Since his arrival at Midland Memorial Hospital in 2007, Dr. Bob Dent has truly transformed nursing care within the organization and the profession of nursing leadership. It was through Dr. Dent's leadership that shared governance was founded at Midland Memorial and has grown into a professional governance model that gives nurses a voice in care delivery.
Dr. Dent facilitates ideas and suggestions from nurse councils into implemented processes and programs. He initiated a collaborative partnership with the American Organization of Nurse Executives (AONE) to create the first customized interprofessional care innovation and transformation (CIT) program for whole-hospital participation in the nation. The CIT program improves patient care experience, performance, collaboration, innovation, leadership development, and employee satisfaction through staff engagement. The success of this innovative program is now a model for other nurse leaders and has gained interest both across the nation and in Saudi Arabia. His presentation of the CIT program's success led AONE to its largest contract with a system.
Dr. Dent launched a regional telephone nurse triage system, 68NURSE, to improve care coordination and appropriate utilization of the ED, and reduce healthcare costs. This type of regional call center was the first whole-community project in the nation. As a result, 65% of callers to 68NURSE were triaged to an appropriate lower level of care. The net improvement in bad debt was $2.3 million. Cost savings to citizens in the region using 68NURSE are $1 million annually. Dr. Dent created a collaborative partnership with another regional hospital and effectively marketed the service in the Permian Basin for a broader regional impact. With his guidance, 68NURSE was replicated at another Texas hospital in the past 2 years. He published this work in Nursing Clinics of North America, on the Agency for Healthcare Research and Quality website, and presented it nationally.
Dr. Dent introduced and implemented TeamSTEPPS throughout the entire organization, which was taught by nursing staff. The professional practice model was developed under Dr. Dent's guidance and incorporates organizational values with the foundations of nursing care.
A true educator
Dr. Dent's influence has molded and changed nursing at Midland Memorial from almost a support role to the governing body for patient care. The commitment to nursing is evident in Dr. Dent's push to increase accessibility and funding for nursing education at Midland Memorial and in the surrounding community. Dr. Dent maintains academic appointments with Texas Tech University's Health Sciences Center and the University of Texas of the Permian Basin, helping teach and mentor the next generation of nurses.
As a transformational leader, Dr. Dent approached the CEOs of Midland Memorial and its affiliated college to create a collaborative academic-practice partnership between the hospital and the college's health sciences division to sustain the nursing workforce in the region. Both nursing programs had lost national accreditation and were placed on probation by the state board of nursing. For 18 months, he served as interim dean while maintaining his role at the hospital. He rebuilt the nursing programs in two cities; both programs were removed from probation and are now working toward becoming nationally accredited again. He mentored the associate degree nursing program director to succeed him as dean. He ensures that all graduates from the nursing programs have a role at the hospital and gives them an opportunity to advance their formal education from RN to BSN as a show of support for the school and programs. Because of Dr. Dent's success with the program, the college president created a continuing agreement for his ongoing leadership influence on the health sciences programs.
Dr. Dent implemented a nurse residency program to ensure new Midland Memorial nurses are fully supported in an environment that creates competent and confident nurses. Dr. Dent's innovative and collaborative leadership led to the development of a comprehensive simulation center and unique partnership with the local community college. Dr. Dent also worked diligently to establish a partnership between the Midland Memorial Foundation and the Texas Tech University Health Sciences Center School of Nursing to provide full scholarships for nurses to complete the BSN program. Dr. Dent's inspiring vision for lifelong learning has resulted in a BSN rate of about 60% last year at Midland Memorial, compared with 7% when he started in 2007.
Focus on patient safety
Nurse satisfaction and safety are key priorities for Dr. Dent. He lives and works by his credo, “Our people first, our mission always, and safety above all.” Dr. Dent challenges all nurses, from the bedside to boardroom, to reward, recognize, and celebrate the contributions of individuals and interdisciplinary teams, and to take ownership in patient and staff safety.
Dr. Dent created a nurse-led patient safety department to review best practices and identify trends early to prevent harm. Dr. Dent facilitates nursing peer review incorporating the taxonomy of error, root cause analysis, and practice responsibility, or TERCAP, process into investigations. Dr. Dent implemented an unsafe act algorithm that allows nurses to utilize a nurse peer support committee, a supplement to nurse peer review. This allows nurses to meet with peers to discuss and improve practices in a supporting environment.
Dr. Dent has recognized unmet needs in our community and successfully implemented new service lines and programs, such as robotics surgeries, total joint replacement, palliative care, a bariatric weigh to success program, a primary stroke center with designation, and a diabetes and nutrition learning center. He's facilitated participation in several upcoming research and evidence-based practice studies, including a national nurse staffing study, OR/postanesthesia care unit handoffs, nursing and quality improvement projects, and the implementation of pain management guidelines for oncology patients.
Dr. Dent truly has a passion for the professional practice of nursing and it shows in everything he does, not only for Midland Memorial, but also through his involvement at the state and national level. Dr. Dent is currently serving on AONE's board of directors, representing Region 7, as well as the AONE Foundation board of directors. He led taskforces to develop nurse executive competencies for both postacute care and population health. This initial work in emerging areas of nursing leadership is designed to assist executives in identifying areas for development. Healthcare organizations may use them as a guideline in job descriptions, expectations, and evaluations of nurse leaders. Dr. Dent has also served on the AONE Strategic Planning Committee, AONE Nominating Committee, and AONE Professional Practice Policy Committee, and as a Texas Organization of Nurse Executives (TONE) board member, TONE Membership Committee chair, and Texas Nurses Association Practice Committee member. He serves on Texas Team's Practice Committee, the state action coalition of the Institute of Medicine Future of Nursing initiatives.
Culture of ownership
The greatest testament to Dr. Dent's transformational leadership ability comes from his creation of a culture of ownership throughout the organization and community. Beginning in 2012, Dr. Dent identified a growing concern about patient and staff dissatisfaction. Engaging a friend and colleague with expertise in culture and values, Dr. Dent began a journey for the organization starting with a shared vision of increasing patient and staff satisfaction through a focus on values. Specifically, the focus was on how individuals incorporate their personal values with the newly defined organizational values.
Through a tenacious commitment to move hospital leadership and individuals from a culture of accountability to a culture of ownership, there's been a remarkable change throughout Midland Memorial and in the surrounding community. Employee satisfaction has increased and through a pre- and postimplementation survey, an empirical improvement in commitment to culture and values has been noted, with decreases in toxic emotional negativity. Now, Dr. Dent is coauthoring two books showcasing the transformation in culture and what it takes for others to succeed.
Dr. Dent serves as a role model and mentor for many people. He's mentored current nursing directors and continues to make himself available for anyone wishing to establish a mentoring relationship. He provides the mentee with a signed agreement outlining the guidelines and details of the mentoring relationship. His biggest effect is his role modeling of lifelong learning. He's effectively positioned nurses from Midland Memorial and the region to lead change, improve healthcare, and drive policy, thus creating nurse leadership sustainability.
Dr. Dent twice mentored a team that achieved the American Nurses Credentialing Center's Pathway to Excellence designation for Midland Memorial and is currently leading a team on the journey to Magnet® recognition. This is, in part, why he's been given several awards, including Modern Healthcare and Witt/Kieffer's Class of 2006 “Up and Comer” of the Year, the TONE 2014 Excellence in Leadership Award, and the 2014 Distinguished Alumni Award from Texas Tech University Health Sciences Center School of Nursing for his significant contributions to the nursing profession.
Dr. Dent shares his knowledge and expertise through presentations, publications, seminars, conferences, and a blog. He produces cogent and persuasive materials for diverse audiences to address nursing, healthcare, and organizational issues. In the past 5 years, he's published more than 10 articles for professional journals and presented more than 34 times around the nation.
A clear vision
Dr. Dent promotes systems thinking as a value, provides leadership, and has built loyalty and commitment throughout Midland Memorial. His seminal contributions to the professional practice of nursing come through his visionary leadership, innovation, and collaboration. His service on local boards, dual roles with the college, and service on state and national boards are examples of his contributions to the generation, synthesis, and dissemination of nursing knowledge and the advancement of nursing. He brings expertise asa nurse leader to create collaborative partnerships, transform health policy, implement innovative strategies to improve patients' experience of care and population health, and reduce healthcare costs to achieve the Institute for Healthcare Improvement's Triple Aim. He provides opportunities for nurses to advance their formal education, practice to the top of their license, lead change to improve health and healthcare, and drive policy. He supports advanced practice nurses to practice to the fullest extent of their education and training through his engagement with Texas Team. He's passionate about improving workplace culture and the care and services provided to patients and the communities served by Midland Memorial. Dr. Dent is a knowledgeable, experienced, and engaged nurse leader. His accessibility, approachability, and visibility make him a leader that many will strive to emulate.