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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


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


  • 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

Improve patient- centered care

Improve teamwork

Increase nurse/patient communication

Increase patient education/engagement in their care

“Shared” communication tool.


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


Improve nurse-patient communication

Increase patient participation with their care

Standardization of information written on the board

Increase patient satisfaction rating

Improve HCAHPS scores


Nurses’ compliance

Whiteboards not completed due to missing markers and erasers

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







Vital Signs

Pain Score

Hearing/Visual limitations

Interpreter needs



Hearing Aid


Patient Goal/Discharge Plans

Case Manager

Respiratory Rx

Patient and Family Communication

  • 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.