AACN Excellence in Leadership Award.

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Vicky Orto, MS, RN, CNAA, BC

Rochester General Hospital, Rochester, N.Y.

Vicky Orto has been the director of Medical Nursing at Rochester General Hospital since 2000. She has received the Excellence in Leadership Award for two primary reasons. The first is for her role in seeking a solution for the care of unstable patients on her general medical units. The second is for her role in grooming a novice clinical nurse specialist (CNS) to develop a critical care outreach program to address the first objective. Her version of a rapid response team has resulted in multiple benefits to the hospital. The program is known as the Early Nursing Intervention Team, or ENIT.

Vicky's vision to provide critical care expertise outside the MICU supported both patients and the "floor" nurses. She assigned the project to her newly hired CNS and guided her through the process. A planning committee began to explore methods to address her mission. A nurse-led team that would provide preemptive rounding on the medical units, as well as respond to calls, was the model chosen. Although the CNS was the designated leader of the project, it was Vicky who anticipated obstacles and eliminated them. She enlisted the support of key stakeholders early in the process by assisting the CNS to present to the attending physicians' grand rounds. She made the business case for increasing MICU staffing to free the charge nurse to round and respond on the medical floors.

The program has become so successful that it has been expanded throughout the hospital. Vicky has sent her CNS to national conferences with poster presentations to further spread the word. A dramatic change in the MICU staff performing the role of ENIT responder has become evident in their drive to seek baccalaureate education and certification. It is Vicky's vision and leadership that have made this program a success.