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Delivering World Class Healthcare, Ruth Hansten, Washington Healthcare News, March 2012

Based on her consulting work at approximately 170 healthcare organizations, Ruth I. Hanstenhas identified several major issues that prevent best clinical outcomes and allow basic patient care breaches. This article discusses these issues and how to resolve them.

Teaching Nurses to Delegate and Supervise at the Point of Care: An Open Request of Educators, Ruth Hansten, April-June Nursing Forum, 2011, DOI: 10.1111/j.1744-6198.2011.00220.x

This article was published in the April-June Nursing Forum, 2011.
In this article I give specific recommendations for nursing educators and academicians for teaching delegation and supervision principles.

A Bundle of Best Bedside Practices: Field Evidence
Hansten, Ruth I., The Health Care Manager, April/June 2009,28(2):111-116

Abstract: A sequential, evidence-based bundle of 10 best bedside practices serves as a template for professional practice and becomes a shared language and standards for interdisciplinary team communication and development. Improvements in registered nurse leadership skill levels, corresponding clinical outcomes, and patient and staff satisfaction have been realized through implementation of the Relationship & Results Oriented Healthcare certification program and practice model.

Thriving in Tough Economic Times Through a Bundle of Best Bedside Practices, Ruth Hansten, Washington Healthcare News, Volume 4, Issue 2, February 2009

Abstract: Foul financial forecasts preview hospitals’ diminishing reimbursements, increased uncompensated care, pressure to avoid unpaid “never” events while publicly proclaiming outcomes with fresh transparency. But retrenchment, paralysis, or waiting for better times won’t necessarily spell survival.

Exploring Nursing Practice Using RROHC as a Model, Sharon LaCrosse RN MSN, Nurse Leader, Volume 6, Issue 6, December 2008 p 42-45.

Abstract: A cairn is a stack of rocks that marks a path. It is laid by an individual trailblazer to mark a path for those that will come behind. Given that,they must have in mind that there will be someone who will come along and need to have the turns on the journey identified for them. So it is with the Relationship & Results Oriented Healthcare™ (RROHC) process at our community hospital as we travel the trail to become a Magnet facility. I hope to lay a cairn for you to follow as you build your path to improved professional practice. At Harrison Medical Center, a 297-bed community hospital with campuses in Bremerton and Silverdale,Wash., metaphor and models have marked the way to transforming the health of our community and our employees. These concepts have come in the form of a common shared language through the RROHC program concepts, the 4 Ps (purpose, picture, plan, and part), and situation, background, assessment, recommendations (SBAR).

The full article is available at Nurse Leader.

Why Nurses Still Must Learn to Delegate, Ruth Hansten, Nurse Leader, October 2008

Abstract: Delegation and supervision of assistive personnel is complex critical thinking process requiring expert clinical judgment, superb emotional intelligence, and flexible, innovative leadership skills. As the forecasted shortage of qualified registered nurses (RNs) continues to visit mayhem on the necessary RN staffing for optimal quality care, nurse leaders must be certain that nurses learn to leverage their brainwork by using available assistive personnel to supplement their eyes and ears. What’s actually happening in RN teamwork with assistive personnel may surprise nurse leaders.

The full article is available at NurseLeader.

News spotlight: Care model builds on eye-to-eye communication, HC Pro Nurse Manager Weekly E-Newsletter

Abstract: A new nursing care model has staff at Oakwood Hospital in Dearborn, MI literally pulling up a chair to improve patient care delivery. Relationship & Results Oriented Healthcare—created by Hansten Healthcare PLLC, a healthcare firm based in Port Ludlow, WA—aims to strengthen staff members' connection with patients and families by adding a personal touch to the delivery of results-oriented care.

The multifaceted, but adaptable model incorporates a number of practices to assist nurses in providing safe patient-centered care. One practice has nurses communicate with patients at eye level while sitting beside them, rather than towering over them when standing. They are also taught to practice focused listening skills and therapeutic eye contact.

Under the model, nurses also hold goal-planning sessions with patients each shift, perform bedside handoffs, and meet to discuss care plans for patients regularly.


RNs See Eye to Eye With Patients; Nursing care model at Oakwood Hospital brings personal touch back to bedside, By Catherine Spader, RN, Jan 2009

Pennsylvania State Nurses Association, last retrieved Jan 2009 at

Abstract: Pull up a chair with the nurses at Oakwood Hospital in Dearborn, Mich., to discover how they have improved relationships with patients through a program called Relationship & Results Oriented Healthcare.

"It's all about bringing the basics back to nursing. As opposed to standing and towering over patients, we're pulling up a chair, talking to patients at eye level, holding their hands, and bringing that personal touch back to the bedside," says Diane Lopez, RN, clinical manager of Oakwood's intermediate care unit.

Communicating at eye level is only one facet of RROHC's adaptable, goal-oriented approach to improving patient safety, clinical outcomes, and staff and patient satisfaction.

"Healthcare professionals are often not functioning within a conceptual framework that allows them to most quickly learn and use expert practice, such as how to best connect with patients and families," says Ruth I. Hansten, RN, PhD, FACHE, principal consultant at Hansten Healthcare PLLC, the developer of RROHC. "RROHC teaches the skills to build relationships, maximize productivity, and help patients and staff focus on the result they are looking for."




On March 10, Ruth Hansten, RN, PhD, FACHE, Hansten Healthcare PLLC, was awarded the Northwest Organization of Nurse Executives' (NWONE) Award for a Transformational Pioneer. This award recognizes those leaders in our region who have had a significant impact on nursing practice, education, research, health care and nursing policy and regulation.

With over 35 years of experience in nursing, Ruth brings intellectual acumen, practical experience and a spirit of innovation to improving the essential work that nurses do. For the past 18 years, Hansten Healthcare has worked with nursing care delivery models, critical thinking, delegation and leadership skills, as well as interdisciplinary team development and the RROHC™ bundle of best practices.

Ruth has positively impacted nurses at all levels in settings along the continuum of care – from critical care to home care. Her unwavering commitment to patients and their families is legendary. Her focused scholarship on critical thinking and clinical judgment and extensive writing and training on delegation and supervision is widely recognized.

In addition to leading her consulting practice, Ruth serves on the Board of Trustees of Harrison Medical Center in Bremerton and the Patient Safety Committee of the Washington State Hospital Association. She provides an essential nursing "voice" to these bodies to ensure the patient is always in the center of deliberations. She is known for her ability to ask the "unasked" questions and to keep the front-line care team's needs at the point-of-care at the forefront of decision making.


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Solid Nursing, Great Process, IT WORKS

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