2.50
Hdl Handle:
http://hdl.handle.net/10755/162550
Type:
Presentation
Title:
Satisfaction in the Emergency Department - Rising to the Top
Abstract:
Satisfaction in the Emergency Department - Rising to the Top
Conference Sponsor:Emergency Nurses Association
Conference Year:2009
Author:Sullivan, Jim, RN, CEN
P.I. Institution Name:Baylor University Medical Center
Title:ED Nurse Supervisor
Contact Address:3500 Gaston Avenue, ED, Dallas, TX, 75246, USA
Contact Telephone:214-820-3344
Co-Authors:Cheryl Gordon, RN, CEN, BSN
[Annual Conference] Clinical Topic: Less than two years ago, this inner-city Level I trauma center emergency department, which sees more than 80,000 patients annually in its 83 beds, was at or below the fourth percentile for "willingness to recommend." Hospital executives and management besieged the ED with a message: "This is not acceptable." Efforts were focused on improving the department's Press Ganey scores with the expectation scores would rise to the 60th percentile by June 2008.

Implementation: Initially the edict was passed down to staff - use hourly rounding logs to bring our satisfaction scores to an acceptable level. Rounding logs were taped in each room at the beginning of the 7 a.m. shift. Each hour a nurse or ED tech would log the type of interaction they had with the patient. Late improvements to the log included checkboxes for action performed (i.e., plan of care discussed, patient resting without complaint, pain management, diagnostics, vitals, empty room, etc).
Nurses complained about the unsightly logs in the rooms, did not complete the logs, or complained it was the dreaded "double charting". Compliance was low, and there was no real method for ensuring staff accountability.
The ED Rounding and Satisfaction Committee was formed. Its purpose was to standardize rounding in the ED and hold staff accountable for rounding on an hourly basis. Those affected would be the nurses and techs - staff that would recognize if there was a condition change or safety issue. Permission was given to eliminate the rounding logs. Taking their place was the electronic charting tool we had already been using for three years. We knew staff were visiting patients and actually in patient rooms much more than was documented on the logs. Our electronic charting provided the data.
Accountability came by way of chart audits. An audit tool was created, crediting nurses and techs providing interventions for patients. Whiteboards in the patient rooms increased staff communication with patients and family. Staff incentives for compliance included "Go Home One Hour Early," "Choose Your Assignment," and "Take 15-Minutes Extra on Your Lunch Break" for consistent rounding and whiteboard performance.

Outcomes: In August 2008, this ED reached a milestone - the Press Ganey 99th percentile for "willingness to recommend." Staff satisfaction also increased simultaneously due to decreased use of call lights by patients, decreased patient falls, decreased LWBS, decreased visits to the nursing station, and an increased awareness of ED staff behaviors.

Recommendations: In an ED world where nurses are reluctant to jump on a patient satisfaction bandwagon, creative incentives and reducing the perception of "double-charting" can lead your department to successes such as we have experienced. We have gone from a four percentile "willingness to recommend" to the 97th-99th percentile, and have maintained that rank for the past six month. Now there is an excitement among ED staff. We have set standards and expectations for other departments in the facility, as well as, other facilities in our system.
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.titleSatisfaction in the Emergency Department - Rising to the Topen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162550-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Satisfaction in the Emergency Department - Rising to the Top</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">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Sullivan, Jim, RN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Baylor University Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">ED Nurse Supervisor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">3500 Gaston Avenue, ED, Dallas, TX, 75246, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">214-820-3344</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">JamesSu@baylorhealth.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Cheryl Gordon, RN, CEN, BSN</td></tr><tr><td colspan="2" class="item-abstract">[Annual Conference] Clinical Topic: Less than two years ago, this inner-city Level I trauma center emergency department, which sees more than 80,000 patients annually in its 83 beds, was at or below the fourth percentile for &quot;willingness to recommend.&quot; Hospital executives and management besieged the ED with a message: &quot;This is not acceptable.&quot; Efforts were focused on improving the department's Press Ganey scores with the expectation scores would rise to the 60th percentile by June 2008. <br/><br/>Implementation: Initially the edict was passed down to staff - use hourly rounding logs to bring our satisfaction scores to an acceptable level. Rounding logs were taped in each room at the beginning of the 7 a.m. shift. Each hour a nurse or ED tech would log the type of interaction they had with the patient. Late improvements to the log included checkboxes for action performed (i.e., plan of care discussed, patient resting without complaint, pain management, diagnostics, vitals, empty room, etc). <br/> Nurses complained about the unsightly logs in the rooms, did not complete the logs, or complained it was the dreaded &quot;double charting&quot;. Compliance was low, and there was no real method for ensuring staff accountability.<br/> The ED Rounding and Satisfaction Committee was formed. Its purpose was to standardize rounding in the ED and hold staff accountable for rounding on an hourly basis. Those affected would be the nurses and techs - staff that would recognize if there was a condition change or safety issue. Permission was given to eliminate the rounding logs. Taking their place was the electronic charting tool we had already been using for three years. We knew staff were visiting patients and actually in patient rooms much more than was documented on the logs. Our electronic charting provided the data.<br/> Accountability came by way of chart audits. An audit tool was created, crediting nurses and techs providing interventions for patients. Whiteboards in the patient rooms increased staff communication with patients and family. Staff incentives for compliance included &quot;Go Home One Hour Early,&quot; &quot;Choose Your Assignment,&quot; and &quot;Take 15-Minutes Extra on Your Lunch Break&quot; for consistent rounding and whiteboard performance.<br/><br/>Outcomes: In August 2008, this ED reached a milestone - the Press Ganey 99th percentile for &quot;willingness to recommend.&quot; Staff satisfaction also increased simultaneously due to decreased use of call lights by patients, decreased patient falls, decreased LWBS, decreased visits to the nursing station, and an increased awareness of ED staff behaviors. <br/><br/>Recommendations: In an ED world where nurses are reluctant to jump on a patient satisfaction bandwagon, creative incentives and reducing the perception of &quot;double-charting&quot; can lead your department to successes such as we have experienced. We have gone from a four percentile &quot;willingness to recommend&quot; to the 97th-99th percentile, and have maintained that rank for the past six month. Now there is an excitement among ED staff. We have set standards and expectations for other departments in the facility, as well as, other facilities in our system.</td></tr></table>en_GB
dc.date.available2011-10-27T10:30:05Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:30:05Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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