Structural Empowerment

William “Bill” Vanderlind, RN, Co-Chair ICU UPC, was the driving force behind the dramatic improvement of ICU mobility metrics at Kaiser Permanente Santa Rosa. Recognizing the unit’s low mobility scores, Vanderlind took the initiative to investigate the root causes and collaborate with the regional team to address them. He formed the ICU UPC Mobility Team and developed the “CLOF/Mobility Reminder-Simplified” reference guide to support staff in implementing best practices effectively. 

Vanderlind’s leadership didn’t stop there; he inspired ICU RNs to become mobility champions, fostering a culture of engagement and accountability. He also motivated the leadership team to partner with the 3 West Medical-Surgical staff, creating a collaborative effort that extended the impact of the initiative. 

The results were extraordinary. Within just two weeks, ICU mobility scores skyrocketed from a low of 17% to achieving 100% on several consecutive days. Simultaneously, 3 West’s mobility scores consistently rose above 80%. These remarkable achievements propelled KP SRO to the top spot in mobility metrics across the entire region. 

Vanderlind’s dedication, innovation, and ability to inspire others have made a lasting impact, solidifying him as a true transformational leader in patient care. 

Non-Invasive Vent Removal has become increasingly prevalent with the aging and chronically ill patient populations. Many of these patients are unable to successfully wean off high-flow oxygen or BiPAP and may reach a point where the focus shifts to quality of life. In such cases, patients often choose to remove life-prolonging devices to prioritize comfort at the end of life. 

To support this critical aspect of care, an extensive multidisciplinary effort, involving palliative care specialists and frontline experts, led to the development of a comprehensive protocol. The Palliative Care Unit Practice Council and Comfort Care Committee led this project with the aim to develop a protocol that ensures that nurses and physicians can seamlessly order and administer medications to prevent dyspnea and other symptoms during vent removal. 

The process was guided by a thorough literature review, adapting guidance and guidelines from trusted sources in palliative and end-of-life (EOL) care, despite the limited availability of evidence. The protocol has been translated into several practical resources: 

• Guideline Format: A clear and concise reference to support clinical decisions. 

• Nursing HealthStream Module: An educational tool designed to bridge knowledge gaps. 

• Order Panel for Physicians: A streamlined tool to guide medication orders effectively. 

• Orientation Component: Educational materials incorporated into nursing orientation to build foundational knowledge. 

The Comfort Care Committee played a vital role in improving workflows, collaborating with nursing colleagues and leadership to ensure smooth transitions for every patient who chooses to remove non-invasive ventilation. This initiative highlights the commitment to patient-centered care, prioritizing comfort and dignity at the end of life. 

In March 2024, the Pediatric Unit Practice Council (UPC) identified the need for a dedicated pediatric treatment room to enhance the care experience for hospitalized children. Research supports that performing “scary” or painful procedures, such as IV or NG tube placements, outside of a patient’s room can significantly reduce stress and anxiety. This approach allows children to maintain their room as a safe and comforting space. 

To make this vision a reality, the UPC repurposed a storage area previously used by lactation services. This required close collaboration with lactation and well-baby nurses to identify new storage solutions, including relocating items to the well-baby nursery. Central Supply and Respiratory Therapy were also consulted to accommodate changes in their storage needs. 

Once the space was cleared, the UPC sourced unused equipment, including a gurney and a storage tower, minimizing costs. The only new purchases were jungle-themed wall decals to create a welcoming, child-friendly atmosphere. A treasure box filled with special toys was also introduced to reward young patients after procedures. 

With support from the engineering team, the room was repainted, and safety supplies were installed. By September 2024, the pediatric treatment room was fully operational, providing a less intimidating environment for procedures and reinforcing the hospital’s commitment to patient-centered pediatric care. 

Pictured above: Lori Tyler, RN, Staff Nurse III and Danielle Cooley, BSN, RN, Staff Nurse III, Pediatrics. 

The Gravenstein Apple Fair was a shining example of Stroke Champion RN leadership and initiative. This dedicated team took the reins, reaching out to fair organizers to secure booth space, obtaining Kaiser Permanente sponsorship, and devising creative ways to engage the community. They designed impactful posters and staffed the booth throughout the entire weekend, ensuring a strong presence and meaningful interactions. 

During the event, they connected with various community organizations, including Food for Thought, to explore partnerships aimed at supporting lower-income stroke patients and their families. Their discussions focused on ensuring access to affordable, heart-healthy foods post-discharge—a vital step in promoting recovery and long-term health. 

The Stroke Champion nurses, Yesenia Acuna, RN; Kate Howe, RN; Jomjai Waters, BSN, RN; Caroline Gorsuch, BSN, RN; and Carmen Ramirez, RN are true superstars, demonstrating their commitment to community health and their ability to drive impactful initiatives.