12.00
Hdl Handle:
http://hdl.handle.net/10755/162428
Type:
Presentation
Title:
Improving Quality, Staffing and Patient Satisfaction in a Rural Hospital
Abstract:
Improving Quality, Staffing and Patient Satisfaction in a Rural Hospital
Conference Sponsor:Emergency Nurses Association
Conference Year:2011
Author:Evans Bailey, Joyce, RN, MBA
P.I. Institution Name:Phelps County Regional Medical Center
Title:ED Director
Contact Address:1000 W. 10th Street, Rolla, MO, 65401, USA
Contact Telephone:573-458-7808
Co-Authors:Regina Kay Shaffer, RN, ADN, CEN; Carol Walter, RN, MSN; Jacob Wieties, BSW, MHA
[ENA Leadership Conference] Evidence-based Practice Presentation: Improving Staffing, Quality and Patient Satisfaction in a Rural Hospital

Purpose: An Emergency Department of a rural mid-Missouri hospital was down 17.6 FTEs. Patient satisfaction was at 23% overall, 28% for nursing. A process improvement project was implemented to improve the overall quality of the ED and improve RN staffing. The project encompassed the entire hospital in 6 core teams to affect improvement.

Design: This project used evidence-based information in both the implementation of the through-put process and the training of staff for an over-all quality improvement project.

Setting: The institution is a 242 bed acute care hospital with a 26 bed Emergency Department in rural Mid- Missouri. It is 90 miles from any larger hospital and access to Level I Trauma care.

Participants/Subjects: Participants in the project were hospital employees and agency RNs.

Methods: Results contributing to a significant change in the Emergency Department can be attributed to two areas; a PDSA (Plan-Do-Study-Act) methodology and a New Graduate RN Intern Intensive Training Program.
The PDSA process: (http://www.valuebasedmanagement.net/methods_demingcycle.html) is an improvement process that started in April, 2009. The PDSA process is based on breaking down change into manageable chunks by testing change on a micro level and analyzing the results to validate improvement before implementing across the organization. P -Plan -Observations, D - Do - Pilots , S - Study - Data analysis weekly with core teams and leadership, A - Act - Hardwiring the changes, including accountability with staff.
The New Graduate RN Intern Intensive program has successfully oriented 16 new RNs (2 classes - May 2009, January 2010) into the ED through an intensive training program. This 6 month program includes a 3-month didactic portion that includes the Emergency Nursing Orientation on-line Modules (http://www.mcstrategies.com/enaorientation), and a 3-month clinical orientation portion including 1:1 Preceptoring in the Emergency Department and shadowing throughout the hospital to help integrate the RN into the role in the ED and how it fits into the hospital as a whole.

Results/Outcomes: Overall patient satisfaction scores (Press-Ganey) in the ED went from 23 % to 83%. Standard Nursing satisfaction scores (Press-Ganey) went from 28% to 91%. Average Door-Doctor time decreased from 65 to 33 minutes. Average overall length of stay decreased from 217 to 173 minutes. Patients who left before medical screening decreased from 5.3% to 1.3%. Average daily registrations to the ED increased from 95 patients to 102 patients.
The RN shortage was 17.6 FTE in 2009, and the ED is now essentially staffed, with 0.6 FTE RN openings in June, 2010. The ED went from 17 agency staff contracts in March, 2009 to 6 contracts, with a plan in place to eliminate agency contracts by Sept 12, 2010.

Implications: Using the purposeful process of PDSA and spending the dedicated time to educate and train newly graduated RNs into the Emergency Department, successful results were achieved. By properly training RNs to be ED nurses, as well as properly training experienced nurses in management and in process improvement, the ED has improved care, patient satisfaction and provided a cost-savings to the hospital.

Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleImproving Quality, Staffing and Patient Satisfaction in a Rural Hospitalen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162428-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Improving Quality, Staffing and Patient Satisfaction in a Rural Hospital</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2011</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Evans Bailey, Joyce, RN, MBA</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Phelps County Regional Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">ED Director</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1000 W. 10th Street, Rolla, MO, 65401, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">573-458-7808</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">jevans@pcrmc.com; <br/>jee3790@comcast.net</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Regina Kay Shaffer, RN, ADN, CEN; Carol Walter, RN, MSN; Jacob Wieties, BSW, MHA</td></tr><tr><td colspan="2" class="item-abstract">[ENA Leadership Conference] Evidence-based Practice Presentation: Improving Staffing, Quality and Patient Satisfaction in a Rural Hospital<br/><br/>Purpose: An Emergency Department of a rural mid-Missouri hospital was down 17.6 FTEs. Patient satisfaction was at 23% overall, 28% for nursing. A process improvement project was implemented to improve the overall quality of the ED and improve RN staffing. The project encompassed the entire hospital in 6 core teams to affect improvement.<br/><br/>Design: This project used evidence-based information in both the implementation of the through-put process and the training of staff for an over-all quality improvement project. <br/><br/>Setting: The institution is a 242 bed acute care hospital with a 26 bed Emergency Department in rural Mid- Missouri. It is 90 miles from any larger hospital and access to Level I Trauma care. <br/><br/>Participants/Subjects: Participants in the project were hospital employees and agency RNs. <br/><br/>Methods: Results contributing to a significant change in the Emergency Department can be attributed to two areas; a PDSA (Plan-Do-Study-Act) methodology and a New Graduate RN Intern Intensive Training Program.<br/>The PDSA process: (http://www.valuebasedmanagement.net/methods_demingcycle.html) is an improvement process that started in April, 2009. The PDSA process is based on breaking down change into manageable chunks by testing change on a micro level and analyzing the results to validate improvement before implementing across the organization. P -Plan -Observations, D - Do - Pilots , S - Study - Data analysis weekly with core teams and leadership, A - Act - Hardwiring the changes, including accountability with staff.<br/>The New Graduate RN Intern Intensive program has successfully oriented 16 new RNs (2 classes - May 2009, January 2010) into the ED through an intensive training program. This 6 month program includes a 3-month didactic portion that includes the Emergency Nursing Orientation on-line Modules (http://www.mcstrategies.com/enaorientation), and a 3-month clinical orientation portion including 1:1 Preceptoring in the Emergency Department and shadowing throughout the hospital to help integrate the RN into the role in the ED and how it fits into the hospital as a whole. <br/><br/>Results/Outcomes: Overall patient satisfaction scores (Press-Ganey) in the ED went from 23 % to 83%. Standard Nursing satisfaction scores (Press-Ganey) went from 28% to 91%. Average Door-Doctor time decreased from 65 to 33 minutes. Average overall length of stay decreased from 217 to 173 minutes. Patients who left before medical screening decreased from 5.3% to 1.3%. Average daily registrations to the ED increased from 95 patients to 102 patients.<br/>The RN shortage was 17.6 FTE in 2009, and the ED is now essentially staffed, with 0.6 FTE RN openings in June, 2010. The ED went from 17 agency staff contracts in March, 2009 to 6 contracts, with a plan in place to eliminate agency contracts by Sept 12, 2010. <br/><br/>Implications: Using the purposeful process of PDSA and spending the dedicated time to educate and train newly graduated RNs into the Emergency Department, successful results were achieved. By properly training RNs to be ED nurses, as well as properly training experienced nurses in management and in process improvement, the ED has improved care, patient satisfaction and provided a cost-savings to the hospital. <br/><br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:28:03Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:28:03Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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