190 - Using Innovation to Improve Perioperative Family Communication
Clinical Issue: A lack of communication to surgical families was identified as evidenced by Day Surgery (DSU) Press Ganey ®scores being below their benchmark at 93.3%
Background: The operating room (OR) and Post Anesthesia Care Unit (PACU) nurses were not providing timely and consistent updates to families. An opportunity for an innovative solution was identified due to Surgical Services (SS) use of a Real Time Locating System (RLTS). An area was built within the system that would allow the nurses to send a chosen, HIPAA compliant text message to the family from the convenience of their computerDescription of Team:The team included the clinical nurse managers of the respective units. The patient liaison and waiting room front desk coordinators. The OR champion of the RTLS to be used and the accompanying software engineer.
Assessment: The current process was for the OR and PACU nurse to call the waiting room and give update to the coordinator. The family was then overhead paged to come to the desk and update given by coordinators. Barriers to success from the OR and PACU mirrored each other being lack of time, lack of phone availability, and inconvenience. The barrier for DSU was the lack of a process to know if the nurse was updating the family independently; which increased calls throughout the day from DSU to OR. Preparation and Planning:Permission from SS leadership team was requested for pursuance of building this software enhancement. The leadership team obtained approval from Memorial Hermann Health System Risk. The family area within the software was designed by the team. Items included were a space for phone number, name/relationship, location family is waiting and option to check “prefers call” if texts not wanted. An implementation process was created and implementation owners were established. Implementation:Each department’s Unit Practice Council (UPC), along with the patient liaison, customized the text messages to be sent. Roles and responsibilities were established between each department regarding inputting of number, person and location. In-Services specific to each unit’s role in the process were given, along with the creation of Power Point presentations and instructional flyers. A two week trial began in October 2018, including adult DSU patients only. Family surveys were handed out to those included in the trial. After positive results from the family surveys and staff; this new process was implemented department wide and is the standard practice for communication between families.Outcome:DSU demonstrated improvement in their Press Ganey ® scores related to the nursing communication question, “Information Day of Surgery” from a baseline of 93.3% in June 2018 to as high as 100% in April 2019.Implications for Perioperative Nursing:Innovative enhancements requires collaboration among nursing, informatics and leadership. The input from the frontline staff is essential to them adopting a new process.