Other Titles

Leading a team of front-line staff to own their outcomes: How one unit transformed the culture and significantly improved their patient quality outcomes [Symposium]

Abstract

Session presented on Tuesday, November 10, 2015:

Introduction: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a metric that represents the patient's perception of quality care received. Data supports that the patient's experience is linked to great clinical care, reduced medical error, and improved patient outcomes. HCAHPS is part of the value-based purchasing initiative that ties reimbursement to quality outcomes. Each individual patient's survey results matters. These questions measure frequency on a scale of never, sometimes, usually, and always. Three of the six categories of HCAHPS questions relate to communication: with doctors, with nurses, and about medications. The purpose of this presentation is to describe the development and implementation of a standardized orientation process for trauma and burn patients and its impact on the HCAHPS composites related to communication.

Methods: In an effort to increase the HCAHPS categories related to communication, a standardized orientation was created. A multidisciplinary team was formed including key stakeholders from the Trauma and Burn Intensive Care Unit (TBICU), Neuro Intensive Care Unit (NICU), Emergency Department (ED), Acute Care Trauma Unit, and the Trauma and Burn Unit. A review of current literature was completed and a best practice identified. The team decided to create a video that patients and families would view within the first 12 hours of admission. Key talking points were identified and distributed to all frontline staff. The team then decided to pilot the standardized orientation process on the Acute Trauma Care Unit. Education was provided to all members of the health care team. During this phase, documentation of the patient viewing the video with in the first 12 hours was validated. Nurse leaders on the unit spoke to every patient in the first 24 hours of admission to answer any questions, ensure compliance with the new process, and address any concerns. Staff nurses were asked to complete a brief questionnaire about the new orientation process. HCAHPS survey results were evaluated by discharge date during the three month pilot phase.

Results: HCAHPS scores in the categories involving communication improved. Nurses involved in the pilot provided positive feedback with qualitative data supporting the consistency and effectiveness of the new process. The exact process is now being utilized in several other units where burn patients receive care and other specialty areas have used the process as a guide to create unit specific orientation videos.

Conclusions: A consistent patient and family centered orientation process, upon admission with individual one on one discussion with the bedside nurse, positively impacts the HCAHPS composites related to communication. Applicability of Research to Practice Success of the implementation of this initiative in practice relies on the commitment of key people within the organization to see activities through from planning to implementation and ongoing evaluation. Involving key stakeholders in the project team, created buy in and provided support for sharing best practices throughout a large academic medical center. Additional research could be completed to evaluate the effectiveness of a video versus a written standardized orientation.

Description

43rd Biennial Convention 2015 Theme: Serve Locally, Transform Regionally, Lead Globally.

Authors

Meredith Palmer

Author Details

Meredith Palmer, CCRN

Sigma Membership

Non-member

Type

Presentation

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Patient Experiences, Outcomes, Technology

Conference Name

43rd Biennial Convention

Conference Host

Sigma Theta Tau International

Conference Location

Las Vegas, Nevada, USA

Conference Year

2015

Rights Holder

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All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

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Improving HCAHPS in a challenging patient population: Trauma and burns

Las Vegas, Nevada, USA

Session presented on Tuesday, November 10, 2015:

Introduction: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a metric that represents the patient's perception of quality care received. Data supports that the patient's experience is linked to great clinical care, reduced medical error, and improved patient outcomes. HCAHPS is part of the value-based purchasing initiative that ties reimbursement to quality outcomes. Each individual patient's survey results matters. These questions measure frequency on a scale of never, sometimes, usually, and always. Three of the six categories of HCAHPS questions relate to communication: with doctors, with nurses, and about medications. The purpose of this presentation is to describe the development and implementation of a standardized orientation process for trauma and burn patients and its impact on the HCAHPS composites related to communication.

Methods: In an effort to increase the HCAHPS categories related to communication, a standardized orientation was created. A multidisciplinary team was formed including key stakeholders from the Trauma and Burn Intensive Care Unit (TBICU), Neuro Intensive Care Unit (NICU), Emergency Department (ED), Acute Care Trauma Unit, and the Trauma and Burn Unit. A review of current literature was completed and a best practice identified. The team decided to create a video that patients and families would view within the first 12 hours of admission. Key talking points were identified and distributed to all frontline staff. The team then decided to pilot the standardized orientation process on the Acute Trauma Care Unit. Education was provided to all members of the health care team. During this phase, documentation of the patient viewing the video with in the first 12 hours was validated. Nurse leaders on the unit spoke to every patient in the first 24 hours of admission to answer any questions, ensure compliance with the new process, and address any concerns. Staff nurses were asked to complete a brief questionnaire about the new orientation process. HCAHPS survey results were evaluated by discharge date during the three month pilot phase.

Results: HCAHPS scores in the categories involving communication improved. Nurses involved in the pilot provided positive feedback with qualitative data supporting the consistency and effectiveness of the new process. The exact process is now being utilized in several other units where burn patients receive care and other specialty areas have used the process as a guide to create unit specific orientation videos.

Conclusions: A consistent patient and family centered orientation process, upon admission with individual one on one discussion with the bedside nurse, positively impacts the HCAHPS composites related to communication. Applicability of Research to Practice Success of the implementation of this initiative in practice relies on the commitment of key people within the organization to see activities through from planning to implementation and ongoing evaluation. Involving key stakeholders in the project team, created buy in and provided support for sharing best practices throughout a large academic medical center. Additional research could be completed to evaluate the effectiveness of a video versus a written standardized orientation.