The Emergency Department at the Boise hospital was struggling with patient experience scores. In early 2022, the ED leadership team reviewed patient comments to identify themes. It was immediately noted that three nurses were consistently called out for great care.
After speaking with these individuals, it was clear the three nurses shared similar behaviors and attributes that impacted patients’ perception of care. To help others develop these unique strengths, the nurses agreed to be the unit’s Care Experience Champions.
The leadership team changed the new employee orientation in the ED to include an observation day with one of the champions. During this day, new employees were taught about the importance of AIDET® (Acknowledge, Introduce, Duration, Explanation and Thank You) and narrating care so they could better understand each process step when interacting with patients.
To reinforce the positive changes, patient experience comments were posted monthly so staff could see the feedback in real time. While two of the three original champions have moved to other departments, the positivity of the program has inspired two more nurses to put on their Champion shoes.
Meridian’s fifth and sixth floors implemented a sharedstaffing strategy. This decision arose from a discussion among interested leaders and administrators about ways to meet staffing needs in the face of the considerable hiring challenges brought on by the COVID-19 pandemic.
All new hires to the Meridian medical-surgical unit are receiving comprehensive cross-training to both floors. The first cohort recently completed their full orientation and are now working independently to support all unit needs. This approach is better for staff because it allows them to learn all facets of the medical-surgical unit, increasing their satisfaction with professional growth and development opportunities.
With the community’s capacity challenges, this also allows
for more flexibility in patient flow and placement. It ensures all
medical-surgical patients will receive the highest level of care
from all nurses.
Unfortunately, health care workplace violence continues to trend upward. Having a child in the hospital is stressful, and the tension can increase the risk of family members or visitors becoming volatile and disruptive. In 2022, the Boise NICU Care Council decided to create a proactive approach to addressing potentially disruptive family behaviors.
The Council wanted to develop a written document that staff could use to establish behavior expectations with families at the beginning of patients’ hospital stays. The Council’s additional goal was to empower staff to not tolerate abusive and disruptive behaviors by families and visitors, thus improving patient care and staff safety. The NICU Care Council partnered with social work, leadership, bedside nursing and legal to develop the Family Commitment to Safety Agreement. This document is now used not only in the NICU but throughout St. Luke’s Children’s Hospital, both inpatient and ambulatory.
Manager Jenny Hopkins, BSN, RN, CMSRN, and Director Amy Bradley, BSN, RN, NE-BC, were early adopters of Microsoft Teams® technology and had experience using it with other units prior to the rollout on the medical-surgical unit. The Teams platform was introduced to the unit during COVID as a necessary way to communicate—quickly and accurately—the rapid changes that were transpiring for all staff members at the same time.
Teams usage has become indispensable to the unit. It is used for handoff reports between health unit coordinators, allowing for full transparency to the work. With input from clinical staff, Hopkins created separate channels for quality and safety, connecting with leadership and staff recognition. The chat feature is used for multidisciplinary team collaboration, equipment management, and as a real-time vehicle for polling staff and sending out quick surveys. Education sessions are now recorded, ensuring all team members have access to the information.
The platform is also used for case studies, inviting staff to provide insight and
share expertise. The unit has exceptional nursing engagement performance
around feeling involved in decision making, leadership accessibility and working
collaboratively as a team.