Title : Caught you caring: A nurse driven PDSA project aimed at improving patient satisfaction scores in an outpatient cardiovascular unit
The Consumer Assessment of Healthcare Providers and Systems (CAHPS) program developed by the Agency for Healthcare Research and Quality (AHRQ) surveys the patient experience from the patient point of view in various ambulatory and institutional settings (AHRQ, 2016). CaroMont Regional Medical Center partners with Health Stream Inc. to gather and analyze data through the CAHPS surveys. The manager of the cardiac catheterization laboratory (Cath Lab), cardiovascular short stay (CVSS), the electrophysiology laboratory (EP) and the imaging nursing unit (INU) at CaroMont Regional Medical Center chose the following two questions for the staff of those units to focus on in performance improvement efforts: H4WW “How would you rate the staff’s: Easing (Your/Your Family Member’s) fears?” and H2WA “How would you rate the staff’s helping if (You/Your Family Member) had questions or concerns?” Senior management has set a facility wide goal of increasing the score for H30 “Overall rating of facility.” Performance Improvement Council members from all of the involved units met to brainstorm and discuss ideas for the project. In consideration of the close interaction between INU and radiology, the imaging department was invited to participate in this project and accepted. The CVSS unit focused on H2WA.
Measures were planned to increase staff’s awareness of the wording of these questions on the patient satisfactions surveys. Each unit’s council members surveyed their coworkers regarding their ideas of actions, approaches, and scripting that is helpful in calming the fears of patients and family members and showing willingness to provide desired information and answer questions. The results of these surveys were displayed in a revolving manner in staff areas for the twelve months of the project for modeling of the best ideas of others, as well as, to keep the questions and goals in mind. Results of the Health stream surveys were discussed at monthly department meetings.
Actions were planned to increase the patients’ and their family members’ awareness of staff commitment to assist them in feeling less fearful and to provide the level of information that they desire. Literature supports the provision of preprocedure teaching to assist in reducing anxiety (Liebner, 2015 and Kruzik, 2009). A group was asked to develop a teaching tool to be provided by cardiology offices to patients scheduled for cardiac catheterization or arteriogram. Some literature suggests that listening to music chosen by the patient in reducing anxiety. A menu of the nearly 50 music genre channels available on the televisions in patient rooms was placed in each room and staff encouraged offering this option to patients and their families.
Staff requested that signage be improved to assist family members from these areas in navigating to public rest rooms, the surgical waiting area, the cafeteria, and the parking deck.
A monthly recognition award was developed for staff to award to peers whom they observe taking measures to calm fears and answer questions.
Audience Take Away:
• This project demonstrates measures that used the input of bedside staff to formulate a performance improvement plan aimed at improving patient satisfaction scores.
• Suggestions from staff involved in direct patient care regarding measures they felt increased patient satisfaction around questions chosen by management for focus were used as a guide for both the literature review and the test actions.
• Both staff actions and environmental factors were targeted as issues impacting patient satisfaction scores.