Registered nurses are well-positioned to take a leadership role in improving the quality and safety of care in the hospital. They are the ones who spend the most time caring for patients at the bedside and are often best equipped to drive change to prevent harm and to deliver high-quality care.

For more than a decade, the Betty Irene Moore Nursing Initiative helped RNs throughout the San Francisco Bay Area and greater Sacramento deliver high-quality, safe care. With our grantee partners, we implemented evidence-based practices to prevent harm and measurably improve nursing-related patient outcomes in local adult acute care hospitals. We targeted outcomes which are preventable and can cause the greatest harm to patients, such as sepsis mortality, falls, bloodstream infections and intensive care unit delirium.

The core of our support and partners’ work included:

  • use of data to identify issues and measure improvement,
  • development of RN clinical skills and leadership capabilities, and
  • alignment of improvement efforts with organizational and policy priorities.

We supported and worked with all 53 adult acute care hospitals in the San Francisco Bay Area and Greater Sacramento to improve patient outcomes across 17 different conditions. As a result, 83 percent of San Francisco Bay Area hospitals substantially improved patient care outcomes, including:

  • 75 percent reduced sepsis mortality rates by an average of 37 percent, resulting in 1,000 lives saved annually.
  • 78 percent reduced central line-associated bloodstream infection rates to near zero.
  • 62 percent reduced hospital-acquired pressure ulcer rates by an average of 41 percent.

And in Sacramento, 80 percent of hospitals achieved evidence-based improvement thresholds for at least three key causes of mortality, such as sepsis and surgical complications.

Check out our infographic on the initiative's results.

To sustain these efforts, and to ensure broader and continued improvements, we created collaborative infrastructures so that hospitals could share knowledge – both successes and learnings – with one another. One such collaborative, known as The Bay Area Patient Safety Collaborative or BEACON, involved 100 percent of San Francisco Bay Area hospitals and helped accelerate the dissemination of evidence-based practices and promoted peer-to-peer learning and information sharing. Another is the Avoiding Readmissions Collaborative or ARC, whose aim was to reduce readmission rates.

Part of our quality efforts focused on helping hospitals to achieve Magnet Recognition, a nationally-recognized designation program for nursing excellence. Less than seven percent of all hospitals in the country receive this prestigious recognition. When we started the nursing initiative, there were no Magnet hospitals in the five-county San Francisco Bay nor in Greater Sacramento. We supported five hospitals to reach this status, including El Camino Hospital; Stanford Hospital and Clinics; Washington Hospital Healthcare System, University of California, San Francisco Medical Center; and University of California, Davis Medical Center.

We invite you to watch this brief video to learn about a few successful quality improvement efforts developed with our hospital partners. In it, nurse leaders, frontline clinicians and administrators discuss their unique approaches to improving patient safety and care; and the impact their efforts have made across their hospitals and hospital systems.



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