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Whiteboards across the system. A Standardized Tool for Nurse-Patient Communication and Patient-Centric Care. Mari Dee Sandra Cid RN, PCCN University of San Diego Master’s of Science in Nursing. Maria Sudak RN, MSN, CCRN NEA-BC Palomar Pomerado Health Transformation. Background.

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whiteboards across the system

Whiteboards across the system

A Standardized Tool for Nurse-Patient Communication

and

Patient-Centric Care

Mari Dee Sandra Cid RN, PCCN

University of San Diego

Master’s of Science in Nursing

Maria Sudak RN, MSN, CCRN NEA-BC

Palomar Pomerado Health

Transformation

background
Background
  • Patient/ Customer Quality of care and Satisfaction is undoubtedly on the minds of hospitals and healthcare systems.
  • Patient satisfaction is tied to reimbursements.
  • One of the things that patients value is good communication.
  • The Joint Commission states that 65% of reported sentinel events were caused by communication errors.
  • In 2007, one of the National Patient Safety Goals (NPSG) declared by The Joint Commission was to engage patients in their care.
pico question
PICO Question

Does the use of a standardized or structured whiteboard versus a blank board result in increased nurse-patient communication and increased patient/family engagement with their care?

goals of the project
Goals of the Project
  • Standardize “whiteboards” across the system
  • Provide a tool for better communication between caregivers and patients.
  • A mechanism for patient /family engagement in their care and education.
  • Increase patient satisfaction scores / Improve HCAHPS survey scores.
    • HCAHPS ( Hospital Consumer Assessment of Healthcare Providers and Systems)
      • A standardized survey instrument designed to produce data about patients’ perspective of care.
      • Publically reported data
swot analysis
Strengths:

Improve patient- centered care

Improve teamwork

Increase nurse/patient communication

Increase patient education/engagement in their care

“Shared” communication tool.

Weakness:

Controversy over nurses burdened with “one more task” to their responsibilities.

Opportunities:

Improve nurse-patient communication

Increase patient participation with their care

Standardization of information written on the board

Increase patient satisfaction rating

Improve HCAHPS scores

Threats:

Nurses’ compliance

Whiteboards not completed due to missing markers and erasers

SWOT ANALYSIS
challenges to implementing whiteboards
Challenges to implementing whiteboards:
  • Standardization across the system…”special needs”
  • Compliance
  • Privacy
  • Valid and accurate information
  • Expectations
  • Accountability
  • Patient involvement
  • Who’s “GOAL” is it?
strategies and solutions to challenges
Strategies and Solutions to Challenges?

Recruit Input

- Direct care providers

- Ancillary team members

- Customer Advisory Panel

- Leadership

- Professional Practice Committee

Education and communication

- in-services will be provided to staff

- staff awareness through “huddles”

- provide “Inpatient Communication Board” handouts to the team

Participation and involvement

evidence summary
Evidence Summary
  • Standardized templates
  • Structured format = more inclusive of relevant/accurate information
  • Direct Care Provider accountability
  • Whiteboards should be placed in clear view of patients
  • Erasable markers should be readily available
    • greatest barrier
financial projection
Financial Projection

Size of whiteboard:

24 x 36

18 x 36 for space challenges

$ 110/whiteboard X 30 (# rooms/unit) = $ 3,300 approximate cost per Inpatient unit

steps taken to standardize whiteboard format utilization and expectations
Steps taken to standardize whiteboard format,utilization and expectations:

Literature reviewed / unit rounds completed to evaluate current state

Template created and searched

Presentation to Service Excellence work group

Templates combined

Unit rounds at PMC & POM to recruit end user input/feedback

Suggestions incorporated into template

Template to marketing for quote

Recruit funding

Template sent out to Directors to share with UPC’s and recruit input/feedback

Visit to Mother Baby and ED to assess special needs

Template taken to Community Advisory Panel for input form the “Customer”

Care Delivery 1/28/2011

Clinical Leadership Committee & Professional Practice Committee 2/2011

Pilot units…30 days…any last minute revisions 3/2011

Education and Deployment 6/2011

slide16

Name

Nurse

CNA

MD

Diet

Vital Signs

Pain Score

Hearing/Visual limitations

Interpreter needs

Glasses

Dentures

Hearing Aid

Intake/Output

Patient Goal/Discharge Plans

Case Manager

Respiratory Rx

Patient and Family Communication

evaluation
Evaluation
  • A post-intervention 5-questionnaire survey will be given to the patients upon discharge on the pilot units regarding usefulness of patient whiteboards.
  • A post-intervention audit will be conducted to check for staff compliance and identification of removable barriers at 3 and 6 months
  • Outcome= to increase nurse-patient communication/education and patient engagement in their care.
    • Increased patient satisfaction scores (Press Ganey) that reflects
      • nurses’ attention to patients’ special/personal needs
      • nurses kept patients informed.
  • Improve HCAHPS survey scores in 3 months post-intervention.
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