1. Quality Care Improvement Project 4D Trauma Unit Kelly Quinn RN, MS, CNS Allison Morton, RN, BSN Jignasa Pancholy, RN Holland Stephens, RN, MSN, CNL

3. HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems)  Designed to elicit comparable & measurable data based on perceptions of patients’ experience of hospitals nationally.  Results are ranked & hospital reimbursements can be affected based on our performance  SFGH lags just 4 percentage points behind the national average when patients are asked to rank hospitals worst to best.

4. HCAHPS 10 Composites  Communication about medication  Communication with doctors  Communication with nurses  Discharge information  Pain control  Rate hospital  Responsiveness of hospital staff  Room kept clean  Room quiet at night  Would recommend the hospital

5. HCAHPS RESULTS

6. 4D Patient Survey Questions  I am receiving sufficient teaching about my condition.  I feel confident I'll be able to manage my condition at home.  My nurses always explain things clearly to me.  My nurses always tell me about side effects of new medications.  My doctors always explain things clearly to me.  I always receive help when I need it.  My pain is always well-controlled.  My room is always clean.  It's always quiet at night so that I can rest.  Overall I've had a good experience at this hospital.

7. Project to Improve Noise at Night on 4D  Based on the HCAHPS: the lowest score was patients' perceptions of noise at night  Aim Statement: Goal is to reduce noise at night by 10% by April 20 th 2012  Baseline: Patient survey done January 2012 on 4D

8. Interventions  SILENT campaign to remind nurses to be noise conscience after 11p  Shhhh in the hallway  It's nighttime  Low TV volume ( TV Signs)  Earplugs can be offered!  No loud voices  Turn down nursing station phone ringers

9. Supportive Interventions  Volunteers educate patients on what to expect at night (e.g. VSQ4H, AMLs, early MD rounds)  Bi-weekly patient survey conducted  Noise audits performed to identify noise-prone areas of the unit

10. Noise Data Graph

11. Future Projects Impacting Patient Experience  Nurse to patient communication regarding side effects of medications  Cheat sheet on COWs  Signs (e.g. pt rooms/hallways/med room)  CALNOC med pass audit  "Med of the week"  M/S AIM: Increase “communication about medicine” score by 10% (from 55-65%)

12. Medication Communication Graph

13. Future Projects Impacting Patient Experience (cont):  Organizing education material and accessibility  Music therapy available for patients to decrease pain  Increasing responsiveness to patient needs  Increasing communication with MDs/NPs

14. Staff Communication  Focus placed on increasing staff communication and disseminating knowledge about unit changes  Emails  Monthly meetings  Communication binder  Open forum board for suggestions/feedback  Positive Recognition Board

15. Roles and Responsibility Of Quality Care Coordinator Nurse  Provides patient centered care.  Educates patients and professionals.  Enhances care and work environs.  Develops systems to support quality nursing and quality care.  Provides assistance to patients throughout care transitions.  However, this is a nurse among nurses. Our goal is to support you in your role as med-surg nurses.

16. Sustainability  Continue to create immediate, visible, flexible and unit-specific changes that address the unique needs of the unit  Unit shared governance based project  Continue to promote nursing excellence  Continue to improve patient experience by providing support and voice for the nurses

17. Spreading Change through the SG Structure