Collaboration is a term frequently used in healthcare research and clinical practice (Green & Johnson, 2015). The ability to collaborate is increasingly seen as a fundamental competency for 21st-century clinicians (Paradis, Pipher, Cartmill, Rangel, & Whitehead, 2017). Benefits of collaboration among caregivers and researchers within an institution include sharing of knowledge and expertise, improving communication, strengthening of relationships among caregivers, and, ultimately, improving patient care and safety outcomes. However, the benefits of collaboration across healthcare institutions, especially otherwise competitive hospitals, are not as commonly addressed. Similarly, collaboration among nursing professional development specialists (NPDSs) from different facilities is rarely noted in the literature. With the current reality of tight educational budgets, a compelling argument can be made for crossing organizational boundaries to provide high-quality nursing professional development services.
Educating nurses about research and evidence-based practice (EBP) can be a particularly difficult challenge for hospital-based NPDSs, who may not have the prerequisite knowledge, experience, and expertise to teach the content themselves. Often, this expertise lies in academic centers or with known experts in a particular specialty or field. Bringing experts to one's local area to speak can be expensive when considering honorarium, travel, hotel, meals, and other incidental costs. Additionally, there may be pressure on the NPDS to ensure a large attendance to justify the costs, even though staffing pressures may make it impossible for nurses to leave patient care areas. In an attempt to surmount these obstacles, NPDSs in an urban setting in Kentucky have found a way to provide quality educational programming through the development of an annual city-wide nursing research symposium.
In the mid-2000s, the Magnet Recognition Program® of the American Nurses Credentialing Center (ANCC) became a driving force for hospital-based nursing research in Louisville, Kentucky. When a number of healthcare systems in the area began their efforts toward Magnet Recognition®, each facility began developing its own processes to meet Magnet® requirements regarding nursing research and evidence based practice. These included the demonstration of how they supported the advancement of research, how they disseminated it to internal and external audiences, and how clinical nurses were using evidence-based findings in their practice (ANCC, 2017).
At the same time, key stakeholders from several of the city's healthcare facilities became involved with an existing community research effort, Research!Louisville, and began discussions to use this umbrella event as a way of pooling nursing research education resources across organizations. Research!Louisville is a longstanding annual city-wide celebration of health-related research, sponsored by the University of Louisville. The weeklong event includes a number of seminars, workshops, guest lectureships, and poster presentations focused on healthcare-related research. It is an opportunity for researchers from the fields of medicine, dentistry, nursing, bioengineering, and other health disciplines to present their work to other members of the healthcare community. In the early years of this event, nursing did not have strong representation within the Research!Louisville planning group, nor was there any nursing-focused education included as part of the schedule of activities. The NPDSs from a number of the participating facilities saw this as an opportunity to facilitate their efforts toward nursing research education, while capitalizing on the infrastructure and advertising reach of the Research!Louisville event. Leadership support at the various sites permitted planning and implementation to take place.
The first collaborative Research!Louisville Nursing Research Symposium (RLNRS) was in 2008, cosponsored by Baptist Hospital East, Jewish Hospital, Norton Healthcare (a five-hospital system), and University of Louisville Hospital. Three local chapters of Sigma Theta Tau (Iota Gamma of Spalding University, Iota Zeta of the University of Louisville, and Lambda Psi of Bellarmine University) also cosponsored the event, which was free to participants. The education focus was on evidence-based strategies for safety and risk reduction, and the conference also included a peer-reviewed poster session.
For the first few years, attendees of the RLNRS were primarily nursing students and nursing leaders, as the general Research!Louisville event focused heavily on academic activities, studies, and projects. Very few direct care nurses attended. The RLNRS planning committee set a goal to increase attendance and participation by direct care nurses, both at the symposium and in the conduct of scholarly projects. Committee members advocated for funding to send a select number of direct care nurses to the conference, with pay, to encourage attendance. That approach, along with the planning committee's careful selection of speakers and topics of interest to staff nurses, resulted in a gradual increase in the number of direct care nurse participants over the next several years, most recently, n = 114 nurses attended the event.
The RLNRS planning committee includes at least one nurse leader, NPDS, or clinical nurse from each sponsoring hospital, as well as representatives from the Sigma Theta Tau chapters from local universities. This group collaborates early in the year to begin the planning for the annual fall conference. Participating hospitals take turns hosting the program.
Table 1 provides a timeline and detailed account of the steps in the planning process for the program. The group meets via conference call approximately once a month. Calls are generally limited to 1 hour, in order to maintain efficiency and respect members' busy schedules. The planning committee chair, who represents the host hospital, sends out the agenda in advance along with the conference call dial-in instructions.
The first goal each year is to determine a general topic or direction for the conference, with consideration of current gaps in staff knowledge related to research and/or EBP. Suggestions from participant evaluations of the previous year's conference are also considered in the planning process. Table 2 provides a listing of selected program titles and topics from 2009 through 2018. Once the key topic is identified and speakers are secured, collaboration continues to address other conference logistics and needs such as conference title, objectives, agenda, advertising, food, and evaluation methods.
The host hospital takes additional responsibility for conference registration, continuing education credits, setting up rooms and posters, travel and accommodations for speakers, parking, summarizing evaluations, and presenting a final report back to the RLNRS planning committee. The final report includes attendance, attendee comments, number and type of posters presented, and costs of the program, less donations, to be divided evenly among the participating hospitals.
To find and select local poster presentations for the conference, the RLNRS planning committee appoints a review subcommittee made up of one representative from each healthcare entity (n = 4) and 1 or 2 representatives from the Sigma Theta Tau chapters involved (nursing faculty members) to create and release the call for abstracts; review submissions; categorize submitted abstracts as research, EBP, or quality improvement (QI) projects; and make final decisions about abstract selection. Primary criteria for abstract acceptance include (a) nurse as a project leader or study author, (b) study or project to be completed by the conference date, and (c) adequate detail provided so that the type of project (research/EBP/QI) can be identified. Subcommittee members provide mentoring and assistance for authors of abstracts that sound promising but may not fully meet criteria.
Because a primary goal of the symposium is to promote the conduct and dissemination of projects by direct care nurses, the subcommittee accepts most abstracts after individual coaching and assistance are provided to submitters. The review subcommittee also selects two to four abstracts in each category for oral presentation at the conference. The number of oral presentations varies from year to year, depending upon abstract quality and representation from each of the sponsoring hospitals.
Over the years, the RLNRS planning committee has realized a number of benefits from this collaborative approach. For hospitals with tight budgets for staff education and professional development, cost sharing is a key benefit. By pooling scarce resources with other similar institutions, hospitals are able to provide quality education to a greater number of employees (McLaughlin, 2017). They are also able to invite expert speakers from other parts of the country, improving staff exposure to the latest information on subjects of interest. Symposium costs, including speaker expenses, refreshments, and incidental costs, are shared among the eight participating hospitals and three Sigma Theta Tau chapters. Over the last 9 years, the average program cost per hospital has been $527, but has varied from $224 to $1,300 per year.
The symposium has helped meet the goals for external dissemination of research and EBP projects as required by the Magnet® program certification. The opportunity for nurse clinicians to present their study or project outside of their organization contributes to their professional growth. Additionally, once posters are developed, nurses may submit their work for presentation at regional or national conferences, and they will have the experience and confidence to do so.
Sharing information among local hospitals is another benefit. This sharing rarely creates any proprietary conflict. Rather, symposium presentations and roundtable discussions help to stimulate networking and mentoring relationships among participants, generate new thoughts and ideas, and aid in the sharing of best practices and outcomes. This not only contributes to one of the goals of the Magnet Recognition Program®, it also enhances the provision of quality nursing care in the local community.
Our local schools of nursing also benefit from their involvement with the RLNRS, which helps to close the gap between academia and the clinical setting. When students see clinical nurses presenting their research, EBP, and QI projects, they realize that the process of conducting and applying nursing research in the clinical setting is not just something they learn in school; rather, it is how nurses in the community are advancing their practice and improving patient outcomes. It is also very rewarding for faculty to see past students present their own projects in a professional setting.
A number of lessons have been learned in the process of presenting the conference over the last 9 years. First, collaboration is important and helps to bring our organizations together. Creating successful collaboration is no small task in a competitive healthcare environment, and naysayers may scoff at the idea due to the potential for competing loyalties and conflicting opinions about how things should be done (Green & Johnson, 2015). However, the RLNRS is proof that it can be done and that all who participate, whether in a planning role, or as a presenter or attendee, can benefit from it. We have learned that it requires a commitment from all stakeholders, support from leadership, a willingness to share resources, and joint accountability for success, but we have also learned that it can be a very rewarding experience.
We have also found it important to be as cost-conscious as possible in order to maintain support from participating organizations' nursing leadership. Holding the event within our hospitals' auditoriums or other conference spaces means that we do not have to pay rental fees. Limiting the program to a half-day format means that more nurses can attend, while limiting staffing issues and replacement costs.
Finally, we learned how valuable the poster and podium presentations are to direct care nurses. When seeing examples of projects conducted by their peers, nurses see what is possible and are encouraged to engage in their own projects, allowing their units to be represented as well. Evaluation data consistently demonstrate that the podium project presentations are among the highest rated components of the conference. As one attendee noted, “staff nurses like me [were successfully completing research studies], and that gave me confidence that I can do it too”.
Collaboration usually provides a means for organizations to achieve more than they can on their own (Niemi, McErlane, & Tillett, 2013). Collaborating with other local hospitals, NPD educators, and partners in academic settings to provide a high-quality nursing research education program can help advance scholarly work within the entire community. These efforts can also help each participating organization meet educational needs and Magnet® requirements more cost-effectively.