Transcript Quality Care Improvement Project 4D Trauma Unit

Quality Care
Improvement Project
4D Trauma Unit
Kelly Quinn RN, MS, CNS
Allison Morton, RN, BSN
Jignasa Pancholy, RN
Holland Stephens, RN, MSN, CNL
HCAHPS
(Hospital Consumer Assessment of Healthcare Providers and Systems

Designed to elicit comparable &
measurable data based on
perceptions of patients’ experience
of hospitals nationally.

Results are ranked & hospital
reimbursements can be affected
based on our performance

SFGH lags just 4 percentage points
behind the national average when
patients are asked to rank hospitals
worst to best.
HCAHPS 10 Composites
 Communication about
medication
 Communication with
doctors
 Communication with
nurses
 Discharge information
 Pain control
 Rate hospital
 Responsiveness
of hospital staff
 Room kept clean
 Room quiet at
night
 Would
recommend the
hospital
HCAHPS RESULTS
4D Patient Survey
Questions
 I am receiving sufficient teaching about my
condition.
 I feel confident I'll be able to manage my condition
at home.
 My nurses always explain things clearly to me.
 My nurses always tell me about side effects of
new medications.
 My doctors always explain things clearly to me.
 I always receive help when I need it.
 My pain is always well-controlled.
 My room is always clean.
 It's always quiet at night so that I can rest.
 Overall I've had a good experience at this
hospital.
Project to Improve Noise at
Night on 4D
 Based on the HCAHPS: the
lowest score was patients'
perceptions of noise at night
 Aim Statement: Goal is to
reduce noise at night by 10% by
April 20th 2012
 Baseline: Patient survey done
January 2012 on 4D
Interventions
 SILENT campaign to remind
nurses to be noise conscience
after 11p
 Shhhh in the hallway
 It's nighttime
 Low TV volume ( TV Signs)
 Earplugs can be offered!
 No loud voices
 Turn down nursing station
phone ringers
Supportive Interventions
 Volunteers educate
patients on what to
expect at night (e.g.
VSQ4H, AMLs, early MD
rounds)
Other
3%
Nurses Station
phone
15%
Equipment
19%
Call Light
18%
Patient TV
16%
Hallway 1
10%
Nurses Talk
7%
 Bi-weekly patient
survey conducted
Hallway2
7%
Break Room
5%
 Noise audits performed
to identify noise-prone
areas of the unit
Dates
4/18/2012
3/12-3/19
2/27-3/9
1.5
2/13-2/24
2/6-2/10
1/30-2/4
1/23-1/27
1/12-1/20
1/5-1/11/12
1=Strongly Disagree, 2=Disagree, 3=Agree, 4=Strongly Agree
Noise Data Graph
4.0
3.5
3.0
2.5
2.0
It's always quiet at night so that I can rest.
1.0
Future Projects Impacting
Patient Experience
 Nurse to patient communication regarding side
effects of medications

Cheat sheet on COWs

Signs (e.g. pt
rooms/hallways/med room)

CALNOC med pass audit

"Med of the week"

M/S AIM: Increase
“communication about
medicine” score by 10%
(from 55-65%)
3/12-3/19
2/27-3/9
2.50
2/13-2/24
2/6-2/10
1/30-2/4
1/23-1/27
1/12-1/20
/5-1/11/12
1=Strongly Disagree, 2=Disagree, 3=Agree, 4=Strongly Agree
Graph
4.00
3.50
3.00
My nurses always tell me about side effects of new
medications.
2.00
1.50
1.00
Future Projects Impacting
Patient Experience (cont):
 Organizing education material
and accessibility
 Music therapy available for
patients to decrease pain
 Increasing responsiveness to
patient needs
 Increasing communication with
MDs/NPs
Staff Communication
 Focus placed on increasing staff communication
and disseminating knowledge about unit changes





Emails
Monthly meetings
Communication binder
Open forum board for
suggestions/feedback
Positive Recognition
Board

Roles and Responsibility
Of Quality Care Coordinator
Nurse
 Provides patient centered care.
 Educates patients and professionals.
 Enhances care and work environs.
 Develops systems to support quality nursing
and quality care.
 Provides assistance to patients throughout care
transitions.
 However, this is a nurse among nurses. Our goal
is to support you in your role as med-surg
Sustainability
 Continue to create immediate,
visible, flexible and unit-specific
changes that address the unique
needs of the unit
 Unit shared governance based
project
 Continue to promote nursing
excellence
 Continue to improve patient
experience by providing support
and voice for the nurses
Spreading Change through
the SG Structure