salisbury, Sherry Slone, Melinda Stumbo and Billie Turner
(pictured left).
20

NURSING FACTS:
NUMBER OF NURSES
RNs: 48
LPNs: 11
Exemplary Professional Practice
Recognizing the importance of expertise and professionalism, all nurses are encouraged to grow and
develop in their career and assist the profession by helping others develop.
Through formalized relationships with area schools of nursing, SJM nurses are afforded the opportunity
to serve as preceptors and mentors for students and graduates. Carol Bentley, LPN; Lynn Goble, RN;
Wanda Hall, RN; Kathy Moore, RN; and Leeda Music, RN, mentored students throughout the year.
AVERAGE YEARS OF SERVICE
0-5 years:
41%
6+ years:
59%
AVERAGE AGE OF NURSES
21-44 years:
49%
45+ years:
51%
New Knowledge Innovations and Improvements
Continuous Performance Improvement remains a high priority at SJM as we strive to always improve
the quality of care provided.
• Electronic documentation was expanded to include EBP requirements for Catheter Associate
Urinary Tract Infection and DVT screening. Following implementation, DVT screening for
inpatients improved from 78% to 95%.
• The Nurse Call System was upgraded to facilitate better communication between the bedside
nurse and the patient by allowing the patient to call the nurse directly, resulting in improved
nursing response times.
• Bedside registration was implemented in the Emergency Department.
• An electronic status board for tracking EBPs and other patient care information was developed
for the Med/Surg unit.
• As part of the Med/Surg restructure, bedside report was initiated. This provides opportunities
for better communication between nurses, safer handoffs from shift to shift, and improved
communication with patients. The beside report initiative resulted in an improvement in patient
satisfaction scores related to nurse communication from 85% in FY09 to 96% for FY10.
• An ultrasound for bedside bladder scanning was purchased and procedures were implemented
to prevent unnecessary insertion of urinary catheters.
• eClinical Reference Solutions was made available for use by all clinical staff. This includes three
evidence-based references encompassing more than 30 full text nursing references, 31 full text
professional journals and 8,000 patient education handouts.
TURNOVER
RN:
18%
21

Empirical Quality Outcomes
• Patient satisfaction remains a top priority for SJM, resulting in scores for overall satisfaction and
ranking in the top 10 within CHI throughout FY10.
• The Emergency Department implemented processes and mechanisms to improve the door-todoctor
time and saw an 11% reduction in the time, resulting in a decrease from an average wait of 48
minutes to 41 minutes. Efforts will be continued to meet the goal of 30 minutes.
• The Agency for Healthcare Research and Quality Culture of Patient Safety survey was conducted
with SJM receiving an “A” rating with a score of 90.3% in overall perceptions of safety.
• The triennial unannounced Joint Commission survey was conducted with exceptional results of only
two findings, both of which were related to the environment of care standards. There were no clinical
recommendations during the survey.
• The Surgery Department implemented the World Health Organization (WHO) Surgical Safety
Checklist and the CHI surgical counts policy to improve surgical safety for our patients. We had 0%
surgical never events.
• A new wound care protocol was developed and implemented for inpatients. The protocol includes a
standardized assessment, reassessment and treatment protocol.
• As part of the Service Excellence program, the Surgery Department developed personalized thankyou
cards that are mailed to each patient following their surgery. This and other service excellence
initiatives resulted in Same Day Surgery patient satisfaction ranking 4th in CHI for FY10.
• SJM continued to be involved in region 9 disaster planning activities by participation in a regional
disaster drill that tested the area’s preparedness for any community-wide emergency situation.
NATIONAL CERTIFICATIONS
RECEIVED
Carla Hayes, RN: CNOR
Mary Martin, RN: CIC
ADVANCED DEGREES
RECEIVED
Tammy King, LPN: ADN, RN
AWARDS AND RECOGNITIONS
Natashia Osborne, RN, was the
recipient of the Waneta P.
Newsome Award. This award
recognizes employees who best
exemplify the core values.
DAISY Award Recipients:
LEADERSHIP IN
PROFESSIONAL
ORGANIZATIONS
Billie Turner, COO/CNO, member
of Big Sandy Community and
Technical College Advisory Board;
board member of Saint Vincent’s
Mission; Chair of Floyd County
Relay for Life Survivorship
Committee.
Melinda Stumbo, RN, member
Region 9 Healthcare Preparedness
Planning Committee.
Kay Fugate,
RN, ED
Theresa Hyden,
RN, House
Supervisor
Cathy Johnson,
RN, Med/Surg
Natashia
Osborne, RN,
Surgery
22
Nurses (from left) Jan White, Jenny Twiss and Lisa Little and their team members in the Emergency Department
implemented processes and mechanisms to improve the door-to-doctor time, resulting in a decrease from an
average wait of 48 minutes to 41 minutes. Efforts will be continued to meet the goal of 30 minutes.

In this past year, our nursing team at Saint Joseph - Mount Sterling
has continued our pursuit of high quality care for our patients and community, provided
by an educated and highly competent nursing staff. Our accomplishments include the
implementation of numerous Evidence-Based Practices, along with our sister hospitals,
initiation of changes in staffing and scheduling to be responsible stewards related
to expenses and productivity, launch of the new Observation/Inpatient E.H.R.
program, and successful improvements in clinical areas of patient care related to our core measures.
Our progress was acknowledged when our body of work on “Transforming Cardiac Care in a Rural
Setting” was honored with two awards. The first award was from Catholic Health Initiatives and
was received at the annual Quality & Risk Conference in St. Louis. The second award was from
the Kentucky Organization of Nurse Leaders and was received at the annual KHA Convention
in Lexington in May. As we continue our work in the quality arena, we are focusing on the
Orthopedic Service re-assessment as part of the Clinical Covenant, and we are participating in the
ED Reinvention and Med/Surg Reinvention teams to improve care and service to all our patients.
In addition to quality, our leaders and nurses are committed to Growth and Stewardship.
Nursing participates in activities related to growing our business, such as physician recruitment
and the development of new procedures and services. Nurses are actively engaged in planning
and designing the new hospital, which will open in 2011. With regard to Stewardship, our nurses
understand the need to meet productivity targets, keep overtime to a minimum, and match
worked hours to volumes. I am proud to present our accomplishments in the next few pages.
With gratitude,
Cinda Fluke, M.Ed., BSN, NEA-BC
Chief Operating Officer/Chief Nursing Officer
SAINT JOSEPH - MOUNT STERLING
23

Transformational Leadership
Saint Joseph - Mount Sterling (SJMS) continues to develop our leadership team through a variety of activities and opportunities. Our site visits to other health care organizations have
provided us with information to update our practices, procedures, skills and equipment. Our exposure to the Master Facility Planning process has presented an opportunity to
dream big, while being intentional and pragmatic in our planning for our new hospital and the patient care, service and flow we want to provide. This particular learning
experience forces us to reevaluate everything; it is a detailed process both fun and demanding, as we anticipate how we will be better able to serve our community in this
new space.
As we continue to promote a culture of learning at SJMS, our leaders have been the role models for professional development. At this time, 100% of the nursing
leadership team is BSN-prepared or enrolled in a BSN program. Three of the nursing leaders who are in BSN courses will graduate in the spring of 2011. In
addition, 38% of this team is master’s degree-prepared or enrolled in a master’s degree program.
As our nursing staff has witnessed their leaders’ pursuit of additional education, it has spawned a return to college for numerous employees. We have
nursing assistants who are pursuing nursing degrees, LPNs returning for an RN degree, and RNs returning for a BSN. Approximately 5% of the RNs
at SJMS are currently pursuing an MSN.
Our hospital is a clinical site for 87 nursing students from the area nursing programs. We host nursing students six days per week, with Sunday
as the only day students are not on our units. We have provided clinical rotations in all areas, allowing all our nurses the experience of helping
develop new nurses into the profession. SJMS partners with Morehead State University and Maysville Community College to provide clinical
opportunities for nursing students.
Structural Empowerment
Saint Joseph - Mount Sterling places value on advancing nursing education. During fiscal year 2010, Edwina Melton, RN, obtained her
advanced registered nurse practitioner degree and Leah English, SW, completed her registered nurse degree.
SJMS nurses developed “always the best” standards, focusing on people, stewardship, quality and growth. These standards are a commitment
to our patients and executive leadership to provide safe, cost-effective care to all who enter our doors. Every area of nursing developed their
standards, which serve as the basis for our achievements in Perfect Care and Service Excellence.
ER and Med/Surg nurses developed and led an interdisciplinary committee in order to increase communication and develop
constructive relationships. This committee resulted in a positive rapport and improved flow between the participating
departments, as well as improved hand-off communication and patient satisfaction.
TOUCHING THE COMMUNITY: BEYOND OUR DOORS
Saint Joseph - Mount Sterling is an active participant in the Montgomery County Relay for Life. Our Relay for Life
team consists of nurse managers and staff nurses. Sheila Barnes, OR nurse manager, serves as the event chair for the
entire county. For several years, SJMS has played a prominent role in Relay events and activities in our community.
“A Walk to Remember” is held annually in Mount Sterling, a day set aside for families to come together to
acknowledge and honor a child or children lost, including losses from miscarriage, fetal death, still birth or SIDS.
In October 2009, approximately 150 community members and SJMS employees participated in the event.
Nurse leaders at SJMS, in collaboration with the Montgomery County Cancer Coalition, sponsor a health forum
about cancer, specifically directed to women in Montgomery, Bath and Menifee Counties. This forum seeks to raise
awareness and educate community members about cancer.
24

Nursing Facts:
NUMBER OF NURSES
RNs: 102
LPNs: 15
ARNPs: 2
Masters: 6
Nurse leaders and RNs serve the community in these volunteer capacities and memberships:
• Advisory Board for St. Claire Home Health • Kentucky Association for Healthcare Quality
and Hospice
(and NAHQ)
• Bluegrass Association for Healthcare Quality • Kentucky Organization of Nurse Leaders
• Board member of Montgomery County • Montgomery County Cancer Coalition
Health Department
• Montgomery County Chamber of Commerce
• Board member of Gateway Children’s Services • Participation in community health fairs and
• Church ministry in several local congregations local events
• Clothing drives, bake sales and food donations • Participation in health screenings and health
to local charities and churches
information sessions at local schools
• Frequent blood donors
AVERAGE YEARS OF SERVICE
0-5 years:
45%
6+ years:
55%
AVERAGE AGE OF NURSES
21-40 years:
47%
Exemplary Professional Practice
Along with the other Saint Joseph Health System hospitals, Saint Joseph - Mount Sterling implemented
all Evidence-Based Practices (EBP), with a result of reaching the targeted 50% or greater reduction in
the corresponding indicators. We are proud to have received a high CRMIP score, excellent report on
our Anthem scorecard, and acknowledgement from CMS that our quality program and core measures
are “awesome.” This reflects the work of the whole team, coming together to work toward high quality
of care, and being committed to that end.
Through the work of the Med/Surg Reinvention team, we are exploring the pursuit of Heart Failure
Accreditation. We are working with the Diabetic Treatment team to implement improved protocols
for glycemic control for our patients. We have implemented numerous initiatives as part of the ED
Reinvention team and will soon be launching the “5 and 30” program (“No Wait ER”).
With facilitation by nursing and quality leaders, SJMS launched the “Treatment and Planning Team” in
the Spring of 2010. This interdisciplinary team meets monthly to review selected cases, with regard to
diagnosis, treatment and care planning. These fascinating cases (focus on oncology patients) offer lively
discussion and have led to improved collaboration, care planning and hand-off communication.
TURNOVER
RN:
10.23%
Voluntary RN:
5.68%
Vacancy:
4.41%
41+ years:
53%
Our Case Management team has restructured responsibilities in order to improve in numerous areas.
Length of Stay (LOS) management has resulted in a very low all-payer average LOS of 3.2 for the fiscal
year. Improvements have been made in overturning denials from third-party payers and documenting
medical necessity for inpatient stays.
Through the efforts of our Clinical Educator, Infection Control, Pharmacy and Nursing leaders, we
realized amazing success with our Flu Shot program this fiscal year, increasing from 43% compliance to
73% compliance with our employees.
The new Saint Joseph - Mount Sterling facility will open in the summer of 2011.
25

New Knowledge Innovations and Improvements
As new physicians have come to SJMS, our services, procedures and skills have grown. Having a
pulmonary intensivist has resulted in an increase of care for critically ill patients, requiring additional
skills for the all-RN ICU staff. Biphasic defibrillators have replaced monophasic defibrillators on all
nursing units.
Over the past year, SJMS has added laparoscopic colectomies to our OR procedures, in addition to
other procedures being performed by two new general surgeons. The OR staff has cross-trained in many
areas in order to accommodate a growing volume with additional variety.
SJMS’s Sleep Wellness Center is now hospital-run, instead of being provided by a contract service.
With that change came new equipment and the availability of capnography equipment, serving both
the Sleep Wellness Center, as well as inpatients with sleep disorders.
Empirical Quality Outcomes
Some of SJMS’s accomplishments for FY10:
• Core measure scores improved for SCIP, pneumonia and heart failure
• Hospital-acquired conditions decreased from prior year, from 7.75% to 3.69%
• Inpatient falls decreased by 52% and there were zero falls with major injury
• Median time for door-to-EKG improved from 6 minutes to 4 minutes
• Mortality rate decreased for the second year in a row (2%) and there were zero Box D deaths
• Zero surgical never events
NATIONAL CERTIFICATIONS
RECEIVED
Kimberly Hamilton, RN, ED: CCM
Phyllis Lucas, RN, Case
Management: CWOCN
Tim Winterfeld, RN, ICU: CCRN
Teresa Murphy, RN, OR: CST
Cinda Fluke, RN, Administration:
NEA–BC
ADVANCED DEGREES
RECEIVED
Kemberly Spencer, RN, House
Administrator: MSN
Edwinna Melton, RN, ED: MSN
Tina O’Hair, LPN, ED: ADN
Leah English, SW, Case
Management: BSN
AWARDS AND RECOGNITIONS
In March 2010 our poster
presentation for “Transforming
Cardiac Care in a Rural Setting”
was awarded 4th place by
Catholic Health Initiatives.
In May 2010 our poster presentation
for “Transforming Cardiac Care
in a Rural Setting” was awarded
1st place by the Kentucky
Organization of Nurse Leaders at
the KHA Convention.
In October 2009 the SJMS
Orthopedic Service presented
a body of work at the annual
tri-state quality conference and
was recognized by Anthem,
receiving the “Successful Practice
Program” award.
DAISY Award Recipients:
Dana Brundon,
RN, PACU
Teresa Tufano,
RN, Med/Surg
Saint Joseph - Mount
Sterling Emergency
Department nurses and
paramedics from the
Montgomery County
Fire/EMS launched a
new program this year
that utilizes wireless
EKG technology to slash
time from heart attack
diagnosis to treatment.
The wireless EKG technology transmits data directly to the Saint Joseph - Mount Sterling Emergency
Department from the scene, such as a patient’s home, saving valuable time for heart attack victims.
In a flash, a physician in the Saint Joseph - Mount Sterling Emergency Department can read the results
to determine if a patient is suffering a heart attack, all before the patient is even transported.
26
Saint Joseph - Mount Sterling’s body of work on “Transforming Cardiac Care in a Rural Setting”
was honored with two awards. The first was from Catholic Health Initiatives and was received
at the annual Quality & Risk Conference in St. Louis in March. The second award was from the
Kentucky Organization of Nurse Leaders and was received at the annual KHA Convention in
Lexington in May.

Excellence in patient care at Flaget Memorial Hospital is an expectation
of each person who trusts us to provide service in a time of dependency and vulnerability.
Our community expects the best care and our mission impels us to provide a safe place to
heal. This requires constant vigilance and a commitment to do the right thing with each
patient encounter. The addition of new services and physicians to our community
makes the role nurses play as the last line of defense even more imperative.
To ensure patient safety remains first, Flaget Memorial Hospital engaged in the system goal of
implementation of evidenced-based practices. In addition, the engagement of the nursing staff
and other clinical partners at the point of care took on a new look as LEAN strategies helped us
define points of delays and barriers to the patient flow and care process. The positive change in
our culture is evident as staff nurses look for ways to improve processes on a daily basis and feel
empowered to take an immediate action or make a needed change.
After a recent obstetrical emergency, one of our staff surgical nurses came in the next day on her
day off and debriefed the obstetrical nurses. The group developed a list of improvements that
they presented to leadership the following Monday. The recommendations were put in place
the next week. How comforting to know that departmental barriers no longer hinder us from
doing what is best for the patient.
Nursing continues to be the most trusted profession. The nurses and clinicians at Flaget
Memorial Hospital know this trust is earned on a daily basis.
With gratitude,
Sue Downs, RN, MSN, BSN, CRRN
Chief Operating Officer/Chief Nursing Officer
FLAGET MEMORIAL HOSPITAL
27

Transformational Leadership
In 2008 the Flaget Memorial Hospital (FMH) leadership team began reading Jim Collins’ book Good to Great. Implementation of the key concepts throughout the hospital began
with “Picking the right people first, and then figuring out where to go.” Nursing leaders collaborated with HR leaders to implement a “shadowing process” prior to hire to ensure
the right persons are “on the bus.” Each potential nursing hire shadows with a nursing staff member for a minimum of four hours. Multiple persons interview the candidate
and all must agree the person is the right fit. That is, the person is passionate about our healing ministry and patient safety. This process continued throughout 2010. Our
voluntary RN turnover was at a record low in FY10 of 3.08%.
In 2010, nurses and other caregivers committed to another concept in the book to “develop the discipline to do the right thing and to stop doing the wrong
things.” Through the leadership of nurses and clinicians from multiple departments, facilitated by Cheri Davidson, RN, MSN, the journey began with
detailed charts of our current processes to identify delays and barriers to patient flow and safety. This working document is posted in the units for feedback
on a daily basis when problems are identified in real time. The nursing staff is empowered to make quick fixes within their respective departments.
Persons are challenged to think through old processes and defend the need to continue the practice if it is not relevant to the mission.
Structural Empowerment
Flaget Memorial Hospital’s Nurse Council continues to use a self-governance model. The council identifies problems and works with other
departments to resolve them. They approve new products and identify problems with products, such as IV start kits and upgrade of ace wrap
bandages. The group provided guidance and approvals through the Evidence-Based Practice implementations. They review and approve all
nursing policies and procedures to verify accuracy and reflection of concurrent practices.
Bedside nurses and clinicians met each week using LEAN concepts to identify the barriers and delays in care in the ED and for the
orthopedic patients admitted to our hospital. The empowerment the employees feel is evident in other areas of the hospital as we experience
the breaking down of departmental silos when employees talk outside of these meetings to make a quick fix that will benefit patient care. For
example, the OR and OB nurses wrapped the surgical packs that are needed during an emergency C-section with pink so anyone can easily
identify what needs to be opened in an emergency.
TOUCHING THE COMMUNITY: BEYOND OUR DOORS
The annual Birth Center Community Baby Fair was held April 24, 2010, in Bardstown for expecting parents, parents of toddlers and anyone
planning a pregnancy. Members of the Birth Center staff planned and implemented the fair. Nurses volunteered to work in the
Nelson County Community Clinic, which is a free clinic with a focus on health care for the working uninsured population
of Nelson County. Flaget Memorial Hospital provides and supports first-aid booths at the Bourbon Festival, Old
Kentucky Home Bike Tour, Bourbon Chase, and the Bourbon City Challenge.
Volunteers from the hospital participated in fundraising walks and other events associated with March of Dimes,
Relay for Life, American Heart Association, Go Red for Women, and Colon Cancer Awareness. We sponsored
the Relay for Life survivors’ tent in Bullitt, Marion and Nelson counties that included a hospital speaker in
each county highlighting the new Cancer Center at FMH. St. Vincent DePaul food drive and back-to-school
drives continued with great success. FMH sponsored “Faces of Cancer” for seven surrounding counties,
highlighting the courage of survivors of cancer.
Nurse volunteers active on community boards include Delisa Arnold, RN, who serves on the planning
committee for the March of Dimes Tri-County walk; Jill Clark, RN, BSN, Nelson County Community
Clinic Board; Cheri Davidson, RN, MSN, National League of Nursing Accreditation Commission; Sue
Downs, RN, MSN, Advisory Board for St. Catherine College and president of Kentucky Organization of Nurse
Leaders; Jerri Passo, RN, BSN, ambassador for American Heart Association with Go Red for Women campaign;
and Rick Vancise, RN, MBA, Advisory Board for Elizabethtown Community College Nursing Program.
28

Nursing Facts:
NUMBER OF NURSES
RNs: 202
LPNs: 8
ARNPs: 8
MSNs: 14
Exemplary Professional Practice
All directors and managers completed a book review with the leadership team on StrengthsFinder.
Leaders’ strengths were identified and shared in discussions with the group. The positive energy of
looking at strengths instead of weaknesses continues to reap benefits.
Hospital staff members also participated in opportunities for professional development and outside
presentation. Nurses on inpatient units developed a poster presentation on “Inpatient Satisfaction
Improvement Process” that won first place at the CHI Quality and Risk Conference in April 2010.
Norma Goss, RN, BSN, presented at the conference on improving inpatient satisfaction and at the
Kentucky Organization of Nurse Leaders district meeting.
AVERAGE YEARS OF SERVICE
0-5 years:
59%
6+ years:
41%
AVERAGE AGE OF NURSES
21-44 years:
48%
Jerri Passo, RN, BSN, shared her personal story at Go Red for Women events in Bardstown and
Lexington. Sue Downs, RN, MSN, taught a wellness class at First Christian Church in Elizabethtown,
Ky., and spoke at the survivors’ meeting during Relay for Life for both Nelson and Hardin counties.
EDUCATIONAL ACCOMPLISHMENTS AND MENTORING
Flaget Memorial Hospital provides mentoring and preceptors for nursing students upon completion of
a nursing program. Elizabethtown Community College, Galen College and Saint Catherine College
use the hospital for clinical rotations.
TURNOVER
RN:
13.85%
Voluntary RN:
3.08%
Vacancy:
5.26%
45+ years:
52%
The hospital provided education throughout the year with an Advanced Cardiac Life Support
Provider course, Cardiopulmonary Life Support Provider course, Neonatal Resuscitation Provider
course, Nonviolent Crisis Intervention training program, and Pediatric Advanced Life Support
Provider course. Other offerings included Assessment of the Pulmonary System III, Cardiac Rhythm
Interpretation course, Hospice volunteer training, KODA workshop, Interventions to Decrease Postoperative
Respiratory Complications, Identification and Application of Appropriate Patient Transfer
Techniques, Care of the Post Surgical Bariatric Patient, Bariatric Surgical Procedures and Signs and
Symptoms of Transfusion Reactions.
Three nurse leaders participated in the AONE Aspiring Nurse Leader course sponsored by CHI. Kim
Buckley, ARNP, attended the Hospitalist Boot Camp. Cheri Davidson, RN, MSN, completed a course
called “LEAN for Healthcare.” Sue Downs, RN, MSN, attended the ACHE Chief Operating Officer
Boot Camp.
29

New Knowledge Innovations and Improvements
Laura Larue, RN, BSN, MBA, worked with other hospital and emergency community leaders to train
the executive team and leadership on command center operations during emergencies.
The Fall Prevention Program included putting into place identification of assistive devices and patients
at high risk for falls that resulted in fewer falls and a secondary outcome of a significant decline in
employee injuries by 42.8% in FY09. Marlene Hardin, RN, BSN, Director of Medical Surgical Services,
worked with the Med/Surg nursing staff in 2010 to focus on reduction of employee injuries on the
unit. The nursing staff received education on transfers and lifting devices. More importantly the buy-in
was obvious as we decreased our employee injury costs on the unit from $3,931/30 full-time employees
to $323/30 full-time employees.
Bariatric cases started in December of 2010. The new Flaget Center for Weight Loss Surgery required all
nurses and nursing personnel to attend classes. Our first patient successfully improved her quality of life
by increased mobility, controlled blood pressure without medication, and a weight loss of 80 pounds.
CLINICAL COVENANT WORK
About 18 months ago, the governing board for Saint Joseph Health System challenged each of the
hospitals to implement a concept that few other hospitals have been successful in implementing. The
concept was the Clinical Covenant. After implementation of the Clinical Covenant, care at the bedside
would be changed through the formation of a transactional relationship between the patient and caregiver.
NATIONAL CERTIFICATIONS
RECEIVED
Andrea Ames, CEN
Stephanie Bradshaw, RN, Wound Care
Certified Nurse (WCCN)
Sarah Livers, RN, Certified SANE Nurse
ADVANCED DEGREES
RECEIVED
Laura Larue, MBA
LEADERSHIP IN PROFESSIONAL
ORGANIZATIONS
Delisa Arnold, RN, serves on the
Program Committee for KONL.
Sue Downs, RN, MSN, CRRN,
is president of the Kentucky
Organization of Nurse Leaders
(KONL).
LEADERSHIP IN NURSING
Delisa Arnold, RN, Director of Birth
Center and Skilled Nursing Unit
Susan Brown, RN, Manager of
OR and PACU
Cheri Davidson, RN, MSN, VP of
Quality, Risk and Medical Staff
Sue Downs, RN, MSN, COO/CNO
Norma Goss, RN, BSN, Director of
Nursing Services
Marlene Hardin, RN, BSN, Manager of
Medical Surgical Services
Carolyn Hollingshead, RN, Manager
of Pain Management
Brooke Hurst, RN, BSN, Manager of
Critical Care Services
Laura Larue, RN, MBA, Director of
Emergency Services
Carrie Medley, RN, Manager of Flaget
Immediate Care Clinic
Pat Russman, RN, Manager of
Oncology Services
Rick Vancise, RN, MSN/MBA, Director
of Outpatient and Projects
Geri Werkman, RN, Director of
Surgical Services
AWARDS AND RECOGNITIONS
Delisa Arnold, RN, Director of Birth
Center and Skilled Nursing Unit,
awarded a KONL scholarship.
DAISY Award Recipients:
Cheryl Bundy.
RN, House
Supervisor
Dianne Chesser,
LPN, Med/Surg
Anna Culver,
RN, Surgery
Natalie Vancise,
RN, House
Supervisor
30
Flaget Memorial Hospital was given the honor of being the pilot hospital for this design work. In
February 2010, Flaget met with Saint Joseph - Mount Sterling, Saint Joseph - London and Saint Joseph
East to begin the journey. The charter of the team was to create an environment where the patient
receives highly reliable, patient-centered, seamless, transparent care. The fundamental basis of this work
is to promise patients that we will always do certain things and always not do certain things.
Our journey is involving many different facilities and many of our departments and staff. With this
collaboration between Flaget’s Ortho Clinical Covenant Team (“Hercules”) and other stakeholders,
perspectives have been broadened. This is allowing us to realize the importance of consistency in the way
we work and in the way we work together, to ensure our patients’ experiences are seamless and highly
reliable, while at the same time improving patient safety, care and satisfaction.
Empirical Quality Outcomes
• The respiratory care bundle initiated in 2006 continues to show a decrease in complications and
readmission rate of adults with respiratory conditions. The hospital decreased the readmission rate
from 12% to 7.5% in calendar year 2009. The impact of this work was recognized nationally with
the HealthGrades 5-star rating for COPD survival rates.
• OB compliance to the perinatal bundle is 100%. Newborn transfer rates to a higher level of care
declined by 40% from FY09 to FY10.
• Skilled Nursing remained number one in patient satisfaction for subacute units in CHI. This unit
continues to demonstrate outstanding care for over a decade. Nursing Home Compare, a federal
website sponsored by CMS, rates the unit as a Five-Star facility (with five stars being the best).
• FMH received the HealthGrades 5-star rating for Hip Fracture Repair complication rates.
• BMCA continues to make a difference. The success of this is based on the nurses’ compliance
with using the system. FMH nurses are committed to providing safe administration of
medications; therefore, our
scan rate is over 92% for all
medications administered on
our inpatient units. While
nationally a .5/1000 doses error
rate is considered acceptable,
with BMCA FMH reduced our
medication error rate last fiscal
year to a historical low rate of
.09/1000 doses.
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
Flaget Memorial Hospital — Medication Errors per 1000 Doses
January 2006 to June 2010
BMV Hospital
Wide Dec 2007
QUALITY EVIDENCE
0
• Recognition of physicians as
Jan-Dec 2006 Jan-Dec 2007 Jan-Dec 2008 Jan-Dec 2008 Jan-Jun 2010
internal customers is the driving force to remove barriers that would discourage the use of FMH
services and impede growth. Physicians are often heard to say that our “Nursing services far surpass
those in surrounding hospitals.” As a result, volumes grew in admissions by 8%, 21% in general
surgery, 22% in Hospice, and 3% in ED. FMH’s surgical team continues to turn around rooms in
12.7 minutes safely and efficiently, as other surgical departments struggle to get to 15 minutes.
• FMH implemented 28 evidenced-based standards as part of the system initiative that resulted
in a decrease of Health Care Acquired Conditions. A big thank-you to the registered nurse team
leaders: Susan Brown, RN; Jill Clark, RN, BSN; Nancy Fink, RN; Brad Gagne, RN; Norma Goss,
RN, BSN; Marlene Hardin, RN, BSN; Barbara Leake, RN; Jerri Passo, RN, BSN; Clara Powell,
RN, BSN; and Ricky Reiter, RN, BSN. Also, a special thank-you to Bernadette Sutherland for
clerical support and coordination of the project.

SAINT JOSEPH HOSPITAL • SAINT JOSEPH EAST
We are pleased to present the 2010 Nursing
Annual Report, “Person-Centered Care.”
This report reflects the previous year’s work and the many accomplishments for which
all Saint Joseph Hospital (SJH), Saint Joseph East (SJE) and Saint Joseph - Jessamine
(SJJ) nursing team members should take pride. The report is an excellent venue for
acknowledging the tremendous effort each nurse puts forth each day to deliver
collaborative and compassionate care. It also allows us to reassess our current
state, determine our gaps and refocus for future opportunities and
progress. In 1914 Florence Nightingale said, “Unless we are
making progress in nursing, every year, every week, take my
word for it, we are going back.”
Throughout this annual report, there are countless illustrations of nurses
demonstrating unwavering commitment to providing evidence-based, highquality,
person-centered care, which is central to our mission. At the core of patientcentered
care is patient safety. Patient safety continues to be a driver for numerous
new ideas and changes at SJH/SJE/SJJ. Nurses have a sense of pride in fulfilling our
responsibility to keep patients safe. Each day we hear testimonies from patients and families
acknowledging how nurses make a difference in the lives of so many people.
As we embark on another year, rapid changes in health care will challenge us
daily. Expectations for efficient, high-quality, cost-effective care, along with the
complexity of patient care, will require us to focus on developing future patient
care delivery processes that sustain quality outcomes. Our accomplishments as
portrayed in this annual report are a clear reflection of the contributions made
by nurses at every level of the organization. While we reflect on our previous
year’s accomplishments, we have greater expectations for our future, based on our
commitment to reverence, integrity, compassion and excellence.
We are proud and privileged to serve so many exceptional nurses. We salute you, we celebrate you, and
we honor you for all you do. Thank you for the work you do each and every day to make SJH/SJE/SJJ
all outstanding organizations.
SAINT JOSEPH-JESSAMINE
With gratitude,
LaJava Chenault, MSN, RN
VP of Nursing
Christine H. Mays, MSN, RN
Chief Operating Officer/Chief Nursing Executive
31

Transformational Leadership
Nurses are responsible for providing high-quality patient care in a culture of safety and clinical quality performance. Transformational leaders help achieve this goal. Nursing’s mission,
vision, values, philosophy and strategic plan provide the framework from which all components of the nursing division are developed. Interdisciplinary teams were created to
develop a shared vision for the desired performance-driven culture, guided by the behavioral attributes of our core values.
Saint Joseph’s model for nursing care is person-centered care. This professional practice model aligns with our current patient care provision and shared governance
practice model, and allows the patient and family an opportunity to share in the care delivery decision-making process. Patients and families work with the nursing
staff to direct the care provided to the patient by sharing knowledge and providing support, creating a partnership for care. This partnership makes the patient
(and family) a stakeholder in the care, which allows a more competent, tailored plan of care to ensure healthier outcomes.
Both the structure and philosophy of nursing at SJH/SJE/SJJ reinforce shared decision-making. Many new councils and teams have been established
this year, along with existing councils, to help improve our practice. The roles of the councils include advocacy and influence, visibility, accessibility,
communication and strategic planning. The councils focus on clinical practice, quality, professional development and education, research, management
and operations, and patient satisfaction. This improvement is closely linked with the increase in autonomy, especially with the frontline nursing staff.
Councils include:
• Clinical Patient Safety Council
• Heart Failure Leadership Council
• Interdisciplinary Pain Council (IPC)
• Nursing Quality Council
• Peri-Operative Leadership Council
• Pre-Op/Post-Op Care Excellence Council
• Staff-led Hiring Council
• Unit-Based Quality and Practice Council
• Women’s Hospital Practice Council
Integrated into our person-centered nursing model and shared governance practice setting is Jean Watson’s theory of caring. Watson holds a
view of the human as a valued person in and of him- or herself, to be cared for, respected, nurtured, understood and assisted. Watson’s theory is
consistent with our chosen person-centered model of care. Patient-centered care is defined as:
• Respect for the individual patient
• Coordination of care
• Communication, information and education of care to include patient’s cultural and lifespan needs
• Comfort (emotional, physical, spiritual)
• Emotional support
• Family involvement (to include unmarried significant others, support persons and life partners)
• Transition and continuity of care
Structural Empowerment
ANNUAL EVIDENCE-BASED PRACTICE SPRING SEMINAR
Saint Joseph Health System nurses were invited to the annual Evidence-Based Practice spring seminar, “Evidence for Transformational Care,” April 23, 2010, at SJH.
Special guest speaker was Jim D’Alfonso, COO & CNO for the Watson Caring Science Institute. He spoke about the Caring Theory of Jean Watson.
32

Nursing Facts:
NUMBER OF NURSES
RNs: 1,078
LPNs: 57
ARNPs: 13
MSNs: 45
UNLOCKING CLINICAL EXCELLENCE AND PUTTING PERFECTION INTO PRACTICE
Phil Beauchene, senior director with the Advisory Board Company, was the speaker on June 24, 2010,
at SJH and discussed the most important unit attributes driving clinical excellence, overall strategies
for pursuing those drivers of clinical excellence, detailed best practices drawn from exceptional units
around the country, and zero-defect initiatives custom-fitted to unique care settings. This educational
offering was open to all SJHS nurses.
HEART WALK 2010
More than 500 employees from SJH/SJE/SJJ and family members participated in the American
Heart Association Heart Walk on April 24, 2010, at Commonwealth Stadium, all sporting red Saint
Joseph Heart Institute T-shirts.
AVERAGE YEARS OF SERVICE
0-5 years:
40%
6+ years:
60%
RELAY FOR LIFE 2010
The 6th floor oncology staff at SJH led a team in the Fayette County Relay for Life June 4-5, 2010,
at Lexington Christian Academy. The team held various fundraisers, including bake sales and a quilt
and basket raffle, and walked laps at the event to support the American Cancer Society.
AVERAGE AGE OF NURSES
TURNOVER
RN:
11.05%
Voluntary RN:
7.05%
Vacancy:
7.8%
21-40 years:
45%
41+ years:
55%
GO RED FOR WOMEN
Saint Joseph Health System is the central Kentucky sponsor
of the American Heart Association’s Go Red for Women
program, which alerts women to their risk of cardiovascular
disease. In fiscal year 2010, Saint Joseph hosted several
community events to help raise awareness and encourage
women to take steps to reduce their risk for cardiovascular
disease. Several Saint Joseph Heart Institute nurses
volunteered at these events, providing free blood pressure
screenings and heart-healthy information.
SURGERY ON SUNDAY (SOS)
Dr. Andy Moore was named a CNN Hero for his work with the Surgery on Sunday (SOS) program
in Lexington. SOS utilizes volunteer surgeons, nurses and other medical and non-medical volunteers.
Saint Joseph Hospital nurses provide a large portion of the care. Sheryl Adams, a critical care float
nurse at SJH, is one of the volunteers for Surgery on Sunday.
“Primarily I serve as a recovery nurse,” Sheryl said. “We start at 6 or 7 a.m., and we usually end by 1
or 2 p.m. It’s hard to give up your Sunday mornings, but it’s so rewarding.” For one thing, patients are
extremely grateful for the care, the nurse said. “They realize that we’re giving up our time for them. It
gives you such a good feeling to be able to help them. I come from a very poor family. That makes me
want to give even more.”
33

HELP FOR HAITI
Julia Phillips (left) is a registered nurse at SJH. Julia served in Haiti, arriving only days after the devastating earthquake hit in January. She believes
it was God’s calling. “I became a nurse so I could do this kind of work anywhere in the world,” she said.
She worked in makeshift hospital wards, where secluded solace was broken with chaos. She worked with international teams to provide
medical, surgical and humanitarian support. Her experience is filled with poignant stories of birth, death and determination for survival.
Phillips continues to receive updates about the people she cared for and has since returned in August with another Emergency
Department colleague, Jana Congleton, RN, at SJJ.
COMMUNITY PARTNERSHIPS FOR FITNESS
Emergency Department nurses and techs provided first-aid at the inaugural Bourbon Chase, a 200-mile relay of runners
covering scenic byways along the famous Kentucky Bourbon Trail and Bluegrass horse country.
COMMUNITY RESOURCE CENTER
Janet Morgan, RN, CBPN-IC, Saint Joseph Breast Center, was presented with a Susan G. Komen grant for the
development of a Community Resource Center. This center will include books, DVDs and other materials to
address breast health and care of women with breast cancer. Janet has also developed and started a Breast Cancer
Survivor support group that will meet on a monthly basis in the new Community Breast Resource Center.
NURSES’ CHOICE AWARD 2009
Every year, nurses at SJH and SJE nominate one physician from each campus for the Nurses’ Choice Award. In December
2009, nurses honored Dr. Jorge Ang (above) and Dr. Bruce Belin (above, right).
The Nurses’ Choice Award recognizes physicians who display the following traits every day in their work with nurses. The criteria for
selection of the physician award winner are:
34
• Daily demonstrates the core values of Reverence, Integrity, Compassion and Excellence, as the leader of the health care team.
• Supports nurses in a collegial manner by demonstrating respect and a true spirit of collaboration with nurses in the provision of care.
• Serves as a coach and teacher, whether formally or informally, to promote the advancement of nursing knowledge and practice.

NATIONAL CERTIFICATIONS RECEIVED
Tammy Andrews, SJH: CEN
Anne Baumgartner, SJH: ARNP - Psychiatric Board Certification
Jana Congleton, SJH: CEN
Betty Cornish, SJH Heart Institute Non-Invasive Manager: CCRN
Rosemary Dailey, SJH: SANE Certification
Jennifer Daniel, SJH: CEN
Donna Doty, SJE: ASBS
Jeannie Elder, SJE: ANCC
Michelle Fite, SJH Cardiac Cath Lab: RCIS
Chrystal Hackney, SJE/SJH/SJJ: CEN
Sherry Hearley, SJE: CPAN
Lona Hensley, SJH: LNC
Denise Hundley, SJE: RNC-OB
Davonna Hutcherson, SJE: RNC-OB
Margie Isaacs, SJH: LNC
Sabrina Little, SJE Cardiac Cath Lab: CCRN
Brenda Lloyd, SJH HISSU: CCRN
Tiffany Lowther, SJE: CNOR
Jodi Manley, Heart Institute Procedure Lab: CCRN
Billie May, SJH: ACHPN
Janet Morgan: CBPN-IC
Carol O’Connell, SJE: RNC-OB
Lisa Quinn, SJH: ARNP, Family Practice Board Certification
Linda Rouser, SJE: CCM
Danielle Thomas, SJE: CNOR
ADVANCED DEGREES RECEIVED
Anne Baumgartner: ARNP
Amy Blank, SJE: BSN, Eastern Kentucky University
Marissa Coleman, SJE: BSN, Morehead State University
Bill Currey, SJE: BA General Study Field Allied Psychology, University of Kansas
Susan Fields, SJE: BSN, Eastern Kentucky University
Gretchen Folk, SJE: BSN, University of Kentucky
Pam Graves, SJE: BSN
Sheryl Hardyman, SJH: BSN, Eastern Kentucky University
Kyle Howard, SJE: BSN, University of Kentucky
Margaret Howard, SJH: BSN, University of Wisconsin
Samantha Jackson, SJH: BSN, University of Kentucky
Amber Keath, SJH: BSN, Eastern Kentucky University
Tammy Lancaster, SJE: BSN, University of Kentucky
Celina Milan, SJE: BSN
Michelle Moss, SJE: BSN, Eastern Kentucky University
Karla Mullins, SJE: BSN, University of Tennessee
Victoria Nash, SJH: BSN, South University, GA
Karissa Neidig, SJE: BSN, Eastern Kentucky University
Tisha Newson, SJE: BSN, IWU
Lisa Quinn: ARNP
Felicia Reaves, SJE: BSN
Karen Scott, SJE: BSN
Yvonne Sherman, SJE: BSN, University of Kentucky
Karen Taylor, SJE: BSN, Eastern Kentucky University
Bettina Thomas, SJE: BSN, Eastern Kentucky University
Lee Trimble, SJE: BSN, Midway College
Ashley Witham, SJE: BSN, Eastern Kentucky University
LEADERSHIP IN PROFESSIONAL ORGANIZATIONS
LaJava Chenault, MSN, RN, SJH/SJE/SJJ, executive board member National FIIL Risk Group
Debbie Griffith, SJH, education coordinator for Bluegrass Chapter AACN
Margaret Kramer, BSN, RN, SJH, president of Central Kentucky Staff Development Group
Tiffany Lowther, SJE, appointment to board for AORN
Christine H. Mays, MSN, RN, SJH/SJE/SJJ, American Cancer Society Leadership Council, Palliative
Care board of directors, Camp Horsin’ Around board of directors, UK External Advisory Council
PROFESSIONAL PRESENTATIONS & POSTER PRESENTATIONS
• “Aspetic Technique” Department Poster • Denise Hundley, SJE, AWHONN National
Presentation, Stacy Jude, RN, SJH EP Lab Conference Poster Presentation: “Because
• “Clinical Orientation Re-Design” Poster
One Is Too Many”
Presentation: Margaret Kramer, BSN, RN, • “From Novice to Expert: Mastering the
SJH/SJE Heart Institute Clinical Educator Fundamentals of Staff Development,”
• “The 6 Roles of the Staff Development
October 16, 2009
Specialist”; Margaret Kramer, BSN, RN, • Linda Amon, SJE, new presenter of Patient
SJH/SJE Heart Institute Clinical Educator Education biweekly class for Total Joint
• “Women’s Heart Health”; Tammy
Replacement
Dail, RN, SJH, HISSU Manager, Sullivan • Poster Presentation: “National Patient Safety
University May 2010
Goals” Hospital Safety Poster 2nd Place
• Carol O’Connell, SJE, AWHONN National winner: Tammy Dail, RN, SJH HISSU
Conference Poster Presentation: “Because Manager; Erin Caldwell, RN, SJH HISSU
One Is Too Many”
Clinical Manager; SJH HISSU Staff
• CKSDG Region Staff Development Poster • Poster Presentation: “Time Out” Hospital
Palooza, April 2010
Safety Poster: Denise Alvey, BSN, MSN, RN,
• Debbie Gibbons, SJE, certification course for SJE HISSU; Margaret Kramer, BSN, RN,
“Resolve Through Sharing” for nurses and SJH/SJE Heart Institute Clinical Educator
chaplains
• SJHS EBP Program, April 2010
• Tommie Sears, SJE, EKU College of Nursing-
TB
35

CERTIFIED EMERGENCY NURSE EXAMINATION (CEN)
SJJ was the host site for the first system-sponsored Certification Emergency Nurse review course in May. Dan Andrews, RN, CEN, became involved in the project in early 2010. This project was a collaboration
of RNs to arrive at a unified education format for Emergency Departments. Saint Joseph Health System RNs with national specialty certification served as course instructors. The inaugural course netted a large
response; six RNs have attained CEN certification. This distinctive symbol marks the passion of nurses providing superior patient care and protecting the public’s health and safety.
CCRN REVIEW COURSE
In order to promote and encourage certification for the critical care and telemetry nurses, a CCRN review course, “Certification Exam Cram: A 2-Day Review for CCRN and PCCN Candidates,” was offered in
April 2010. This program is designed for nurses preparing to take on the challenge of either the CCRN or PCCN exam. The course highlights and reinforces exam-essential concepts and should be approached as
the final culmination of one’s own self-study. For the system, we have added 7 CEN nurses as a result of this course review.
STUDENT NURSE PRECEPTOR LIST 2009-2010
Cristy Abrams
Teresa Conley
Jessica Adams
Alicia Cox
Mitzi Alexander
Teressa Cozine
Lola Arnett
Miranda Craft
Almira Bacus
Danielle Craig
Ashley Baesler
Donna Cruze
Cassie Baker
Dianna Davis
Anne Baumgartner Amanda Deskins
Anna Bermundo
Lynette DeTinne
Nikki Bermundo
Donna Doty
Heather Black
Amy Dugan
Christine Bowling
Courtney Elam
Cristy Callahan
Earl Farler
Tiffany Calvert
Amber Field
Teri Chasteen
Susan Fields
Rebecca Chesnut
Shawntal Garr
Carrie Clark
Angela Gibson
Winona Clark
Pam Gill
Amy Claunch
Robbie Gomez
Ashley Clemmons
Julia Greenup
Jessica Collins
Amanda Hamilton
April Hamilton
Judy Hamilton
Gwen Hammons
Andrew Hancock
Amy Hatton
Autumn Haynes
Vada Hays
Joy Hoverman
Sheena Hudson
Dwanett Jarrells
Arlene Jones
Denise Jordan
Mary Beth Keeton
Jodi Kellman
Lynette Laine
Beth Leonard
Pam Long
Danielle Mann
Donna Mann
Terry May
Suzanne McGill
Connie Melson
Shannon Melton
Diane Miller
Melissa Miller
Cindy Napier
Stephanie Niece
Alesha Pennington
Jodi Pernica
Sherry Powell
Jennie Proctor
Stacey Puckett
Mary Frances Regalado
Jennifer Romans
Kellie Rosenbalm
Rubi Russell
Clarissa Scott
Rachel Scott
Sherri Shelby
Amelia Shrick
Phyllis Shrout
Sherry Simmons
Jasmine Sims
Beverly Smith
Cindy Smith
Glenn Standafer
Beth Stearns
Stacy Stephenson
Debbie Stiles
Amber Tarpley
Kari Terando
Rayna Thomas
Heather Wallace
Trish Wallace
Kathleen Warner
Anissa Webb
Whitney Webb
Therese Weinberg
Debby Whitaker
Amanda Wilson
Vicky Wright
Bev Young
CONTINUING EDUCATION
A total of 230 continuing education programs were offered in FY10 for nursing continuing education credit. A grand total of 1,467 nurses attended a free CE
educational program during the year and a total of 961 continuing education credits were provided.
36

Awards and Recognitions
HEART OF SAINT JOSEPH WINNERS (NURSING)
SJE: Rachel Scott
SJE: Sam Griggs (deceased)
2010 DAISY AWARD RECIPIENTS
It is so easy to find extraordinary nurses at Saint Joseph Health System—professional nurses who exhibit extraordinary compassion in the care of their
patients and families. Nominations for the DAISY Award are written by fellow RNs, patients, family members, physicians and staff. They take the time
to nominate nurses because they have been, in some way, impacted by what the nurses do and who they are. Our deepest thanks to Barry Stumbo and the
Saint Joseph Foundation for making this a reality for all of us!
1ST
QTR.
Carrie Clark, RN,
ICU South, SJH
Angie Henley, RN,
4MS, SJE
Kristi McVey, RN,
2 East, SJH
Alesha Pennington, RN,
L&D, SJE
Sherri Shelby, RN,
CCH, SJE
Kari Terando, RN,
2 East, SJH
2ND
QTR.
Becky Alexander, RN,
Cath Lab, SJH
Denise Alvey, RN,
HISSU, SJE
Betty Evans, RN,
CCH, SJH
Mia Howard, RN,
Women’s Care, SJE
Latonya Jones, RN, 3B,
SJH
3RD
QTR.
Kathy Davis, RN,
PACU, SJH
Robin Payton Harrod, RN,
Women’s Hospital, SJE
Michele Lafave, RN,
Surgery, SJH
Sherri Shelby, RN,
CCH, SJE
Vicky Wright, RN,
3 East, SJH
4TH
QTR.
Judy Beauvier, RN,
Pain Management, SJH
Melissa Doss, RN,
Med/Surg, SJE
Mary Beth Keeton, RN,
Med/Surg, SJE
Ernest Morris, RN,
CCH, SJH
Jenny Pulliam, RN,
3rd Telemetry, SJE
37

NURSING EXCELLENCE AWARD
Kimberley Adams, SJE Charge Nurse, Day Surgery & Block Room
Carrie Barnett, SJH Staff RN
Venus Bigham, SJH Care Coordinator Case Management
Traci Brady, SJE Critical Care Float
Charissa Burt, SJH Cardiothoracic Vascular Unit
Danielle Craig, SJHS RN 2 East
Melanie Donnelly, SJH Clinical Manager RN-PRNU
Betty Evans, CCH/SJH Staff Nurse
Earl Farler, SJH RN 3 ICU
Stephanie Garcia, SJH 5A Stroke/Telemetry
Miranda Gibson, SJH Clinical Manager 4A
Karen Greer, SJH HISSU Staff Nurse
Penny Grimes, SJE RN Endoscopy
Tina Hale, SJE 7A ED Charge RN
Sheryl Hardyman, SJH RN Endoscopy
Miranda Hill, SJH ED Nurse
Tricia Kellenbarger, SJHS RN Electrophysiology Labs
Margaret Kramer, SJH & SJE Heart Institute Clinical Educator
Beth Leonard, SJH RN ICU North
Allison Manning, CCH - SJE Clinical Manager
Sharon McCartt, SJH Clinical Documentation Specialist
Celina Milan, SJE RN Surgery
Lauren Mullins, SJE RN 3 Telemetry
Erica Pantaliono, SJH RN Case Mgr, Charge Nurse Wound Center
Shari Pearson, SJHS Staff Nurse Pre-Op & Holding
Mary Ann Powers, SJH ICU South
Stacey Puckett, SJJ ED Staff Nurse
Tasia Rader, SJE RN 4 Medical Surgical Unit
Elizabeth A. Soileau, SJH RN, Clinical I 3A Post-Op Surgery
Amy Wallace, SJE Staff RN HISSU
Kathleen Warner, SJH RN 3B Surgical Telemetry
Shannon Woosley, SJH RN Cardiac Cath Lab
Shannon Young, SJH Staff Nurse Heart Institute
SPIRIT OF SAINT JOSEPH SERVANT LEADERSHIP EXCELLENCE AWARD
During the summer of 2010, Saint Joseph Health System created the Spirit of
Saint Joseph Servant Leadership Award. The award is to be presented to a leader
who consistently demonstrates our mission and core values, and the Seven
Pillars of Servant Leadership. The seven key practices of servant leaders are selfawareness,
listening, changing the pyramid, developing your colleagues, coaching
not controlling, unleashing the energy and intelligence of others, and foresight.
Nurse nominations from SJH/SJE/SJJ include:
• Debbie Bryant, Director of Nursing, Saint Joseph East
• Claudia Carroll, Human Resources Senior Business Partner
• Patti Creed, Unit Manager of Emergency Services, Saint Joseph East
• Pat Jessen, Unit Manager for 4A General Medical Unit, Saint Joseph
Hospital
• Marilyn Swinford, Director of Emergency Services, SJH/SJJ and Patient
Access
• Linda Watt, Director of Surgical Services, Saint Joseph Hospital
CONTRIBUTION TO NURSING PROFESSION
Chris Mays, MSN, RN, COO/CNE, is one of 50 UK College of Nursing
graduates being honored for her contributions to the nursing profession 2010.
38

Exemplary Professional Practice
MATERNITY SERVICE INITIATIVE
The Maternity Service staff developed the following aim statement: to improve and enhance the safety of our perinatal population. In this
effort the team discussed, educated and implemented the H1N1 flu vaccination requirement for all pregnant women who presented to
L&D and were discharged from the hospital prior to or after delivery.
The Maternity Staff developed and implemented an Evidence-Based Educational Competency Week on each unit to address
the educational needs of the staff. They used the LEAN process to identify the high-risk, high-volume care processes used on a
routine basis and developed educational tools for the competency training.
PATIENT SATISFACTION
Saint Joseph Health System partners with HealthStream to measure and monitor its patient satisfaction. HealthStream
Research conducts patient satisfaction surveys for hundreds of hospitals in the U.S. and has a database of more than a
million patient experiences. In FY10, Saint Joseph Hospital, Saint Joseph East and Saint Joseph - Jessamine ranked
high compared to other hospitals within the HealthStream national database. Saint Joseph - Jessamine ranked in
the 94th percentile, Saint Joseph East ranked in the 86th percentile and Saint Joseph Hospital ranked in the 84th
percentile. The goal is for all SJHS facilities, individually and as a whole, to reach the 90th percentile by 2015;
Saint Joseph Hospital, Saint Joseph East and Saint Joseph - Jessamine are well on their way to reaching this target.
These national percentiles correlate with the “Top Box” percentages outlined in the graphs below. Top Box
percentages represent the percent of patients who rated the hospital a 9 or 10 (on a 10-point scale) in the overall
rating of the hospital survey question (“Overall Rating of the Hospital”). In FY10, Saint Joseph East received
an 81.9% Top Box rating, Saint Joseph - Jessamine received an 80.7% Top Box rating and Saint Joseph Hospital
received an 80.2% Top Box rating.
Also noteworthy, Saint Joseph Hospital is the only hospital in Lexington to receive HealthGrades’ Outstanding
Patient Experience Award for 2010. The award from HealthGrades, the nation’s leading independent health
care ratings organization, is based on an analysis of the federal government’s Hospital Consumer Assessment
of Healthcare Providers and Systems survey, also known as the CAHPS® Hospital Survey, or HCAHPS. The
recognition identifies those hospitals performing in the top 15 percent in the nation in patient satisfaction.
39

CARE COORDINATION NEW MODEL
In the new Care Coordination model, the RN Care Coordinators and social workers support an environment of healing grounded in our core values of reverence, integrity, compassion
and excellence. The Care Coordinators’ role has transformed by focusing on excellence in order to provide the patient with a smooth transition to the next level of care. This excellence
and transition is accomplished through the coordination and collaboration among the health care team, the patient and the patient’s family.
SJHS HOSPITALS INTRODUCE KENTUCKY’S FIRST “NO WAIT” EMERGENCY ROOMS
In June 2010 “No Wait ERs” were implemented at Saint Joseph Hospital, Saint Joseph East and Saint Joseph - Jessamine. With the new process, emergency care begins
within five minutes of a patient’s arrival time. A patient is seen by a nurse within five minutes of arrival; the patient is quickly seen by an ER nurse who is authorized
to begin the treatment needed; and a doctor examines the patient within 30 minutes.
After only four short months, the “care begins in 5 minutes” metric is being met 65% of the time, with an average of four minutes for SJH, four minutes for
SJJ and eight minutes for SJE. “See a provider within 30 minutes” is being met 60% of the time with an average of 35 minutes for SJH, 22 minutes for SJJ
and 35 minutes for SJE. Our slogan “Be Safe, Be Nice, Be Quick” has resulted in high patient satisfaction and increased ED volumes at 12% from the
previous year for SJH/SJE/SJJ Emergency Departments.
eCLINICAL REFERENCE SOLUTIONS
In March 2010, Tracey McFarland, clinical educator, worked with national CHI teams to help launch eClinical Reference Solutions, a collection
of three evidence-based references for nursing. Nurses can access an index of more than 900 skills, each with quick checklists, detailed step-bystep
instructions (including rationales and reference links), illustrations and many with video clips for reviewing a procedure. Mosby’s Nursing
Index is a journal abstract and indexing database; the index is a tool our nurses can access to perform comprehensive and systematic searches.
EVIDENCE-BASED PRACTICE (EBP) INITIATIVES
The following EBPs have been implemented:
• Acute Care Fall Prevention
• Catheter Associated Urinary Tract Infection Prevention
• Central Line Associated Bloodstream Infection Prevention
• Health Care Associated Infection Prevention
• Heart Failure Discharge Instructions,
reduce 30-day readmission
• Pain Management
• Pressure Ulcer Prevention
• Safe Patient Handling and Movement
• Surgical Never Events, WHO checklist
• Venous Thromboembolism Prevention
STAFF HIRING
In May 2009, as part of shared governance, several nursing units formed staff-led hiring committees to independently interview and select
qualified applicants for positions within the department. A committee chair and committee members volunteer to participate. The goals are to
decrease turnover, increase staff satisfaction, provide an avenue for professional growth, and allow staff to become personally invested in new hires.
One nurse was quoted as saying, “It feels really good to know that my opinion especially as a new nurse is so valued where I work.” One potential
candidate stated, “I really love how staff nurses are so involved in your unit and I would love to be a part of that.”
PRNU STAFF-LED HIRING COMMITTEE
The Prep-Recovery Nursing Unit (PRNU) has 10 staff members. The attributes necessary to contribute to a great hire are determined by the team who use
questions from the behavioral-based interview guide. In 2009, four staff members participated in the interview process of three candidates. Retention: there has
been zero turnover year-to-date. Staff satisfaction rating in the January 2010 mini-climate assessment increased from 3.38 to 3.82 using a 1-5 scale.
40

CARE BY PARENT
One of the design plans for the Neonatal Intensive Care Unit (NICU) nursery included an area for parents of infants to stay and learn how to care for their infant as well as become
comfortable in caring for their fragile infant prior to discharge. The new Women’s Hospital at SJE had the NICU on a different floor than the post-partum unit, so plans had to be
made to incorporate an area in the NICU for Care by Parent.
The Care by Parent rooms fit the needs perfectly. In looking at the space of the NICU, there was an area at the entry to the NICU, an ideal space for Care by Parent
rooms located outside the doors of the NICU. Moms can socialize with other parents or take a nap, or sleep overnight on one of the sofa beds. The interaction with
other families helps new parents gain confidence in the care of their infant and understand the processes in the NICU.
OBSTETRICS DISCHARGE COORDINATOR
The Women’s Hospital at SJE implemented a new discharge process in September 2009. The process incorporates two designated discharge coordinators,
resulting in improved overall patient satisfaction, as well as increased employee satisfaction. The overall patient satisfaction scores in the Women’s
Department were below the target of 71%. One of the primary dissatisfiers was inconsistency in discharge teaching. Adult learning methods were
implemented to the family’s level of understanding, resulting in an individualized discharge process. The patient satisfaction scores improved in the
first quarter to well over 80%.
SURGICAL SERVICES HAND-OFF-OF-CARE TOOL
Our Surgical Services educator developed a tool for our “hand-off-of-care” between Pre-Op, OR and PACU/Post-Op. The intent of the
tool is to make certain our processes ensure patient safety. Staff was educated on the tool and process. Auditing was completed to determine
compliance and weak areas were identified.
In March 2010 we educated and implemented the recommended OR work practices for preventing sharp injuries and exposures: double
gloving; blunt tip suture needles; sterile field neutral zone and safety scalpels, based on recommendations from the American College of
Surgeons.
41

Empirical Quality Outcomes
On January 1, 2010, Surgical Services went live with reporting on our compliance by using the World Health Organization’s (WHO) Surgical
Safety Checklist. The impetus of the checklist is to ensure we are performing the right surgery, right orientation (right or left when indicated),
right patient, and that we have all items needed. We have also included some core measure items to the checklist. The checklist includes all
members of the surgical team. Currently, we are consistently at 100% compliance with using the checklist.
HEART FAILURE LEADERSHIP COMMITTEE
Toni Gray, MSN, RN, RRT, joined SJH in January 2010 as our Heart and Vascular Institute Program Coordinator. Toni quickly
assembled a team to work on heart failure (HF) management. The decision to focus a strategic alignment with the caregivers
of heart failure patients and to ultimately become a certified heart failure center is the focus of the heart failure committee to
better provide continuity of care.
CLINICAL PATIENT SAFETY COMMITTEE
Concurrent quality score and improvement plans are developed and presented to the members of the Clinical Patient
Safety Committee at regularly scheduled monthly meetings. Core quality measures are reviewed with observations
and actions. Focus group updates reflect the activity toward a site-based initiative. An example of a focus group
update related to Rapid Response Team (RRT) was presented at the May Clinical Safety Committee by Dr. Barbara
Reynolds, Chairman.
Observation: the RRT focus group noticed decreased utilization of the RRT. Education in February 2010 on
activation criteria and visibility of the RRT resulted in an increased utilization in March 2010. Action: The RRT
committee is focused on improvement methods for deceased codes and review of the code process in its entirety.
The RRT committee has also recognized the need to review resuscitation response related to compliance with
advance cardiac life support guidelines. The RRT committee will coordinate physician education in the fall of
2010 to adopt new American Heart advanced life support guidelines.
Saint Joseph Hospital
Saint Joseph East
RRT calls/1000 discharges
90
80
70
60
50
40
30
20
10
0
Jul-09
Aug-
09
Sep-
09
Oct-
09
Nov-
09
Dec-
09
Jan-
10
Feb-
10
Mar-
10
Apr-
10
May-
10
Jun-
10
RRT calls/1000 discharges
40
35
30
25
20
15
10
5
0
Jul-09
Aug-
09
Sep-
09
Oct-
09
Nov-
09
Dec-
09
Jan-
10
Feb-
10
Mar-
10
Apr-
10
May-
10
Jun-
10
RRT calls per 1000 discharges
RRT calls per 1000 discharges
NURSING QUALITY COMMITTEE
The Saint Joseph Nursing Quality mission is to promote improvement in patient outcomes by engaging unit level staff.
Nurses caring for patients at the point of care are in an excellent position to influence outcomes. The primary goal is the
ongoing assessment and improvement of the delivery, quality and outcome of patient care. The scope and responsibility of
the committee is to focus on clinical quality practices at the bedside to improve overall patient outcomes.
42

THE CLOCK IS TICKING: MINUTES MATTER
In an effort to continue to decrease the door-to-inflation times for the STEMI patient, it was suggested to look at the how the RRT could assist with these patients, since every minute matters. An
interdepartmental bi-campus team from CCU, ICU, Cath Lab and ED met to discuss the potential collaboration. The process took six months and the outcomes continue to improve.
• May: Team meeting and scope outlined; training and implementation plan developed.
• June: Bi-campus RRT education offering with 98% attendance.
Door-to-inflation times continue to meet and exceed the core measure target of under 90 minutes.
Current Data: average door-to-balloon time is 68 minutes SJH, 56 minutes SJE; moving toward the goal of under 60 minutes.
A few facts that encouraged us to strive to do better:
• Each 30-minute delay in reperfusion with PCI increases one-year mortality 7.5%
• Door-to-balloon under 60 minutes, 1% 30-day mortality; door-to-balloon under 90 minutes, 6.4% mortality
DeLuca, Circulation 2004;109:1223-1225
Berger, Circulation 1999;100:14-20
• July/August: RRT orientation to ED and Cath Lab, SJH.
• September/October: RRT orientation to ED and Cath Lab, SJE.
New Knowledge Innovations and Improvements
With a passion for patient- and family-centered care and a desire to impact quality outcomes and patient satisfaction scores, Lesly Arrasmith, 3A unit manager, implemented bedside shift report. Lesly describes
the implementation process of bedside shift reporting on 3A:
It was through the Med/Surg Reinvention team that I became more aware of bedside reporting. A unit at our sister hospital in London had begun this process. The manager had noted with
an 80% compliance rate of bedside reporting that patient satisfaction had been dramatically impacted. At this time, as manager of 3A Post-Op Surgery, I was unable to impact my patient
satisfaction scores to take a positive turn. I knew it was time to try something different.
In March of 2010, I pulled in key staff members and clinical managers to talk of this new concept I had learned about. These were all staff with a high level of initiative. It was decided we
would begin with a small cycle of change. This team was educated on asking permission to include any family/significant others present in the room in the report, introducing the oncoming
nurse, what the bedside report should include in report (SBAR) format, and encouraging the patient to involve themselves in the report. A closing positive comment and introduction of the
oncoming shift is always to be included. One nurse began this report on one patient at the bedside. This went well.
During this report it was discovered by the patient, overhearing the allergies we had listed, that we had the allergies incorrect. What a great catch this was! This wonderful rumor spread
like wildfire. Most staff was eager to be able to begin as well. The next day this same nurse got a report on her entire team at the bedside. This, too, went very smoothly. She would discuss
her perceptions with the rest of the team. Such perceptions as “This will put me behind and patients will not like getting woken by report” were quickly dismissed. Because this had gone so
positively and because staff was so enthusiastic about the beginning, as manager I decided we would use a “pay it forward” concept to spread this process.
This “pay it forward” practice meant once a nurse received report at the beside she would educate the next shift nurse getting report on the process and then give report at the bedside as
assigned. This nurse would in turn do the same thing. Within two weeks my entire unit was getting and receiving report at the bedside. During manager rounds at this time, I sought feedback
about our new process. Patients and families loved that we truly were partnering with them. Patient satisfaction scores went from 59% to 71% for this quarter. This process is continued on 3A.
Other units in our facility are beginning this new process at this time.
— Lesly Arrasmith, Unit Manager 3A, Saint Joseph Hospital
43

CLINICAL COVENANT “TEAM LEO” PROJECT, ICU SOUTH
Nurses in the ICU unit at SJH, in collaboration with patient care leaders at SJH, met to discuss the current practices in the critical care areas of the hospital. A clinical covenant, Team
Leo, was conceived for a process-improvement project in the spring of 2010. ICU South, a 10-bed medical/surgical critical care unit, was selected as the unit to study because of
the varied patient population and the tenure of the nursing staff. The core committee team members were thus established, which include staff members from nursing and
leadership of ICU South; quality improvement; pharmacy; dietary; housekeeping; respiratory therapy; case management; education; administration; Critical Care
Advanced Registered Nurse Practitioners; and physicians.
An aim statement was established: “We aim to redesign existing processes and services, eliminate clinical waste and implement highly reliable, transparent,
critical care level, person-centered care using Evidence-Based Practices. The process begins with the planned transfer or admission of the patient to the unit
and ends with the patient’s discharge, transfer to another level of care or alternative care environment.”
RESEARCH USE IN PRACTICE GROUP/LEVEL OF NURSE
Bundles (IHI)
Ventilator-Associated Pneumonia
Central-Line Blood Stream Infections
Perinatal
All bundles implemented in practice areas
affected
Each initiative has an interdisciplinary
team that consists of all levels of
nurses
Intensive Insulin Therapy Post-operative open heart patients Cardiothoracic vascular unit
All levels of nurses
Pain
Pain education series and unit champions.
Research-based pain scale utilized on nursing
flow sheets
Pain team consisting of all levels of nurses
STEMI Program Door to discharge—all units affected STEMI team consisting of all levels of
nurses
Hypothermia Protocol Cardiac arrest patients arriving at the ED Hypothermia team consisting of all levels
of nurses
Pressure Ulcer Reduction All inpatient units Skin Care team consisting of all levels of
nurses
CMS Core Measures
AMI
HF
Pneumonia
SCIP
Implemented in practice areas affected
Each initiative has an interdisciplinary
team consisting of all levels of nurses
44

EVIDENCE-BASED PRACTICE (EBP)
A subcommittee of the SJH nursing evidence-based committee focused on cognition and the geriatric patient. The team, comprising Debbie Kitchen, MSN, RN, CNS, and
critical care staff nurses, focused on the critical care patient experiencing delirium. When a patient has delirium it means the patient cannot think clearly, has trouble
paying attention and is not aware of what is going on around him/her. Causes are multifactorial; to name a few: systemic illness, polypharmacy, sleep deprivation
and pain.
Prevalence and incidents of developing delirium: 20-30% of all acutely hospitalized patients develop delirium; up to 60% go unrecognized; 50-80%
of ventilated patients develop delirium; 20-50% of lower severity ICU patients develop delirium; and 10% remain delirious at hospital discharge.
Consequences include: increased hospital length of stay, increased ICU length of stay, increased ventilator time, increased cost, increased longterm
cognitive impairment, increased post-hospitalization institutionalization, and increased morbidity and mortality.
The most important step in delirium management is early recognition. If delirium is not diagnosed, it is doubtful that any efforts will be
made to reverse it. Once delirium is detected, efforts should focus on identifying the etiologies and correcting them. In January 2010
education surrounding delirium and on performing the CAM (Confusion Assessment Method) ICU assessment tool began. The first
outcome to be measured at SJH and SJE by the critical care nursing staff was if education improved nursing knowledge of delirium and
use of CAM. The ICU nurses completed the delirium pre-test/post-test to compare the nurses’ baseline educational understanding of
delirium prior to the in-service with knowledge gained after the in-service.
Practicing the CAM-ICU tool during the in-service permitted the nurses to ask relevant questions about the tool and provided nurses
with instant use of the new skills learned in the class. Overall, the educational in-service was beneficial for all ICU nurses no
matter how many years of experience the nurses had within the ICU. The difference in pre-test scores between those with less than
three years’ ICU experience and those with more than 10 years’ ICU experience was significant (p

46
INTERDISCIPLINARY RELATIONSHIPS
The Heart Failure Leadership Team for the Saint Joseph Heart Institute at Saint Joseph Hospital and
Saint Joseph East formed in January 2010 to develop a program to ensure the highest quality of heart
failure care to all patients. The team has developed Heart Failure Admission and Discharge orders,
which incorporate Evidence-Based Practice and guidelines from AHA/ACC. The HF team is also
pursuing heart failure certification by TJC and AHA “Get With the Guidelines.”
RAPID RESPONSE TEAM
The Rapid Response Team (RRT) consists of a critical care nurse, a respiratory therapist, a clinical
pharmacist and the house administrator. The team continues to address the impact on patient care and
has made changes in the RRT Standing Orders to include certain labs, EKG and IV documentation. The
team also revised the lab value “triggers” for which the team members receive a page. The next step is to
focus on monitoring and tracking data to identify any areas of weakness and celebrate areas of success.
COLLABORATION WITH UNIVERSITY OF KENTUCKY COLLEGE OF NURSING (UKCON)
Debbie Griffith, MN, CNS, collaborated with UKCON DNP candidate on a study being conducted
to include SJH and SJE heart failure patients. The title of the study was “Testing a Brief Cognitive
Therapy Intervention for Depressive Symptoms in Patients with Heart Failure.” The objectives of the
study were:
1) Participants will describe the impact of depression on morbidity/mortality in patients with
heart failure. 2) Participants will be able to list two techniques taught in a brief cognitive therapy
intervention (thought-stopping and affirmations). 3) Participants will describe whether or not a brief
cognitive therapy intervention improves outcomes in patients with heart failure who have depressive
symptoms. The results of the study, presented at the local Bluegrass Chapter of AACN, showed that
the intervention patients had fewer cardiac events. Since the study has received funding to extend the
dissertation study, the collaboration with UKCON will continue this fall.
INTERNAL COLLABORATION
2 East continues to define its role in the care of the heart failure patient and become recognized as the
“Heart Failure” unit at SJH. Active ongoing collaboration is multidisciplinary, focusing on tailoring
care to meet not only core measure requirements, but also the American Heart Association’s “Get With
the Guidelines” recommendations.
RESEARCH
Celestine Trudy Gochett, Ph.D. (c), AOCNS, CCRP, received a J. Patrick Barnes Grant through the
DAISY Foundation to conduct the Side Effect Index Efficacy study.
Study title: The Cancer Treatment Side Effect Index: A Pilot Study of Efficacy
Study status: IRB approval, funded by the J. Patrick Barnes Grant through the DAISY Foundation.
Principal investigator names: Celestine Gochett, ARNP, AOCNS, CCRP;
Judy Schreiber, Ph.D., RN
Principal investigator credentials: Celestine Gochett, Ph.D. (c), AOCNS, CCRP
Role of nurses: Assist with evaluation of the index content validity by determining
patient report of the presence of 13 listed formative indicators.
Study scope: Internal to a single organization.
Study type: Original research; mixed method cross sectional design.

Honoring Our Daisies
Congratulations to the FY10 recipients of the DAISY Award for Extraordinary
Nurses throughout Saint Joseph Health System. Pictured are several recipients who
attended an appreciation dinner September 7, 2010, along with nursing leaders,
members of the executive team and CEO Gene Woods (front, center).
47

SAINT JOSEPH - BEREA
SAINT JOSEPH EAST
FLAGET MEMORIAL HOSPITAL
SAINT JOSEPH - MOUNT STERLING
48
“Thanks to all of you for the great
care and kindness for my wife
when we had a big car accident.
The doctor, the nurses and the staff
all gave their great professional
effort to help her and gave us a
lot of assistance and comfort. I
will not forget how you did this
wonderful work for us and it
will always be in my testimony to
others as an encouragement.”
–an out-of-state Emergency
Department patient
“This letter is in regard to the care
our mother-in-law received during
her recent stay. She has been in
and out of several hospitals. I have
never seen a more caring, loving,
kind and considerate staff. Even
though she can be difficult at times,
they always attended to her needs
with compassion and a smile.”
–a patient’s family member
“During my stay, I was blessed
with two of the best nurses I
have ever encountered in my life,
Jenny Pulliam and Melissa Doss.
They explained everything clearly,
researched medications and
procedures, advocated to doctors
on my behalf, organized labs,
dressing changes and medication
regiments in order to allow me
to sleep as well as having the best
attitudes I’ve ever witnessed in a
hospital setting.”
–a Med/Surg patient
“My mother was at Saint Joseph
East recently for surgery. Following
her procedure she was faced with
some unexpected complications.
She experienced a lot of
uncontrollable pain. Mary Beth
[Keeton] was my mother’s ‘light.’
She was able to keep my mom calm
and help her work through the
pain.” –a Med/Surg patient
“If you have to have a surgery,
this would be the place to go...
I knew that I was in competent
hands. Michelle Osborne,
Christy [Horton], nurses and
aides both were hands-on with
my care. I am much appreciative
of a night nurse named Teri
[Whitehouse], who I believe
saved my life. The relationship
with the entire staff was very
meaningful and gratifying to us.”
–a Surgery patient
“I am writing to compliment
you and your staff on the care I
received while a patient on your
skilled nursing unit. Your staff
anticipated my needs, were always
pleasant and cheerful, unlike the
care I received in other hospitals.
I will recommend Flaget to
anyone at any time.”
–an RN of 40 years, concerning her
first experience as a patient at Flaget
“I have traveled extensively in
the U.S. and Europe and due to
asthma have had many ER visits.
Saint Joseph - Mount Sterling’s
ER personnel were the most
conscientious, courteous and
thorough of any place I’ve been
for treatment. Kim Henson, Kim
Hamilton, Dr. Forrester, Esther
[Bloom] and Edwinna [Grayson-
Melton] are the best.”
–an Emergency Department patient
“I would, and do, highly
recommend the hospital. You
could tell the concern, caring and
patience from the nurses. You
should be very proud of them,
especially Phyllis Martin, Nathena
Keeton, Teresa Tufano and Robert
Bashford. Their care, personality,
smiles and bedside manners should
be recognized.”
–a Med/Surg patient

SAINT JOSEPH HOSPITAL
SAINT JOSEPH - LONDON
SAINT JOSEPH - MARTIN
SAINT JOSEPH - JESSAMINE
“We would like to express our
sincere appreciation to each person
who attended to the needs of our
mother. Everyone was very helpful,
knowledgeable and caring in all
aspects of meeting the needs of the
patient and/or family. We praise
your dedication and resolve in the
performance of your many and
varied duties.”
–a 4A Medical patient
“Ms. [Pam] Gill, you were working
and caring for my beloved wife
whose illness had progressed
beyond the point of recall. Mixed
with the personal tragedy of her
loss was the awareness of a nurse
who cared for her wonderfully
and kindly, attending to her and
her family with warm humanity.
You were a bright light on dark
days and a person whose care and
skill I will never forget.”
–a 4A Medical patient’s husband
“Marcella [Bruner], you made a
difficult time just a little easier.
You always made me feel like I was
just as important as all your other
patients even though I know many
were so very sick. I will always
remember your kindness.”
–a Med/Surg patient
“Christy [Barger] was so very
compassionate. She showed
so much concern, and has a
wonderful personality.
She gave us hope.”
–an Outpatient Surgery patient
“Everyone provided excellent
care, but especially Sara Craft
and Sara Fitch, they could
always cheer him up.”
–a Med/Surg patient’s
family member
“Cathy Johnson, RN (Med/Surg)
is a nurse who has the caring,
positive attitude all nurses should
have. She always has a smile no
matter what the need is for the
patients, visitors or co-workers.
Cathy gives extraordinary service
and compassionate care.
She is a great nurse.”
–a fellow colleague
“The nurse Sherry Schwarz
was great. She was helpful,
courteous and polite.”
–an Emergency Department patient
“Ryan [Goble] was the best
nurse I have honestly ever had.
Please keep him or give him a
raise or something!”
–an Emergency Department patient
“Reception and all nursing
personnel were all professional
and exhibited genuine care
during my treatment.”
–an Emergency Department patient
“My nurse Stacey Puckett
was really nice and took really
good care of me.”
–an Emergency Department patient
Living Our Core Values

YOU’RE NEVER FAR FROM THE BEST CARE. ®
Saint Joseph - Berea | Saint Joseph East | Saint Joseph Hospital | Saint Joseph - Jessamine
Saint Joseph - London | Saint Joseph - Martin | Saint Joseph - Mount Sterling | Flaget Memorial Hospital
www.SaintJosephNurses.org