Is your local hospital a NICHE facility?

Nurses Improving Care for Healthsystem Elders is a nurse-driven program aiming to improve quality of in-patient care for older adults through its focus on geriatric issues, staff competence, and hospital-wide protocols for geriatric care.

The NICHE program provides facilities with the latest training, tools, and resources, including evidence-based protocols, to improve clinical outcomes, enhance nursing competencies, boost patient satisfaction, and better support their communities.

According to the organization, hospitals that obtain NICHE designation demonstrate the leadership, organizational commitment and cultural competency to achieve patient-centered care.

The program began at the NYU College of Nursing in the early 1980s and grew to some 450 participating hospitals and acute care facilities in the United States and Canada.  Institutions develop and implement their own changes in nurse-driven geriatric care using NICHE-provided tools, resources, project management approaches and best practice solutions, from medication safety to family communication, to catheter removal.

Two issues on a collision course make initiatives like NICHE valuable.First, hospital staff must continually improve their understanding of geriatric care needs; especially as more boomers reach their senior years. The older population (65+) grew by 15 percent, or 5 million people, in the past decade. It’s projected to soar another 36 percent by 2020, and by 2030, there will be twice as many older adults as there were in 2000.

Second, hospitals are under increased pressure to reduce preventable admissions and avoid readmissions at less than 30 days after discharge or face stiff penalties. NICHE gives geriatric care nurses regular, in-service training, to become leaders in care of older adults.

Talking to nurse managers at acute care facilities with NICHE designation may generate to some interesting story possibilities. Among them:

• Quality, outcome, patient satisfaction benchmarks
• Changes in 30-day readmission rates for common ailments such as pneumonia, heart problems, falls.
• Challenges in implementing organizational change
• Specific population-based opportunities and challenges — are staffing levels of geriatric care nurses adequate, how have doctors or other interdisciplinary team members responded to nurses taking a lead role, has this initiative boosted the hospital’s reputation in the community for geriatric care?
• Profiles of outstanding geriatric nurses, top leaders, or satisfied patients

You can also examine community outreach programs, advocacy or policy efforts, or speak with recently admitted/discharged older adults and family members about their experiences.

For more information:

• Hartford Institute for Geriatric Nursing
• Niche Hospitals Report Launch Announcement and Summary Report
• Choosing a NICHE hospital (brochure) Rochester Medical Center
• NYC Health & Hospitals Corporation announcement, NICHE status
• One Hospital’s NICHE Journey (article)

Liz Seegert is an independent health journalist based in New York’s Hudson Valley, who writes about caregiving, dementia, access to care, nursing homes and policy in her role as AHCJ’s Health Beat Leader for Aging. Seegert helps provide context for reporting on this multidimensional issue with story posts, tip sheets, analysis, data and one-on-one interviews with aging experts.