Maria Suvacrov

Introduction/Problem

Patient experience scores are a subjective measure of whether the providers and clinicians have met the patients' expectations during the hospital stay. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey measures patient satisfaction. Like others, a community hospital in the Midwest was seeking to improve the patient experience.

Methods

A literary review suggested improving nursing communication skills could improve the patient experience. In addition, nurse leader rounding on patients also positively influences patients' satisfaction. Finally, there is a great body of evidence suggesting that when clinicians sit down to communicate, patients perceive clinicians spend longer time with them and make better personal connections with them.

Based on the evidence, a bundled approach to improve the patient experience was undertaken. The bundle was composed of nursing education on effective communication, implementation of nurse leader rounding, and asking the nursing team to commit to sit while communicating with patients. Formal education was provided to the nursing team on the bundle elements and process. The outcome measure was an improvement of the nurse domain on HSAHPS survey scores. The process used to measure compliance with the bundle was nurse leader rounds using Google Forms and two anonymous surveys—one for the nurses and the second for the patients. Finally, listening sessions with staff were held to facilitate sharing their experience, wins, and perceived barriers with the bundle.

Findings

The nurse domain scores for February 2024 was 68.94%. The same score for April was 95.24%, reflecting a 27% total increase. Seventy-seven nurse leader rounds were performed during the two months after the project's implementation. Nurse leader rounding revealed 75% of patients perceived nurses sitting down while communicating, and 95% of patients reported nurses communicated effectively. The anonymous patient surveys (n 29) noted only 29% of nurses always sat down while communicating with them, while 59% felt that nurses listened to them carefully. When asked how well nurses communicated the care plan on a scale (1 never to 5 always), 38% scored four (most of the time) and 48% scored five (always).

A total of 21 anonymous nurse survey were revealed, 18% of nurses reported sitting down most of the time, while 19% reported sitting down always. When asked if they thought commit-to-sit helped to improve communication effectiveness and the connection with their patients, 95% felt it made a difference.

Practice Implication

A bundled approach to commit-to-sit, that includes nurse leader rounding and nursing education on effective communication skills was a successful strategy to improve the patient experience. Out of the three elements of the bundle, the commitment to sit was the most challenging with unanticipated barriers such as the lack of chairs. Frequent listening rounds and transparent data sharing was also a critical component of the quality improvement initiative. Future initiatives should aim to replicate and expand in multiple settings.