When Rachel Wells enters a patient care room in the Cox North Emergency Department, she’s armed with more than just the usual syringe and gloves. She also carries a highlighter marker in the pocket of her scrubs.
She uses the marker to “Hit the Highlights” on patients’ written discharge instructions to make them aware of information concerning new medications that they’ve been prescribed.
Giving highlighters to the nursing staff is one of the creative ideas North ER leadership and staff brainstormed to improve patient perceptions of care on two patient satisfaction survey questions.
One question asks patients how often the patient care staff explained what a new medicine was for. The other asks how often patients felt the care and services received during the visit were well coordinated.
After implementing the strategies during the July-September 2011 reporting period, the unit had increased the score for explaining new medicines by 12.5 percentage points compared with the previous quarter. The question received a Top Box score of 87.5 percent, which moved them into the 95th percentile nationally for that question.
The score for coordinating care and service increased 8.3 percentage points to 66.3 percent, which placed the North ER in the 76th percentile nationally for that question.
Besides highlighting information about new medications, nurses also use key words during the discharge process to explain what new medications are for and any possible side effects to watch for when patients return home. After implementing “Hit the Highlights,” the unit also saw a 14.9 percentage point increase over the previous quarter for patient perceptions of clear and complete discharge instructions.
To improve medication communication for pediatric patients, nurses give parents an oral syringe with the dosage clearly marked so parents know exactly what dose to give their child when they return home.
To improve patient perceptions about care coordination, dry-erase boards were placed in patient care rooms. During assessments with patients, nurses write down each test and procedure the physician orders, such as X-rays or EKGs. As each one is completed, the nurse marks a line through the test. Patients see the progression of their care and what exam or procedure they’re waiting on.
“Patients have told us the new process made them feel like the staff was keeping them in the loop about what’s going on with their care,” says Misty Denevan, North ER director. “The use of these visual aids and the use of key words to explain the coordination of care and the new medications helped shape the patients’ perceptions about our consistency with these two important aspects of their care.”
“Just saying little things and making small process improvements that didn’t cost anything and didn’t take any extra time really improved our patients’ satisfaction,” says Wells.
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