2022 AWARD WINNERS
Melissa has been a Duke Nurse for 19 years – all at Duke. She brings to her current role extensive knowledge and experience from caring for patients in the Cardiothoracic ICU and Stepdown Unit, and the 11 years she spent with the Duke Transplant Center, where she was a Coordinator – first for Cardiac Transplant, and then for Quality Assessment and Performance Improvement. She now oversees the operations for 13 heart-related registries across Duke Health, leads projects to drive process improvement, and identifies opportunities in care delivery, quality and safety. For example, she supported a multidisciplinary team in a project aimed at early extubation for cardiac surgery patients that led to a 25% improvement, which enhanced registry results and patient outcomes.
This nurse is responsible for oversight of registry and quality data for 13 heart-related registries across Duke Health. She ensures Duke Health compliance with registry reporting across the system, including data integrity. This nurse has created standard reporting tools for multidisciplinary teams that are timely and meaningful to drive real-time process improvement. This role and work align with the Duke Quality Management System and have been designed to ensure real-time identification of programmatic trends and opportunities with immediate feedback to the teams to capture new opportunities in care delivery and quality and safety. This nurse uses her clinical expertise from her Duke Nursing roles as a former Stepdown Nurse, CTICU Nurse, and then Transplant Coordinator to ensure the data is up-to-date, accurate and applied in a meaningful way across our DUHS heart teams. This nurse is always transparent and supportive when working with teams around opportunities for improvement, and creates a culture of safety. This nurse is seen as a true collaborating partner across all three hospitals and across the teams, due to her respectful approach to opportunities for improvement.
This nurse has worked in several clinical areas and built on each skill set, while continuing her advanced education. Her professional growth included completion of a Masters’ of Health Administration with a focus on quality improvement. She has applied her advanced skills to further advance quality and safety, and to mentor new nurses and multidisciplinary team members. This nurse helped create standard work across the Heart Center of Excellence registries, using the Duke Quality System approach in a nonclinical area in a meaningful way to enhance patient outcomes. She has led numerous projects, including the Collaborative Innovation and Improvement Network Project for the kidney transplant program, where consents for high-risk organs increased from 16% to 33% over six months; the Transplant and PeriOperative Safety Committee (TAPS); numerous “Learning from Defects” event analyses; and Transforming our Future work. Other accomplishments include being a Certified Clinical Transplant Coordinator, Lean Six Sigma Yellow Belt, membership and prior Treasurer of the NC Chapter of the International Transplant Nurses Society, and contributing author to publications on organ donation topics.
This nurse disseminated new knowledge with publications on use of organs from infected donors and use of thyroid replacement during cardiac transplantation to enhance donation and transplant options and care. She presented oral and poster presentations at the Transplant Quality Institute on multidisciplinary morbidity and mortality tracking, and quality outcome projects. She now applies her skills and Duke experiences to analytic support and standardization of registry participation for Duke Heart, to include structured reporting and dissemination of new findings. This nurse leads the newly established CV Medicine and CT Surgery Outcomes Meetings focused on real-time problem-solving and quality improvement discussions. She partners closely with the clinical teams to convert registry data into meaningful and near real-time feedback to enhance clinical care across the spectrum in Cardiology and CT Surgery. This nurse partners with the clinical teams to develop automated data import to reduce time required to harvest data elements and shift effort to data analysis and care improvement. The Duke model is one that other organizations now strive to mirror and spend time learning about.
This nurse partners across DUHS with Nurses, Cath Lab Technicians, Advanced Practice Providers, Residents, Physicians, Data Analysts, and the Operational Leadership Team to ensure registry data is used to not only meet reporting requirements, but enhance current and future care. She works to ensure health system support and a standard approach to work. She uses her Six Sigma training and skills to break down operational and clinical workflows and challenges across Cath Labs, Electrophysiology Labs, and the Cardiac Surgery Service and units. She trains new staff on the evidence behind registry data elements, processes and metrics. She partners with the medical directors, frontline physicians and multidisciplinary staff to improve patient care. One example of her collaborative efforts is the creation of CV Medicine and CT Surgery Outcomes Committees, in partnership with Heart leaders and the CT Surgery and Cardiology Division Chiefs, to support multidisciplinary teamwork in addressing and understanding hospital-acquired conditions, registry data and Duke Quality Management System data. This new structure has led to remarkable attendance and real-time problem-solving unmatched by historical committees.
This nurse is willing to mentor, teach and sponsor learners to enhance patient care and translate data into meaningful outcomes at the patient level. Her belief in the ability of the teams and understanding of their challenges and patient needs, makes her an asset in improving our patient care and safety. She is currently partnering with our leadership team to better understand any health care inequities in our service line and opportunities to better support what patients and families need. She seeks opportunities to ensure the right care and quality of care is provided across all patients in ways they desire to be cared for. This nurse puts the patient and family at the center of the work to ensure we are providing the right care to the right patients at the right time to allow for the best results in cardiac care, including providing real-time data for patients and families to make informed decisions about complex care in partnership with the care team. The data and information this nurse makes available allow clinicians to provide patients with information to make informed decisions and maintain dignity and control at the most difficult time in their lives.
This lifelong learner and nurse exemplifies Duke Nurse career trajectory opportunity and success: achieving professional growth by mastering new skills and knowledge that are selflessly shared to positively impact the heart populations and the multidisciplinary team.
MHA, BSN, RN
Cardiovascular Registries & Quality
Center of Excellence
Duke Heart Center
Duke University Hospital