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Empowering recovery: Optimizing postoperative care for mastectomy and lumpectomy patients

As the demographic of breast cancer patients continues to get younger, they face not only physical challenges from surgery but also significant emotional distress. Same-day surgeries, such as lumpectomies and mastectomies, can leave patients grappling with feelings of anxiety, fear, and body image concerns. Navigating the uncertainty of recovery, combined with emotional and physical healing, can be overwhelming for both patients and their families.

In response to these challenges, the Pre and Postoperative Unit-Based Council (UBC) developed the “Breast Pack” (BP) Program, designed to provide holistic, compassionate care throughout the recovery process. Developed by the UBC committee, this initiative aims to offer both practical and emotional support to patients after surgery, helping them feel comforted and cared for during their recovery journey.

The BP is filled with items that address both the physical and emotional needs of patients. It includes a specialty-made breast pillow with pockets to hold the drain tube(s) and bulb(s), ensuring comfort while in a vehicle and at home. Other items include cozy socks, lip balm, a limb alert bracelet to prevent complications, and aromatherapy to soothe postoperative nausea. The pack also provides educational materials and resources for breast cancer support groups, offering patients a sense of connection and emotional reassurance during this difficult time.

To further enhance care, nurses make a follow-up post-operative phone call to each patient, checking in to answer any questions, discuss pain management, and provide additional resources. This compassionate outreach ensures that patients feel supported throughout their recovery, fostering trust and confidence in the care they are receiving.

By combining evidence-based practices with compassionate care, the BP program offers a comprehensive, patient-centered approach that not only improves physical recovery but also supports emotional well-being. Nurses are central to this initiative, helping to reduce anxiety, enhance recovery, and ensure a positive overall patient experience.

 

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Discharge Lounge

We are thrilled to share the success of the Discharge Lounge at KP Modesto, which officially opened on August 12, 2024. This initiative has been a game-changer in enhancing patient flow and optimizing care delivery.

At the start of the year, our average discharge time from the inpatient area was 170 minutes. Thanks to the Discharge Lounge, we are now approaching our target of 120 minutes, with October averaging just 129 minutes. Month by month, we’ve seen significant progress. This improvement has enabled us to alleviate pressure on the inpatient areas, creating more capacity for patients awaiting admission from the Emergency Department or recovery room. The current process is interdependent on the availability of light duty RNs which has allowed the staff to have a valuable role in helping our members. Some key items that they have been able to provide to members and their families are important readmission prevention strategies such as going to obtain their prescribed medications and the education that goes along with those medications. The key factor that these nurses can provide is a more thorough discharge teaching to allow the primary RN to assist with other throughput strategies with their patient assignments.

The Discharge Lounge is designed to offer a welcoming hospitality area for patients who are ready for discharge but delayed for “simple” reasons, such as waiting for transportation. With comfortable seating, TV, books, crossword puzzles, and light refreshments, the space ensures patients are cared for in a comfortable environment until they can leave the medical center safely.

Our dedicated staff have been equipped with tailored communication tools to explain the lounge’s purpose effectively, and we’ve developed a comprehensive Playbook to support other facilities interested in adopting this best practice.  Thank you to our fellow NCAL facilities that have pioneered this process.  We are excited to see what our future average minutes will be as we continue to apply the PDSA process.  Stay tuned!

Nurses smiling from the Modesto Medical Center

Celebrating the Golden Hour success in our NICU: A year of achievement

As we reflect on 2024, we are filled with immense pride and gratitude for the incredible achievements we’ve made in our NICU. One of the most significant milestones this year has been the success of the Golden Hour program, a direct result of the unwavering leadership and dedication of our NICU leadership team.

Thanks to their visionary approach and commitment to improving care from the very first moments of life, our team has delivered exceptional results for our smallest patients and their families. By championing evidence-based practices and fostering a culture of collaboration, we have not only enhanced patient outcomes but also strengthened the bond within our team.

Our leadership team’s commitment to building a Magnet culture has been instrumental in this success. Through continuous professional development, fostering an inclusive environment, and empowering every member of our team, we’ve created a place where excellence thrives. This year’s achievements are a testament to the power of strong leadership, innovation, and a shared passion for improving the lives of those we care for.

A sincere thank you to our NICU leadership team and every member of our NICU family for the dedication and perseverance that made this success possible. Together, we’ve made a lasting impact, and we look forward to continuing our journey toward excellence in 2025 and beyond.

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Building community and confidence: Volunteering at the Special Olympics

On October 6, 2024, Rajat Sethi, Nursing Professional Development, Operations Coordinator and Sukhie Kaur, DNP, RN, Director Nursing Professional Development had the opportunity to volunteer for the Special Olympics in Northern California (SONC). The Special Olympics provides athletes with physical and intellectual disabilities the chance to compete, build confidence, and form lasting friendships. The focus of the event is not solely on winning, but on creating a community where every athlete is treated with respect and honor. Athletes, ranging in age from 17 to 73, gain self-confidence through teamwork and competition, realizing they are not alone in facing their challenges.

A key element that makes the Special Olympics special is the dedicated group of volunteers who make the event possible. These volunteers handle everything from organizing to running the events. Rajat and Sukhie volunteered as Medics, assisting athletes who might get injured or need extra care during the competitions. They were responsible for ensuring the athletes’ safety and offering support if any injuries occurred, helping them recover and get back on their feet.

This experience provided valuable insights for Sukhie. While familiar with minor injuries in athletic settings, she quickly realized the athletes in the Special Olympics had different needs. They required more time to recover and more immediate assistance when they fell. Hydration also became a challenge, as these athletes, unlike professional athletes, could not push their bodies to the same limits due to their physical and intellectual disabilities. The experience proved humbling for Sukhie, and she felt immense gratitude for the opportunity to serve and make a positive impact in the lives of these inspiring athletes.

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Perioperative national certification review courses

In 2024, Central Valley Perioperative Services took significant steps to support the professional growth and development of their nursing team by sponsoring local national certification review courses. These courses, aimed at preparing nurses for the Certified Nurse Operating Room (CNOR) and Certified Post Anesthesia Nurse (CPAN)/Certified Ambulatory Perianesthesia Nurse (CAPA) exams, were held at Modesto Medical Center.

The CNOR review course, attended by 15 Modesto operating room (OR) nurses in June, and the ASPAN review course, which attracted 49 nurses from across California in August, provided a unique opportunity for participants to enhance their knowledge and prepare for national certifications. These specialized courses are not only a step toward professional advancement but also a testament to the nurses’ dedication to providing the highest quality care.

Through these efforts, four nurses in the Central Valley Perioperative Department achieved National Certification this year. Genise Hardman, RN CNOR (Modesto OR), and Christina Gin-Salvatoreli, RN CAPA (Manteca PACU), Eric Advincula, RN CNOR (Modesto OR), and Raquel Pineda, RN CPAN (Manteca PACU).

This achievement reflects not only their commitment to excellence but also the continuous pursuit of knowledge and growth within the nursing profession. These newly certified nurses exemplify the core values of quality care and ongoing professional development, setting a high standard for their peers and ensuring exceptional patient outcomes across the region.

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Mentoring and Middle Management Institute

Christopher (Chris) Navalta MSN RN, Nurse Manager at Kaiser Permanente Modesto Medical Center, is advancing his professional development through 2 significant programs focused on leadership and operational excellence.

Chris recently graduated from the Middle Management Institute offered by the University of California, San Francisco. This prestigious program is designed to empower nurse managers with the skills and knowledge necessary to excel in leadership roles. By connecting with industry peers and engaging in comprehensive training, Chris is expanding his capabilities in strategic decision-making, team leadership, and fostering a collaborative work environment. The program’s focus on innovative approaches to management is equipping him with tools to enhance team performance and drive improvements in patient care.

In addition, Chris participated in the Kaiser Permanente Mentoring Program, where he was paired with Gertrude Tiangco-Alba, the Associate Chief Nurse Executive of Kaiser Permanente Roseville. Through this mentorship, Chris engaged in monthly meetings to set and evaluate goals aimed at improving his communication and operational expertise. This collaboration offers invaluable insights into effective leadership practices, enabling Christopher to implement strategies that support staff growth and enhance departmental efficiency.

These initiatives align with Chris’ broader professional goals of creating a supportive and thriving work culture. His dedication to continuous learning underscores his commitment to leading with purpose and making a meaningful impact on the teams and patients he serves.

By participating in these programs, Chris is not only enhancing his personal leadership journey but also contributing to the advancement of nursing management practices. His efforts reflect his passion for driving excellence in health care and fostering a culture of growth and innovation.

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The Healthy Room Project

On February 1, 2024, Kerndeep Gill, Administrative Coordinator IV in Nursing Professional Development, and Sukhie Kaur, DNP, RN, Director of Nursing Professional Development, volunteered for the Healthy Room Project, a community policing initiative aimed at creating safe spaces for at-risk children in vulnerable communities. The program has positively impacted over 250 children with the help of 700 police officers and 2,500 volunteers, working to improve the well-being of underprivileged, inner-city children who often face dangerous living conditions.

Kerndeep, Sukhie and many other Kaiser Permanente Central Valley Area volunteers teamed up with local police officers to redesign the bedrooms of seven children in need of support. In collaboration with the Manteca Police Department, the team surprised the children with room makeovers, creating fresh, safe, and inspiring spaces which included painting walls, assembling new furniture, organizing and decorating the rooms with bright colors, new bedding, and thoughtful decorative touches that would make the spaces feel like their own. The day began with a meet-and-greet with parents and older children, and the volunteers focused on preparing the rooms for the younger kids, who were at school.

What made the project unique was the element of surprise—when the children returned home from school, they found their rooms completely transformed. The goal was to show the children they were valued and to provide them with a space that reflected their individuality. The most rewarding part of the experience was witnessing the children’s reactions when they walked into their newly decorated rooms. Their joy and disbelief were heartwarming. It was a humbling experience for both Kerndeep and Sukhie, as they had the chance to give back to their community and play a small part in improving the lives of these families.

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Research and Innovation Academy Conference: A Showcase of Excellence

The inaugural Northern California Research and Innovation Academy (RIA) Conference was a landmark event that brought together health care professionals and researchers to share their innovative work and insights. The conference, which accepted 50 abstracts in total, featured a wide range of excellent lectures and presentations from leading experts in various fields. Among the contributions were the five abstracts and poster presentations from the CVA team, which demonstrated the organization’s commitment to advancing health care practices and improving patient outcomes.

One of the highlights of the conference was the poster presentation titled, Pediatric Perioperative Bays Provide a Caring Environment During Pre and Post Operative Care presented by Farah Cardenas, BSN, RN; Yasmine Baricaua, BSN, RN; and Susan Thimon, MSN, RN, PHN, NE-BC, CCRN. This poster was awarded for being the Best Poster Design for which this team received a certificate and trophy, a well-deserved recognition for the abstract poster and for its innovative approach to creating a supportive, child-friendly environment for pediatric patients undergoing surgery.

All the abstract poster presentations showcased dedication to research, evidence-based practice, patient-centered care, and innovation. The 2-day conference had fantastic speakers, lectures, and break-out sessions with interesting innovative and educational topics and was not only a platform for sharing research, knowledge, best practices, and great learnings, but also a celebration of the remarkable contributions made by all Northern California Kaiser Permanente Medical Centers to the field of health care.

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Maternal Child Health: Labor and Delivery employee engagement

In 2023, our Labor and Delivery Unit-Based Council launched a pumpkin decorating contest to enhance employee engagement across all 3 units. This fun and collaborative activity brought together providers, midwives, nurses, obstetric technicians, and unit assistants, fostering teamwork and creativity. The contest has quickly become a cherished fall tradition, eagerly anticipated by staff each year. It provides a valuable opportunity for both staff and leadership to collaborate, share ideas, and work together as a team.

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Central Valley Engagement Committee

The Central Valley Service Area continues to broaden and expand our focus on employee engagement as a key driver for employee satisfaction, consumer experience, and overall performance outcomes. Most recently we have created a front-line driven advisory committee, with a core vision of representing the employees voice to drive best practices from the frontline employee and supervisor perspective.

This advisory workgroup exists to recommend, evaluate, and track local engagement strategy activities that achieve the Employee Promise of them feeling heard, valued, included. This multidimensional group strives for Kaiser Central Valley to truly be the Best Place to Work by evaluating our current state, understanding strengths and opportunities, and recommend practices determined from both within and outside of Kaiser Permanente to create meaningful recommendations that will drive our People outcomes. As part of this journey, and CNE partnership, our front-lined nurses from each of our 5 Magnet Professional Governance Councils are part of this advisory group to ensure nursing’s voice, bidirectional communication and spread information throughout all nursing units at both Modesto and Manteca Medical Centers and our Stockton Ambulatory Surgery site.

Our initial membership has representation from Kaiser Foundation Hospital (KFH), KFH/Plan (KFH/P), and The Permanente Medical Group (TPMG), including various job roles, locations, shifts, and schedules to be as inclusive as possible. The team is aware that they should bring not only their own voice, as a perspective of their personal experience, but a voice for the entire frontline group as much as they can.

The first project is underway, where this workgroup is going to be “interviewing” groups with high outcomes or tremendous improvements on the most recent Engagement Index survey results. These interactions will be frontline-to-frontline conversations, where we intend to have 3-5 recommendations presented to Senior Leadership before the end of 2024.

This is a workgroup that we are excited about and will continue to mature as an effective advisory function as the voice of the frontline employees.

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