NURSING AT McLEAN

Better Patient Care through Research and Career Development

by Margaret Knight, Phd, PMHCNS-BC

Understanding that research and career development improve patient care, the McLean Hospital Administration has sought to fortify both within Nursing and Social Work through the hospital-wide Strategic Planning process, which began in 2008. Initially, Linda Flaherty, Senior V.P. for Patient Care Services and Joan Cottler, the previous Director of Social Work, organized interested clinicians from both departments. Over 30 individuals with varying degrees of research experience participated, and from this initial group the “Interdisciplinary Research Committee” became the working group for this Strategic Planning Initiative.

First steps   The committee surveyed other organizations about their working research groups involving nursing and social work. Although many local organizations had active nursing research committees, none had social work research committees, and no organization reported an interdisciplinary research group that involved either discipline. We drew from the experience of the few organizations with existing nursing research committees and identified four initial focus areas for our committee: developing a mission, introducing the committee to the Hospital community, promoting an education program for the clinical staff, and establishing a venue to showcase local and regional research and scholarship in both disciplines.

Mission   Our mission is to promote scholarship and conduct research toward improving the quality of life for both individuals with psychiatric disorders and their families. We are dedicated to the education and advancement of nurses, social workers, and trainees in these disciplines, and encourage them to conduct clinical, health systems, and outcomes research. After developing our mission, we introduced ourselves to the Hospital community at the 2009 Ice Cream Social.

Research Education   The Research Education Program, which is designed to help committee members and other interested clinicians to restore and enhance their existing knowledge of the research process, required considerable planning and organization. Over several months, we developed a program to walk participants through the research process from problem identification through method selection and data analysis. While we envisioned committee members identifying clinical problems for study, we also wanted to empower clinical staff with the skills and knowledge necessary to assume adjunctive roles in ongoing projects or trials within their clinical programs. Participation at any level may build a clinician’s interest and, potentially, lead to a discipline-specific perspective about a clinical problem.

Research Forum   The Research Forum invited local and regional clinical researchers to present and discuss their work. While it is attended primarily by nurses and social workers, the forums are open to the Hospital community, and a number of individuals have attended from other disciplines. We have hosted four Forums to date. The next Forum is scheduled for Wednesday, February 23rd. Dr Black from Boston College and Dr Polcari from Northeastern University and McLean Hospital will highlight some of their research with children.

The importance of organizational support   The Administration’s strong support has been a significant factor in the Committee’s success throughout the development and implementation process. The hospital has allocated space and resources, and initiated Career Development Awards. In 2009-2010, three awards were presented to clinical researchers to facilitate proposed research projects. These financial grants allow clinicians to “buy” time away from clinical responsibilities to develop and implement their projects.

Interdisciplinary Connections   Since the inception of the Interdisciplinary Research Committee, the Department of Nursing has strengthened connections with local universities. Four new clinical research proposals have been developed with faculty. They have been credentialed by the Hospital as principal investigators or co-principal investigators. The Social Work Department has initiated similar collaborations. These linkages foster continuing development of research projects.

Visiting Scholar Program   The Department of Nursing initiated this program to increase the visibility of clinical research and scholarship in nursing. Kathleen Delaney, PhD, RN, from Rush University in Chicago and Sandra Talley, PhD, RN, from Yale University both visited this year. Melissa Sutherland, Phd, RN, from The Boston College School of Nursing, has provided ongoing consultation and support for the nursing research team studying risk factors associated with the metabolic syndrome. Planning for the 2011 Visiting Scholars are currently underway.

Collectively, these activities have enhanced understanding of the research process and have resulted in the development of several approved research projects. From January 2005 through December of 2008, there were two research projects led by nurse Principal Investigators. Guided by the strategic planning process and the Interdisciplinary Research Committee, many clinical staff members are now involved in ongoing research. Since January 2009, eight proposals have been submitted and approved in which a nurse or social worker is the Principal Investigator.

All of the psychiatric clinical disciplines are in great need of evidence-based research and practice, but carving out time to conduct research in inpatient, outpatient, residential, and partial hospital settings is a challenge. The initiatives undertaken by Interdisciplinary Research Committee enhance opportunities for clinical staff to develop or refresh their research knowledge and to structure time for research-related activities. The time is right to pursue this essential aspect of patient care.

09.2011