"Service line" is a common phrase used in academic medical centers like Jefferson. "It improves system level performance for the clinical service by involving the right combination of people, processes, and technology to drive the best results for patients," says Mary Ann McGinley, PhD, RN, the Senior Vice President for Patient Services and Chief Nurse Officer at Thomas Jefferson University Hospital.

The Department of Surgery is fortunate to have a clinical administrator devoted to driving change in this way. Eleanor Gates, RN, MSN, the Hospital's Vice President of Neuro/Surgery and Trauma, also serves as the Director of Surgical Nursing.

This collaboration has impacted all aspects of the surgical patient’s experience, from operating room procedures...to dietary and pharmacy concerns.

"My role is largely as a facilitator to accomplish our goals and outcomes," says Ms. Gates. She meets routinely with Surgery Department Chair, Charles Yeo, MD, and Florence Williams, Director of Clinical Operations for the Department (see On the Job, page 3) to evaluate the entire continuum of care for surgical patients: examining efficiencies, reporting on downfalls, and making recommendations. This collaboration has impacted all aspects of the surgical patient’s experience, from operating room procedures and information systems to dietary and pharmacy concerns.

Ms. McGinley credits the Department of Surgery for fostering open communication and collaboration with the nursing staff through multidisciplinary educational forums and rounding with attending physicians. Ms. Gates adds that this has improved patient care.

Jefferson also employs clinical nurse specialists, who bring the best clinical practices into the patient's plan of care and additionally guide the more novice nurses. "Surgery's alliance with these clinical specialists, who become embedded with a given team of physicians, has been critical," Ms. McGinley explains.

This collaboration is reflected in a number of hospital initiatives, including:

• The Jefferson Rapid Response Team – which offers bedside care for the patient whose condition is at risk of rapid deterioration.
• Logging Critical Care Unit activities online, so that physicians can access vital signs easily.
• Creating teaching space in the Intensive Care Unit where attendings, residents, nurses, and students can evaluate cases.

"Surgery's commitment to areas beyond their traditional realms of responsibility — and the reciprocal interest of Nursing in the details of the surgical endeavor — have created a very successful partnership," says Ms. Gates. Ms. McGinley adds that "in many ways, this inter-departmental relationship is a model for the entire institution."