EP - Exemplary Professional Practice

Exemplary Exemplar

EP33EO:  Quality Care Monitoring and Improvement-Describe and demonstrate how the allocation and/or reallocation of resources improved the quality of nursing care.

Background and Purpose:

In an effort to enhance patient engagement and health education, Jersey City Medical Center subscribed to a web-based education platform named Emmi Solutions™ (See attached invoice & expense report).  The Emmi Solutions™ program was implemented in an effort to reinforce teaching, engage patients and families in their health condition and plan of care, and tackle the barrier of low health literacy within the patient population.  The program platform offers multiple interactive audiovisual, simple language lessons that can be assigned by staff to be viewed by patients on any computer or mobile device with internet access. The program allows nursing staff to assign multimedia video-based education to patients in preparation for surgical procedures, upon admission, and throughout their stay.

As part of the strategic plan for patient engagement, and nursing, Emmi Solutions™ was implemented in stages hospital-wide beginning in June 2012. The pioneers for this initiative included the 6W medical surgical unit, Emergency Department, Same Day Surgery and Preadmission Testing. Progress was tracked monthly based upon the total number of programs issued to patients and total number of programs viewed by patients. That information was utilized by the team to guide their choices to continue with the existing process, or to make modifications based upon the feedback received.  After collecting six months of baseline data, the following goals were established by the team:


  • Maximize standardized patient education house-wide through use of EMMI Solutions to achieve greater than 400 programs issued per month.
  • Meet or exceed Emmi usage as compared to facilities of similar size and population nationwide
  • Increase satisfaction scores on 6E telemetry unit to exceed the 50% top box score for nurse sensitive questions
    • Communication with nurses
    • Nurses treated you with courtesy and respect
    • Nurses listen carefully to you
    • Nurses explain in a way you understand
    • Info regarding symptoms and problem to look for
    • Good understanding of managing health
    • Understood purpose of taking medications


Name: Title
Rita Smith Rita Smith DNP, RN, NEA-BC CNO
Nicole Sardinas MSN, RN, Process owner/contract holder
Colleen Masterson BSN, RN Nurse Educator
Chaya Lidor MSN, RN, CNL Nurse Educator (project lead)
Michelle Lopez MSN, RN ED Director
Kim Palestis BSN, RN ED Manager
Mina Yi,  BSN, RN Staff nurse
Regina Pena, BSN,  RN Staff nurse
Khulud Adem Patient  Engagement Coordinator
Suzanne Nardone Patient Engagement Coordinator


Methods and Approach:

After reviewing the data the team decided to prioritize patient assignments to those with the following conditions: acute myocardial infarction, congestive heart failure, pneumonia, chronic obstructive pulmonary disease, coronary artery bypass surgery patients, and diabetics. Nicole Sardinas MSN, RN, Director of the Education Center of Professional Development designed a strategic plan to address this change (see attached strategic plan). The Emmi Solutions™ program was rolled out in stages to additional units who serviced this patient population. Patients, physicians, nurses, and case managers work in collaboration to identify priority learning needs and assign lessons to the patient to be viewed and discussed with their support team of family and or friends. Although lesson could be assigned to patients based on any learning need, the nurses were encouraged to assign specific modules as part of the patients’ plan of care.

A pilot was initiated on 6E telemetry unit to identify if the use of Emmi Solutions™ increased HCAHPS scores above the 50% top box score for the nurse sensitive indicators. Mina Yi RN, BSN was assigned to take the role of education nurse. Her role was to assess, disseminate, and address patient education needs. She also focused on communication and providing patient support for a clearer delivery of communication as well as more engaged listening.

Time line

April 2013

Process was developed to track outcomes specific to patient diagnosis through Emmi Solutions™

Established monthly goals for patient assignments

Emmi Solutions™  program was expanded to the cardiothoracic unit

March 2013

Emmi Solutions™  program was expanded to 6E telemetry unit, education provided to nursing staff

May 2013

Educated Staff to focus on Key diagnosis (See attached sign in sheet)

Increased awareness of Emmi Solutions™ by discussing it in RN orientation and Patient Care Coordinator training

Developed “RX pad” resource with available courses for selected diagnosis  (See attached example of RX pad)

5 additional computers and carts ordered for nursing units

Emmi Solutions™  program was expanded to 6E telemetry unit, education provided to nursing staff

July 2013

Emmi Bundles developed for nursing staff  (See attached list of bundles)

Emmi Solutions™  program was expanded to 5E observation unit, education provided to nursing staff

September 2013

Emmi Solutions™  program was expanded to 7E medical Surgical unit, education provided to nursing staff

October 2012

Mina Yi, BSN, RN takes on role of education nurse, pilot program begins on 6E

November 2013

Emmi Solutions™  program was expanded to 7W medical Surgical unit, education provided to nursing staff

December 2013

Emmi Solutions™  program was expanded to Critical Care, education provided to nursing staff


Measurements & Outcomes:

Since initiation of the Emmi Solutions™ program in July 2013, Jersey City Medical Center has issued over 10,500 web-based learning programs to our patients.  Nursing has embraced the program and increased communication with patients to engage and provide the necessary tools and information in preparation for discharge for comprehensive disease management. Due to the dedication of JCMC’s nursing staff the number of programs issued far exceeds the goal of 400 per month. Emmi Solutions™ is now normal workflow for patient education on all available units. For example, in 2013, 53% of patients started the Emmi Solutions™ program, compared to a15% startup rate in hospitals of the same size and patient population nationwide. Due to these statistics JCMC has now become Emmi’s “model of success” for exceeding the targeted baseline numbers set out by the organization. In addition, patients who have viewed the Emmi Solutions™ program report that they are 97% more likely to improve their health management. Please refer to the data below.

2013 Survey of patient who participated in Emmi Solutions™ program

* For additional results please refer to attached survey results