On August 14, 2023, ambulatory surgery/endoscopy moved into the new Joan and Paul Rubschlager Building. The increased endoscopy footprint enabled widespread clinical areas to merge, optimizing patient flow and care efficiency while improving quality. Overall, patient satisfaction scores improved following the move to the new space. However, the Press Ganey survey question, the “Degree to which you were informed about any delays,” decreased and continued to pull down the overall score.
Evidence shows that increasing patient experience scores is associated with improved clinical outcomes. Therefore, an area for improvement the clinical team worked to improve was the procedural schedule for patients and families. The team expected they could improve patient satisfaction by working to streamline processes to ensure proactive communication regarding schedule changes.
In January 2024, the Press Ganey mean score for the “Degree to which you were informed about any delays” in the survey was 77.98. Humberto Rodriguez, MSN, RN, CNML, unit director, brought the patient satisfaction data to the unit advisory committee (UAC), or unit-level shared governance, for discussion and problem-solving. Rodriguez used the Plan, Do, Check, Act (PDCA) framework to support this quality improvement project.
Plan and Do
Rodriguez collaborated with the UAC and an advanced practice provider (APP) team as the project leader to review clinician roles during the “Do” phase. The charge nurse’s role was identified as a primary communication hub, responsible for triggering the admission nurse and the assigned APP to each update the patient and family for all delays exceeding 30 minutes. Having both of these care team members provide the update allowed for patient and family questions related to the delay to be expediently addressed and answered.
Check
During the PDCA “Check” phase, the team recognized that they needed a location in the electronic medical record (EMR) to document that communication occurred with the patient and family. During a UAC meeting, the team located a previously unused area of the EMR flowsheet labeled “family update” that could be used. This benefited the project timeline since the team did not need to request additional documentation fields be added to the EMR.
Act
Throughout the PDCA “Act” phase, Rodriguez communicated the plan regarding new workflows and role expectations with the nursing and APP teams via meeting minutes, emails and huddle discussions.
On March 25, 2024, the updated communication workflow with patients and family members about all procedural delays went live. Within a few months, the improved communication coordination with patients and family members about procedural delays by the admission nurse and the assigned APP increased the Press Ganey survey question scores to more than 85%. The improvement project added to the positive overall patient satisfaction results following the move to the Joan and Paul Rubschlager Building.