Healthcare organizations have learned to quickly adapt during the pandemic — the HILNNY conference has too. We’ve updated our format to an innovative, Lean approach to allow easier, more flexible access to programming relevant to your everyday life. This year’s conference will be broken up into bite-size sessions over three months to maximize impact and minimize waste.

Day 3: Friday, Dec. 3

Noon - 12:15 p.m.

Poster highlights

Poster 1

Development of an intensive care unit within a post-anesthesia care unit

Shea Beiter, BSN, RN, CCRN, CPAN, Senior Level 3 Registered Nurse, Post–anesthesia Care Unit, University of Rochester Medical Center–Sisters of Charity Hospital

Samantha Dandrea, RN, BSN, Assistant Nurse Manager, UR Medicine–Strong Memorial Hospital

Mary K. Rogers, RN, BSN, CCRN, CPAN, Assistant Nurse Manager, UR Medicine‐Strong Memorial Hospital

Poster description

During the COVID-19 pandemic, Strong Memorial Hospital increased capacity within their critical care service. The post-anesthesia care unit developed a pop-up ICU that cared for six ICU level-of-care patients for 46 days. The nurses within the PACU department showed resiliency by caring for a different population of patients during the time of need. They took on the challenge of caring for chronic ICU patients day in and day out and learned from the situation.

Poster 2

Staying the course: Maintaining safe environments while reopening ambulatory services amidst COVID-19

Linda Greene, RN, MPS, CIC, FAPIC, Director, Infection Prevention, UR Medicine–Highland Hospital

Allison Norenberg, MSc, Manager, Performance Improvement, UR Medicine–Highland Hospital

Ann Marie Pettis, RN, Director, Ambulatory Infection Prevention, UR Medicine‐Highland Hospital

Mary Lynn Siegel, RN, Clinical Quality Project Manager, UR Medicine–Highland Hospital

Poster description

In March 2020, ambulatory services everywhere shut down partially if not completely. At the end of April, New York state announced the reopening of services. At Highland Hospital, an affiliate of UR Medicine, the infection prevention and quality performance improvement teams united and established a common vision to support 32 ambulatory clinics within 10 days to safely reopen clinics. Each site worked directly with a member of each of the IP and QPI teams.

Together, the teams leveraged Lean/Six Sigma and basic quality improvement methods like process mapping and gemba walks, as well as human factors engineering techniques (built environment maps). To continue supporting frontline teams and facilitate bottom-up innovation and learning, we created a weekly ambulatory redesign networking call where representatives form support teams and share new changes in policies; then clinical staff from any level of ambulatory clinic ask questions and share learning. From this, new and standard practices emerged across clinics, such as daily improvement huddles as a tactic to facilitate local change, learning, improvement and innovation. The central ambulatory learning and innovation network call continues to consistently engage more than 40 local leaders and organizational support staff.


12:15 - 1 p.m.

Concurrent sessions

Session 1

Resilience and recovery: Leader rounding at Mount Sinai Beth Israel

0.75 hours for CNE/CPHQ credits

Diana Grillo, Patient Experience Coach, Mount Sinai Beth Israel

Nicole Porto, Associate Director, Patient Experience and Engagement, Mount Sinai Downtown

Shria Raghunathan, MHA, Process Improvement Facilitator, Health System Operations, Mount Sinai Health System

Session description

COVID-19 both reinforced and enhanced leader rounding at Mount Sinai Beth Israel. Previously, MSBI leaders rounded in an ad-hoc manner and were fixated on solving problems for their staff rather than coaching staff through the problem-solving process.

During the pandemic, leader rounding was appreciated by the staff on the units, as indicated through employee surveys, but leaders found themselves increasingly fire-fighting and problem-solving due to the chaos of the pandemic.

After the surge, the patient experience team was able to put some structure to leader rounding by creating leader standard work using a visual management board that indicates which leaders are rounding on what units and when. They created a regular cadence for leader rounding (Thursdays at 11 a.m.), prepped the leaders beforehand and debriefed the rounds afterwards.

This session will focus on the effect of these changes including promoting resiliency and engaging staff on topics like vaccination status, employee engagement surveys and burnout and training that will develop leader roles as coaches by shifting their mindset from reactive problem-solving to proactive coaches of problem-solvers throughout the organization.

Learning objectives

  • Describe the importance of structured leader rounding in a culture of continuous improvement, creating accountability and transparency between nurses and leadership.
  • Review the difference between reactive and proactive problem-solving in improving both quality and operational metrics.
  • Explore the importance of coaching in developing problem solvers throughout an organization.

Session 2

Perioperative flex team

0.75 hours for CNE/CPHQ credits

Heidi Leonard, BSN, RN, CAPA/CPAN, Senior Level III, PACU/Perioperative flex team, University of Rochester/Strong Memorial Hospital

Kristen Evans, RN, CPAN/CAPA, Perioperative flex team, University of Rochester/Strong Memorial Hospital

Session description

This innovative project was designed to improve staffing holes, vacancies and staff satisfaction within the perioperative service of our hospital. The goal was to create a team of nurses, cross-trained to care for patients in all phases of the perioperative experience except for the OR. These highly flexible and skilled nurses provide care in pre-anesthesia, phase 1, phase 2 and discharge within three units of the main hospital and one outpatient surgical center, with a goal to expand as the service expands locations.

Our pilot project ran October 2020 through April 2021 with five nurses. We now have nine full-time nurses on our team. Anonymous polling of management and flex team nurses provided positive feedback regarding increased nursing satisfaction. The flex team filled 88% of posted holes in the first time block with four nurses.

Learning objectives

  • Observe the possible causes of staff vacancies, staffing shift deficiencies and low nursing satisfaction.
  • Identify methods of incentivizing and creating a broader nursing role within the perioperative service.
  • Discuss methods to initiate and train a Perioperative flex team of nurses.

Session 3

Improving patient and staff safety; using Lean tools to enhance ED and psychiatry collaboration

0.75 hours for CME/CNE/CPHQ credits

Steven Corey, RN, MS, Director, Acute One Emergency Services, St. Peter’s Health Partners

Session description

During the pandemic there was an increase in new mental and behavioral health patients. As that volume increased, availability of services decreased. COVID-19’s impact on staffing continues to affect our ability to provide timely and efficient care.

This session will discuss this problem and offer possible solutions.

Learning objectives

  • Discuss how Lean tools and methodology can help build a coalition of stakeholders and support creativity in providing solutions to improve patient flow in the ED.
  • Review the data addressing the burden mental health has on the emergency department and patients.
  • Demonstrate how data-driven problem solving’s focus on process, not people, improves collaboration among clinicians and staff.
  • Describe how Lean interventions can support the multidisciplinary teamwork necessary to serve psychiatry patients in the ED, maintain focus on patient outcomes, reduce staff burnout and promote staff safety.