RESEARCH POSTER PRESENTATION DESIGN © 2012

www.PosterPresentations.com

A nursing team at Nash Health Care Systems developed interactive

communication boards to guide bedside shift report and improve patient

satisfaction. The team designed this project to upgrade the hospital’s

outdated white boards with multipurpose communication boards based on

evidence-based research, current literature review, and evolving practice

standards that integrate patients and family members into every element of

care. This strategy rapidly supported efforts encouraging bedside shift

report and generated improved perception of quality among patients as

validated using measured standards.

Patient satisfaction increases when patients and families feel included in

planning and communication. Nursing teams ensured patient participation

by increasing time spent at the bedside, communicating messages with

patients, and sharing daily plan updates in clear and understandable terms.

The innovative design created by a team of bedside nurses communicates

elements of daily care with patients and their families. This project differs

from previous communication methods by transferring focus from

providers to patients. Headings provide space for patients to write “What

is important to me and my family” and clearly identifies “My pain goals”

using bright colors and open spaces.

Nurses can deliver bedside shift report using the communication boards to

guide conversations. As nurses share traditional shift-change information,

patients can visualize reminders about planned procedures, tests, and

upcoming events.

Patients and their families are encouraged to write questions or comments

on the boards to prompt discussions when team members visit the room.

Leaders approved this communication tool and expanded efforts to include

all applicable patient care areas. Based on standardized templates, nurses

can easily customize subjects and content to address individual patient

concerns, unit-wide issues, language barriers, or educational changes.

Board inserts can be interchanged to meet the needs of Spanish-speaking

or pediatric patients to meet patient-specific needs.

Nurses successfully introduced this tool by reinforcing it with:

► Step-by-step flyer

► 12-minute training video staring

hospital employees as actors to

demonstrate bedside shift report using

the new communication boards

► A hospital-approved competency

and validation for bedside nurses

This “Writing on the Wall” preceded positive, measured outcomes for

NHCS. The project points to opportunities for continued improvement and

integration of patients and their families with every element of care and

communication. This tool allows members of the health care team to

support successful outcomes while continually re-directing efforts that

maintain the patient as the most important member of each team. The

team continues to pursue approval from the organization’s internal review

board to complete additional front-line research to validate this success.

INTRODUCTION

STRATEGY

Leaders measured and monitored the success of this project by tracking

patient satisfaction scores collected using Press Ganey surveys and

reported to the Hospital Consumer Assessment of Healthcare Providers

and Systems (HCAHPS).

HCAHPS provides standardized metrics and uses nationally recognized

measurements for publicly reported information about the patient’s

experience. HCAHPS allows hospitals to compare performance to other

providers in the health care industry locally, regionally and nationally.

EVALUATING OUTCOMES MEASURED RESULTS

CONCLUSIONS Using the communication board to guide shift report and share data

promotes inclusion of patients and families in team conversations. Future

trends in health care require delivery of high-quality, patient-centered care.

This tool facilitates our goals and improves patient satisfaction.

Barriers the team identified and overcame included:

• Fear that shift report will take too long.

• Desire to share information without the patient or

family as an audience.

• Concern about patient confidentiality.

• Accountability: Who is responsible for updates?

After an introductory period, the nursing population has overwhelmingly

accepted this tool and reported the design as convenient and useful. As

employee culture adapts to embrace the shift toward patient and family-

centered care, this tool remains relevant for sharing information.

REFERENCES

Schwerdt, A. L. , Crouch, S. J., & Cabibbo, T. L. (2011). Empowering patients with a voice in decision-

making. MedSurg Matters: newsletter of the Academy of Medical-Surgical Nurses, 20(6), 1, 14-16.

Greene, J. (2009, July). Warm and fuzzy hospitalists: Hospital leaders see these specialists as key to

improving patient satisfaction. Hospitals & Health Networks, 83(7), 42-43. Retrieved from

EBSCOhost database.

Professional. (2010, February). Clinical handover and patient safety. Queensland Nurses Union, 29(1),

18-19.

Cheung, K. (). Whiteboards key to improved communication. Retrieved from

http://www.strategiesfornursemanagers.com/ce_detail/250809.cfm

Bisoganano, M. (2012, July). A simple lesson plan for patient-centered care. Hospitals & Health

Networks, 86(7), 12. Retrieved from ProQuest database.

CONTACT INFORMATION

Nash Health Care Systems: Nash General Hospital, Rocky Mount, NC

Author: Caroline Cusick Vierheller, MSN, MHA-I, BA, RN, CEN, COHN-S

The Writing on the Wall

Caroline Cusick Vierheller, MSN, MHA-I, RN, CEN, COHN-S

Operations Improvement Process Coordinator

Chair for Pneumonia Process Improvement Team

2460 Curtis Ellis Drive, Rocky Mount, NC 27804

252-962-6484 E-mail: cvierheller@nhcs.org

IMPLEMENTATION

Future plans include a formalized qualitative research study to identify

patient perspectives and further validate the value of communication

boards. Based on a study identified during literature review, a request has

been submitted to the organization’s internal review board for approval to

begin the qualitative survey among inpatient populations for data

collection.

FUTURE PLANS

2013 HCAHPS Scores- for Inpatients

1st Quarter 2013

(n=417)

2nd Quarter 2013

(n=604) July 2013 (n=173)

August 2013 (n=161) Percentile Ranking

Rate hospital 0-10 28 41 31 51 Communication with Nurses 50 64 60 76 Communication with Doctors 45 40 72 70 Communication about Medicines 72 79 41 82

28th

41st 31st

51st

0 10 20 30 40 50 60 70 80 90

100

1st Quarter 2013

(n=417)

2nd Quarter

2013 (n=604)

July 2013 (n=173)

August 2013

(n=161)

2013 HCAHPS Scores-NGH Inpatients

Rate hospital 0-10 Percentile

50th

64th 60th

76th

0 10 20 30 40 50 60 70 80 90

100

1st Quarter 2013

(n=417)

2nd Quarter

2013 (n=604)

July 2013 (n=173)

August 2013

(n=161)

2013 HCAHPS Scores-NGH Inpatients

Communication with Nurses Percentile

45th 40th

72nd 70th

0 10 20 30 40 50 60 70 80 90

100

1st Quarter 2013

(n=417)

2nd Quarter

2013 (n=604)

July 2013 (n=173)

August 2013

(n=161)

2013 HCAHPS Scores-NGH Inpatients

Communication with Doctors Percentile