Staff Writer

The Children’s Hospital  Denver is consistently recognized as one of the top pediatric hospitals in the U.S., and its nursing staff plays a huge role in its success.
For CNO Kelly Johnson, MSN, RN, NEA-BC, who has been at the nursing helm for just over a year, continuing to build on the talented nursing staff and maintain that reputation is paramount.
“The quality is peerless. They’re at the top of their game,” she said of TCH’s 1,800 nurses. “Part of what I see  doing in the future is to continue to establish us as nursing leaders in pediatrics, nationally and internationally.”
When Parents magazine named Children’s one of the “10 Best Children’s Hospitals” in February, it noted that TCH scored the highest amount of points for the nursing section of any hospital in the top ten. Johnson attributes that recognition to “a strong nursing foundation built over decades of really supporting an atmosphere of professional practice and autonomous decision making and the ability of nurses to really work within the context of the team, and to be a valued member of the team.”
The nursing staff is highly educated; 86.9 percent of its nurses have BSNs and 4.3 percent have MSNs. But Johnson sees more opportunities at continuing education among the nursing staff.
“There are lots of resources here and a lot of talented nursing leaders to move us to an all-BSN bedside nursing staff, with more advanced practice nurses, more Ph.D. nurses and supporting certification of nursing staff,” she said.
There’s a push industrywide for more BSN nurses, which Johnson says prepares  them for patients’ complexity of care.
Johnson herself has been in nursing for 26 years, but says she didn’t necessarily dream of being a nurse as a child. Instead, after exploring a variety of career options in high school, including spending time at a veterinarian’s office, she became interested in the nursing program at the University of Northern Colorado (UNC) in Greeley, where she lived.
But a high school tragedy touched her and influenced her career path. One of her friends was severely injured in a football game; he had a spinal cord injury and was paralyzed.
“I found it profound and sad what happened to him,” Johnson said of her friend who was ventilator-dependent and in a nursing home. “It always stuck in the back of my head and I got really interested in neuroscience.”
While earning her BSN from UNC (she graduated in 1982), Johnson said she had great clinical experiences at Poudre Valley Hospital in Fort Collins that continued her fascination with neurotrauma. Following graduation, Johnson helped open the Greeley Center for Independent Living and her injured classmate from high school was their first client.
“It was just serendipitous that I was asked to be the the first RN,” she said. “We opened the independent living center and he was the first guy to live there. Now, it’s a huge program.”
Johnson said she’s always been interested in trauma and enjoys working with young adolescents affected by spinal cord injuries. “I found the nervous system fascinating, and how the brain and spinal cord work,” she said.
After working at the Greeley center for a few years, Johnson’s interest in neurotrauma led her to the University of California San Francisco, where she earned her MSN as a neuroscience clinical nurse specialist in 1988. She had a dual major and also became a family nurse practitioner. While in San Francisco, she worked at Shriners Hospital and got involved in pediatrics, working with adolescents with spinal cord injuries.
Prior to joining TCH in September 2008, Johnson worked at Craig Hospital in Denver from 1993 to 2008. She worked as a clinical nurse specialist for three months and then became CNO.
During her 15 years at Craig, which specializes in rehabilitation and research for patients with spinal cord injury and traumatic brain injury, Johnson helped elevate nursing status in the organization and helped Craig earn prestigious Magnet designation in 2005.
“My time at Craig was unbelievable,” Johnson said. “It’s a wonderful program and a great team, but it was time for me to grow in a different way and to be on an academic campus in an academic medical center. My role has grown exponentially with the scope of my job.”
In her role at TCH Johnson said she’s unconditionally challenged in a very positive way. “It’s a very exciting place to work at during a very exciting time.”
TCH is also a very different environment, Johnson said, from serving more hot dogs and mac and cheese to the colors and how everything is thought about from equipment and supplies to education. But it’s also similar to Craig in that it’s a very family-centered organization, she said.
In her first year as CNO, one of her goals has been to strengthen nursing’s interdisciplinary partnership as TCH moves toward service-line development. In this health care model, the different disciplines involved with a patient and their family are integrated to better the continuity of care.
“It’s a  different way of thinking about providing the continuum of care,” Johnson said. “It’s the way the team collaborates care in a patient-family-centered way.”
For example, Johnson said, TCH is developing a Neuroscience Institute that will integrate neurology, neurosurgery, neuropsychology, radiology and rehab.
TCH has had a few service lines in place for sometime, such as its Heart Institute and Center for Cancer and Blood Disorders. As the organization develops more service lines in key clinical areas, Johnson wants to ensure that nurses are aligned to be integrated into them.
In the past six months, Johnson has worked with other hospital leaders on an organizational redesign of the leadership structure to make it better aligned with Children’s strategic goals.
That work has included aligning director-level positions to a service-line model rather than a floor-based model, elevating the status of the director positions and expanding the scope of responsibility of nurse managers. As a result, new positions have been added, not cut, Johnson said, as they are rethinking how work is done.
All of the staff realignment is focused on the goal of making sure nurses are highly involved, Johnson said, “so that we have a strong nursing voice in these continuum of care models and have a partnership in medicine and nursing on how these are developed and executed.”
Along with her TCH responsibilities, Johnson is working on her Ph.D. in nursing with an emphasis in health outcomes at the University of Colorado Health Sciences Center.
Reflecting on her first year at Children’s, Johnson said it has been challenging to integrate into such a complex system.
“The balance of national, community and higher executive level expectations with the need and desire to be out and rounding the staff is probably the biggest challenge,” she said.
When Johnson was recently submitting documents for re-designation for Magnet status, she said she was overcome with a sense of pride of all the great nursing.
“We do all kinds of community outreach and prevention programs and volunteer work,” she said. “It’s amazing all the incredible things the nurses in this organization do. It’s very impressive. And there’s potential to do even more.”