Ruth Merenguelli, RN, (fourth from right) is involved in transitional care rounds with physicians and staff on the Heart and Vascular Center Observation unit. One of the hospital's clinical outcomes leaders, Merenguelli helps lead efforts to improve the quality, safety and value of care and enhance communication among physicians, staff and patients.

On the Center for Musculoskeletal Care unit (Verdi 4 North), Megan Webb, RN, is working with clinical staff to reduce surgical-site infections and improve pain management.

Jennifer Barna, RN, is integral to efforts to prevent readmissions to the Medical Intensive Care Unit (NP-9/10). On the General Medicine unit (EP 5-5), Michelle Willard, RN, is helping to lead initiatives to mobilize patients, maintain their function and remove catheters and central lines when no longer necessary.

These are just a few examples of how Yale New Haven Hospital's clinical outcomes leaders (COLs) are making a difference, though they've been on the job less than a year.

EP 5-5, Verdi 4 North and the MICUs at both campuses, along with the Heart and Vascular Center Observation unit (EP 5-7) and Center for Restorative Care for Older Adults unit (Verdi 4 West) each has a COL. More COLs – all master'sprepared nurses – will be hired in the future.

The COLs' main responsibilities are to help staff provide evidence-based care targeted to their unit's patient populations, manage patient outcomes and engage in ongoing improvement. COLs can provide assistance right at the bedside, said Ruth Merenguelli, RN, EP 5-7 COL.

"One of the most important things I do is to communicate," she said. "I spend a significant amount of my time building relationships with patients and all members of the healthcare team to keep everybody on the same page."

Asghar Rastegar, MD, said that in addition to working to improve care, Willard has improved communication and the patient experience on EP 5-5.

"The major impact of the COL has been to improve real-time contact between nurses and physicians," he said. "She has helped them collaborate more effectively, resulting in improvement in quality as well as patients' perception of the quality of their care."

COLs also serve as liaisons between the patient and healthcare team, improve processes so care is provided efficiently and cost-effectively, and design and evaluate patient care within Yale New Haven Health System.

"Their work ties in with clinical redesign, in that the overall goal is to increase value by improving the quality of care and reducing the expense," said Diane Vorio, RN, vice president, Patient Services. "The successful practices and protocols the COLs help develop on their units will ultimately become standard across similar units throughout the hospital."