EP18

 

Patient Experience EP18

 

Provide one example, with supporting evidence, of an initiative led or co-led by a clinical nurse(s) to address patient experience based on feedback from patients and/or families.

 

 

Example: 5E Clinical Nurses Lead Unit-Based Council Initiative to Improve Patient Experience

Patient Feedback
At Catholic Health Initiatives (CHI) St. Vincent Hot Springs (SVHS), all leaders round daily on patients and families to ensure they are receiving excellent care and having positive patient experiences. Leaders discuss with patients and families the following:

  • Communication: Ensure patient and family understand their plan of care and goals for the day.
    • Manage staff up at any opportunity.
  • Intentional hourly rounding: Needs are met through staff rounding throughout the day.
  • Medication side effects: Understand the side effects of new medications they are receiving.
  • Recognition: Ask if there are any staff members who have gone above and beyond that we can recognize on their behalf.
  • Thank you: Thank them for trusting us with their care and let them know we have time if there is anything we can do for them.

(Evidence EP18-1, Leader Rounding Tool & Log)

 

Once the leader has rounded on the patients and families, they will follow up with any necessary staff to give kudos, share any feedback that there is an opportunity to improve, and/or make leaders aware of circumstances that may need to be followed up on. CHI SVHS has a daily patient experience huddle where all leaders attend and report out the number of patients rounded on and any feedback received from patients and families that can be used to improve.

 

During leader rounding in November 2023 on 5 East Orthopedics/Neurosurgery (5E), Laura McAnally, BSN, RN, RN-BC, Nursing Excellence Manager, Magnet Program Director, rounded on a patient who was getting ready to discharge. The patient shared that they would like to contact McAnally in the future to provide thorough feedback on how CHI SVHS could improve the patient experience and the care provided to them. McAnally provided a business card with her contact information to the patient.

 

The patient contacted McAnally and asked to meet in person, to which McAnally agreed. During the in-person meeting in January 2024, the patient provided McAnally with a detailed outline of observations and opportunities for improvement. The patient gave feedback on 17 different areas or topics. Feedback included what the patient observed, details, and any negative effects that could have been involved and provided suggestions for opportunities to improve. (Evidence EP18-2, Patient Feedback)

 

McAnally relayed to the patient that this information would be shared with the appropriate leaders and clinical nurses at CHI SVHS. McAnally thanked the patient for sharing their experience as feedback is viewed as a gift by CHI SVHS. McAnally also sent a handwritten thank you note to the patient in February 2024 and shared the feedback with Kaitlyn Atkins, MSN, RN, CPN, Clinical Director of Nursing.

 

Clinical Nurses Lead Initiative

Atkins shared the patient feedback with Sarah Ostrem, BSN, RN, CMSRN, Clinical Nurse, Unit-Based Council (UBC) Chair, to bring to the February 23, 2024, 5E UBC meeting. Ostrem led the conversation to identify an area of feedback that the staff could improve upon. The team was receptive and appreciative of the feedback. The UBC agreed to improve the hydration status, offer hand sanitizer to patients, and print out discharge paperwork to improve the quality of the handouts.

 

The observation by the patient during the admission was one large cup of water and ice was given per shift, which could have led to potential dehydration. Ostrem asked for feedback from the team on how to improve the overall patient’s hydration status. Spencer Burris, RN, Clinical Nurse, suggested ice water be passed every four hours, using the same schedule as obtaining vital signs every four hours.

 

The PCTs would pass the water, and the charge nurse would ensure the task was completed. The team discussed how there used to be individual hand sanitizer available for the patients. Atkins indicated those were still available and would reach out to the supply department to get them placed on the unit again. The UBC discussed putting hand sanitizer into the nurse servers right outside the patient's room for staff to offer them to the patients. Sue Snezana Ratkovic, Inventory Technician, is responsible for stocking items in the nurse servers.

 

The team also discussed how the discharge paperwork could easily be printed instead of copied to provide the patients with a more professional handout. Ostrem and Burris shared that they could lead these three initiatives being clinical nurses and charge nurses on the unit to get them started and to sustain the initiatives on 5E. Ostrem and Burris would delegate to PCTs to pass water out to patients every four hours, delegate to Sue to stock the hand sanitizers in the nurse servers, and oversee that all discharge paperwork gets printed. (Evidence EP18-3, UBC Meeting Minutes and Roster)

 

Barbara Ellis-Erby, MSN, RN, Nurse Manager, 5E, also reviewed the opportunities shared by the patient, including securing and emptying of drains, compression devices, meal service program, incentive spirometry, and communication options for patients with staff.

 

Patient Experience Addressed

5E clinical nurses Ostrem and Burris put the initiatives in place of improving the hydration status, offering hand sanitizer to patients, and printing out discharge paperwork to improve the quality of the handouts by March 1, 2024. The initiatives were communicated in unit-based huddles for a week to catch all coworkers. (Evidence EP18-4, Huddle Sheet)

 

McAnally also shared this patient's feedback in March 2024 with Tonya Baier, MBA, BSN, RN, Clinical Director of Nursing, the suggestion of preoperative warming before surgery. Baier stated the nursing leadership had been working on bringing this practice into CHI SVHS. McAnally shared the concerns of physical therapy and walker with Megan Savage, M/S, OT/L, CBIS Manager of Therapies of Therapy Services, who shared the feedback with the physical therapy team.

 

In April 2024, McAnally wrote a follow-up letter to the patient. McAnally shared the interventions implemented at CHI SVHS to address the patient’s concerns, including the UBC-led initiatives, including passing out water every four hours to address patients’ hydration needs, offering hand sanitizers to patients, and printing discharge paperwork instead of copying it.

 

McAnally thanked the patient for their feedback and for trusting CHI SVHS with their care. In May 2024, the patient responded by thanking McAnally for the follow-up and acknowledging how they appreciated the thought and detailed information and how it made them feel their opinions and suggestions were significant. (Evidence EP18-5, Follow-Up Patient Letter and Patient Response)

 

Clinical nurses on 5E at CHI SVHS led multiple initiatives to improve the patient experience based on the feedback from their patient.