Purpose: According to the Agency for Healthcare Research and Quality (AHRQ), communication with patients and families is the primary means of establishing a trusting, collaborative relationship. Effective communication dramatically influences the quality of decisions and patient motivation to follow treatment protocols and achieve desired clinical outcomes (2018). In October 2020, nurse leaders noted a decline from 89.7% to 68.8% in the patient satisfaction domain concerning the question “nurses carefully listened to you” on a medical-surgical (COVID-19) unit. Additional observations identified opportunities for the medical-surgical unit to improve patient interactions. This poster describes the implementation of an effective communication course to impact patient satisfaction on a medical-surgical unit.
Description: A task force was formed to investigate the causes for the decline and identify solutions to improve the patient satisfaction category to the 80th percentile or above. The task force consisted of the professional practice leader, department director, and the unit nurse manager. The task force identified opportunities for improvement in how clinical nurses and support staff communicate with the patient and their families. A collaborative decision to utilize Prosci’s awareness, desire, knowledge, ability, and reinforcement (ADKAR) model for change was adopted as the foundation for the task force (Dighe, Shah, & Raulgaonkar, 2015). The task force decided on a workshop-style “effective communication in nursing” course via in-person and virtual formats, which consisted of a didactic lecture and case studies. Professional development on effective communication is an excellent way for nurse leaders to highlight the importance of listening to patients and that it is a priority in providing patient-centered care (Loos, 2019). The course consisted of education related to the standards of effective communication, the organizational service standards, and compassionate communication.
The registered nurses and support staff on the unit attended a 1-hour workshop-style training in November and December 2020. The professional development activity allowed the participants to reflect on and improve their interactions with patients, including verbal and nonverbal listening skills, ultimately improving patient outcomes. The course allowed the staff to become more aware of perceptions that patients and families observe during conversations.
Evaluation and outcome: The task force met to evaluate the impact of the professional development activity on effective communication. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) question specific to “nurses carefully listened to you” increased from the baseline of 68.8% in October 2020 to 69.4% during January 2021 and 81.8% in February 2021 and March 2021. Additional observations showed improved communication between the clinicians and the patients and the communication among the unit staff.
Knowledge is enhanced through increasing awareness on effective communication, nurses’ listening skills, addressing patient concerns, and creating a better patient experience. In reinforcing the change, the task force decided to continue offering the course monthly to include hospital-wide medical-surgical units. Incremental rollout to all other medical-surgical units began in March 2021. The course was also presented to newly hired employees during unit orientation. Unit leaders reinforce the information from the class during quarterly leader rounding and staff meetings.
Evidence-based references 1. Agency for Healthcare Research and Quality. (2018, July). TeamSTEPPS Fundamentals Course: Communication. Retrieved from https://www.ahrq.gov/teamstepps/instructor/fundamentals/module3/slcommunication.html 2. Dighe, A., Shah, Z., & Raulgaonkar, H. (2015). Decision modelling technique:Pharmacoeconomic approach. Retrieved from: http://ijpsbm.com/docs/papers/november2015/V3I1002.pdf 3. Loos, N. (2019) Adult patient perceptions of nurse listening behaviors in an acute care setting (unpublished doctoral dissertation). Azusa Pacific University, Azusa, CA. Retrieved from https://sigma.nursingrepository.org/handle/10755/18284