The UHealth/University of Miami Hospital and Clinics' Sylvester Comprehensive Cancer Center (SCCC) has advanced transformational leadership in several key areas that include engagement with the UHealth Nursing Professional Practice Model in all ambulatory clinics and the comprehensive treatment units. As Nicole Doell, MSN, RN, AMB-BC, Executive Director of Clinical Operations for Sylvester Comprehensive Cancer Center Ambulatory Clinics noted: “Our nursing care model was instrumental in guiding practice in our oncology-focused areas during the COVID-19 pandemic. We addressed staffing based on volume and we utilized critical thinking skills in addressing oncology ambulatory settings in our satellite clinics.” During the current COVID-19 situation, standards of practice were further aligned to assure that patients received the most optimal level of care. Physician and nurse providers received the support needed to offer the highest level of care in accordance with our nursing mission, vision, and values. Nursing teams worked to the full extent of their scope of practice during the complex times of the pandemic thus assuring that patients were at the center of their necessary plans of care. Lisa Philipp, MSN, RN, OCN, Executive Director of Clinical Operations for Infusion Services noted that another key area was to assure that certain aspects of care such as utilization review work could be moved to a remote format to limit COVID-19 exposures while maximizing productivity and outcomes for patients. When possible, patient care and chemotherapy initiation were moved from the inpatient to the outpatient settings with excellent patient- and family-focused outcomes.

Engagement and job satisfaction among nursing staff were additional critical touchpoints for nursing leadership and clinical staff. Embedded in the Sylvester Comprehensive Cancer Center was the voice of the customer—the patients, families, and communities that were served. One aspect of success in assuring the voice of nurses with the Nursing Professional Practice Model included a 7-question survey to uncover the key aspects that should be addressed in the framework of the model within the Sylvester Comprehensive Care Center. Other key tools and enhancements included the development of an acuity tool to address the optimal constellation of the care team that includes physician, advanced practice providers, nurses, and clinical pharmacists. Optimizations were aimed at having the highest functioning teams for the Sylvester Comprehensive Cancer Center with the inclusion of clinical pharmacists and a new approach to the phone triage system to assure that both patient-centered care and productivity were maximized.

As Jeannette Garcia Slanker, MSN, APRN, FNP, PMHNP, CPON^® , Associate Chief Nursing Officer for Ambulatory Clinics, Infusion Centers, and Pediatric Services shared: “Our nursing focus was always a lens of a shared vision—despite COVID-19—to assure that our blueprint for patient care was based on caring, compassion, respect, excellence, and discovery in our approach to cancer care, as well as pediatrics and ambulatory care.”