Quality care starts with communication
Nursing enhanced their bedside shift reports and incorporated hourly rounds and patient assistant walking rounds to ensure the patient's needs were met. View Larger Image
UF Health Jacksonville's HCAHPS scores increase thanks to a nursing communication initiative.
UF Health Jacksonville has world-class providers who use the latest medical advancements to treat their patients, but all of that can fall short if a patient has a negative experience during their hospital stay.
The Hospital Consumer Assessment of Healthcare Providers and Systems, or HCAHPS, is a patient satisfaction survey required by the Centers for Medicare and Medicaid Services, or CMS, for participating hospitals in the United States.
Communication between nursing staff and patients is one focus of HCAHPS surveys. Scores are based on the percentage of surveyed patients that give each hospital the highest possible rating. The scores are adjusted based on patient mix and survey mode. UF Health Jacksonville’s standard for patient experience is a satisfaction rate of 70.2 percent or higher. The hospital’s goal is to consistently meet this number during the 2018 fiscal year. As of Feb. 19, UF Health Jacksonville earned a satisfaction rate of 71.56 percent through organizationwide improvements of all HCAHPS domains.
“Having effective communication between nurses and patients is the backbone of many facets of patient care, like pain management,” said Seth Osenkarski, a clinical quality nurse leader at UF Health Jacksonville and chair of the Nursing Communication Committee. “Did the nurse respect the patient, listen to the patient and explain to the patient? Those are the three domains we examined.”
Beginning in 2016, the Nursing Communication Committee created a plan to improve the scores, using evidence-based solutions. “Literature says three things can fix nursing communication: bedside shift reports, hourly rounding and patient care assistant walking rounds,” Osenkarski said.
The communication initiatives began on Aug. 1, 2017. Bedside shift reports were completed during every shift change in the patient’s room. “Outgoing nurses meet with the incoming nurse in front of the patient,” Osenkarski said. “They give a report and allow the patient to be a part of it. It gives the patient more control over their own care and provides them greater autonomy. They can ask questions, and it gets everyone on the same page.”
Hourly rounding provides patients frequent contact with their nurses and patient care assistants, or PCAs. Hourly check-ins allow patients to remain updated on their treatment schedule, receive pain management or get assistance going to the restroom.
PCAs also complete walking rounds at the end of each shift. This means they visit each room to check for cleanliness and ensure it is ready before new patients are admitted.
“Because nurses are at the forefront of patient care, it is imperative to develop and continuously promote effective communication skills, such as listening, studying body language and understanding cultural differences, in order to provide the first-rate care that all patients deserve,” said Amanda Hagg, a nurse in the UF Health Jacksonville Labor and Delivery Unit.
The Nursing Communication Committee measures HCAHPS survey results every quarter. Their next steps to further increase patient satisfaction include giving all units access to simulation training on patient satisfaction and incorporating these communication protocols into nursing orientation.
Nursing enhanced their bedside shift reports and incorporated hourly rounds and patient assistant walking rounds to ensure the patient's needs were met.