SE1EOa

 

Interprofessional Care SE1EO

 

Using the required empirical outcomes (EO) presentation format, provide an example, of an improved patient outcome associated with the participation of clinical nurse(s) serving as a member(s) of an organization-level interprofessional decision-making group. 

 

 

Example a: Clinical Nurses’ Participation in Patient Experience Huddle Increases Inpatient Units Meals Overall Percentage

Problem

Catholic Health Initiatives (CHI) St. Vincent Hot Springs (SVHS) Inpatient Units Top Box percentage patient experience scores decreased for Meals Overall.

 

Pre-Intervention

The CHI SVHS Patient Experience team, consisting of Teresa Lambert, MBA, BSN, RN, Vice President of Patient Care Services, Assistant Chief Nursing Officer (role of CNO); Tonya Baier, MBA, BSN, RN, Clinical Director of Nursing; Kaitlyn Atkins, MSN, RN, CPN, Clinical Director of Nursing; Renee Fechuch, MSN, RN, Clinical Director of Nursing; Allison Fitts, RN, CMSRN, Clinical Nurse, Nurse Supervisor; Teresa Moore, BSN, RN, Clinical Nurse, Nurse Supervisor; Chae Brewer, MSN, RN, Clinical Nurse, Nurse Supervisor; and Phillip Petty, RN, Nurse Supervisor, along with nurse managers from each of the inpatient units report out in a daily interdisciplinary patient experience huddle.

In addition, Crystal Bohannan, MBA, CPA, Vice President of Operations, and leaders from clinical departments, ancillary departments, and clinical supervisors participate in the daily interdisciplinary patient experience huddle. They share leader rounding feedback to gain patient perspectives on communication, call light response, cleanliness, quietness, and meals on the inpatient units.

During the daily August 2023 interdisciplinary patient experience huddles, clinical nurses and leaders mentioned multiple complaints shared by patients about the lack of dietary options. CHI SVHS’s inpatient unit dietary options included a limited menu of food choices on a four-day rotating schedule. Clinical nurses, attending the daily interdisciplinary patient experience huddle, proposed the need for additional food selections to be added to the menu to improve the patient experience.

 

In August 2023, the CHI SVHS Inpatient Units Press Ganey Top Box percentage patient experience scores for Meals Overall was 25.25%.

 

Goal Statement

Increase CHI SVHS Inpatient Units Press Ganey Top Box percentage patient experience scores for Meals Overall.

 

Participants

 

Interdisciplinary Daily Patient Experience Huddle Group
Name/Credentials	Discipline	Title/Role	Department
Teresa Lambert, MBA, BSN, RN	Nursing	Vice President of Patient Care Services, Assistant Chief Nursing Officer (role of CNO)	Administration
Philip Petty, RN	Nursing	Nurse Supervisor	Float Pool
Allison Fitts, RN, CMSRN	Nursing	Clinical Nurse, Nurse Supervisor	4 East Medical/Surgical
Teresa Moore, BSN, RN	Nursing	Clinical Nurse, Nurse Supervisor	2 East Cardiology
Chae Brewer, MSN, RN	Nursing	Clinical Nurse, Nurse Supervisor	2 West Oncology/ Renal
Delia de los Reyes, BSN, RN	Nursing	Nurse Manager	4 East Medical/ Surgical
Barbara Ellis-Erby, MSN, RN	Nursing	Nurse Manager	5 East Orthopedics/ Neurosurgery
Jeannie Roberts, BSN, RN	Nursing	Nurse Manager	1 East Geripsych
Angie Pike, MSN, RN, CMSRN	Nursing	Nurse Manager	2 West Oncology/ Renal
Megan Schaub. BSN, RN	Nursing	Nurse Manager	2 East Cardiology
Richard Pope, MSN, RN	Nursing	Nurse Manager	4 West Medical/ Surgical/Pediatrics
Sheila Clemens, BSN, RN	Nursing	Nurse Manager	Surgical ICU
Trish Nicholas, BSN, RN	Nursing	Nurse Manager	Medical ICU
Amy Gates, BSN, RN	Nursing	Nurse Manager	LDRP, Pregnancy Clinic
Kimberly Dawn Spurlock, BSN, RN	Nursing	Nurse Manager	Outpatient Department
Marcie Herman, BSN, RN, CIC	Nursing	Infection Preventionist	Infection Control
Kathryn Goad, BSN, RN	Nursing	Patient Safety Manager	Risk Management
Stephanie Bailey, LPN, MA	Nursing	Manager of Patient Experience, Volunteer Services	Patient Experience, Volunteer Services
Laura McAnally, BSN, RN, RN-BC	Nursing	Magnet Program Director, Nurse Excellence Manager	Nursing Administration
Mike Long, BSN, RN, CNML	Nursing	Nurse Manager	Cardiac Cath Lab, Cath Lab Recovery, Interventional Radiology
Tim Lambeth, BSN, RN	Nursing	Nurse Manager	Operating Room
Tanner Ross, BSN, RN	Nursing	Nurse Manager	Emergency Department
Douglas Ross, MD, FACHE	Physician	President of CHI SVHS, Chief Medical Officer of St. Vincent Market	Administration
Crystal Bohannan, MBA, CPA	Administration	Vice President of Operations	Administration
Renee Fechuch, MSN, RN	Nursing	Clinical Director of Nursing	Nursing Administration
Kaitlyn Atkins, MSN, RN, CPN	Nursing	Clinical Director of Nursing	Nursing Administration
Tonya Baier, MBA, BSN, RN	Nursing	Clinical Director of Nursing	Nursing Administration
Vicky Sanders, MSN, RN, CNML	MSN, BSN, RN	Director of Care Coordination	Care Management
Melinda Hannafious	Lab	Lab Manager	Laboratory
Tracy Bays	EVS	Director of EVS	EVS
John West, RT (R)	Imaging	Director of Radiology	Imaging
Julie Clift Hays, BSRT, RRT	Respiratory	Respiratory Therapy Manager	Respiratory Therapy
Jessica Wilson, MHA, HACP, CPHQ	Quality	Patient Safety Program Manager	Quality
Tiffany McCain, PharmD	Pharmacy	Director of Pharmacy	Pharmacy
Christi Amerson, PharmD	Pharmacy	Manager of Pharmacy	Pharmacy
Thomas Ford	Security	Security Supervisor	Security
David Clay Bowen	Facilities	Facilities Supervisor	Facilities
David Terry	Facilities	Director of Facilities	Facilities
Jeff Erwin, CDM/CFPP, BSBA	Kitchen	Kitchen Manager	Kitchen
Debra Erwin, RDN/LD	Dietary	Nutrition Manager	Dietary, Nutrition

 

Description of the Intervention

September 2023

• CHI SVHS clinical nurses Fitts, Moore, and Brewer and leaders Lambert, Atkins, Baier, Fechuch, and Bohannan further collaborated with the nutrition team to discuss the limited menu selections, patient feedback, and patient experience scores for Meal Overall during the daily patient experience huddles. They noted the increase in service recovery related to meals and brainstormed additional food options. Debra Irwin, RDN/LD, Nutrition Manager, and the nutrition team created a menu that provided new patient meal options, including salads, sandwiches, chicken strips, hamburgers, and quick meal options.
• During a daily patient experience huddle, Irwin met with clinical nurses Fitts, Moore, Brewer and nurse leaders to discuss the proposed new patient meal options. The group recommended piloting the new menu on all inpatient units immediately before finalizing to gain patient feedback.
• During a daily patient experience huddle, clinical nurses Fitts, Moore, and Brewer and leaders discussed the patient feedback elicited from leader rounds during the pilot. Patients voiced they were pleased with having more options to choose from, and there were little to no complaints overall. The group had a consensus to move forward with the additional menu items.
• Once the menu was finalized, Irwin sent the menu to the marketing team to create. Irwin brought the first menu drafted to the daily patient experience huddle where clinical nurses Fitts, Moore, and Brewer and leaders gave feedback on the menu’s appearance and content. They recommended a larger menu, expanding from 8x11 (front and back) to 8x17 (book format) to have the menu in larger print for patients to be able to read better. The menu went back to marketing for the editing.
• Irwin brought the revised version to the next daily patient experience huddle where clinical nurses Fitts, Moore, and Brewer and leaders voiced their approval.
• The nursing team leaders Lambert and Atkins worked with Tracy Bays, Director of Environmental Services (EVS), to place the updated menus on patient bedside tables during the cleaning process to ensure each room had a new menu readily visible to the patient.
• The patient experience team decided to roll out education on updated menus via daily unit-based safety huddles because this was the most effective way to reach all staff. During daily unit-based safety huddles, unit-specific charge nurses cascaded the new process to frontline nurses and techs. The unit-specific charge nurses would bring a new menu to the unit-based safety huddles for a week and explain the new process of how patients had more options.
• Nurse managers and charge nurses educated EVS and inpatient units on the new menu options and the importance of discussing the menu and ordering timeframes with patients to improve their meal experience.
• As discussed by the patient experience huddle group, on admission and during patient rounds, clinical nurses and all leaders rounding on patients reviewed the standardized menu selections and the new food options with patients on all inpatient units.

 

The interventions were fully implemented by September 2023.

 

At CHI SVHS, the participation of clinical nurses Fitts, Moore, and Brewer, serving as members of the organization-level, decision-making group, Interdisciplinary Daily Patient Experience Huddle Group, was associated with an improvement in CHI SVHS Inpatient Units Press Ganey Top Box percentage patient experience scores for Meals Overall.

 

References

MacKenzie‐Shalders, K., Maunder, K., So, D., Norris, R., & McCray, S. (2020). Impact of electronic bedside meal ordering systems on dietary intake, patient satisfaction, PLATE WASTE AND COSTS: A systematic literature review. Nutrition & Dietetics, 77(1), 103–111. https://doi.org/10.1111/1747-0080.12600

 

McCray, S., Maunder, K., Krikowa, R., & MacKenzie-Shalders, K. (2018). Room service improves nutritional intake and increases patient satisfaction while decreasing food waste and cost. Journal of the Academy of Nutrition and Dietetics, 118(2), 284–293. https://doi.org/10.1016/j.jand.2017.05.014

 

Outcome

• (Evidence SE1EOa-1, CHI SVHS Inpatient Units Percentage Meals Overall Graph)