Hallway Patient Satisfaction
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- Derrick Fleming
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1 Lehigh Valley Health Network LVHN Scholarly Works Patient Care Services / Nursing Hallway Patient Satisfaction Donald Hoff BSN, RN Lehigh Valley Health Network, Donald_S.Hoff@lvhn.org Shelbi McGraw BSN,RN Lehigh Valley Health Network, Shelbi_B.Mcgraw@lvhn.org Tracy Woodruff BSN,RN Lehigh Valley Health Network, Tracy_A.Woodruff@lvhn.org Follow this and additional works at: Part of the Nursing Commons Published In/Presented At Hoff, D., McGraw, S., Woodruff, T. (2015, July 8). Hallway Patient Satisfaction. Poster presented at LVHN UHC/AACN Nurse Residency Program Graduation, Lehigh Valley Health Network, Allentown, PA. This Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by an authorized administrator. For more information, please contact LibraryServices@lvhn.org.
2 IMPROVING HALLWAY PATIENT SATISFACTION IN THE EMERGENCY DEPARTMENT Donald Hoff, BSN RN Tracy Woodruff BSN RN Shelbi McGraw BSN RN
3 Purpose To increase patient satisfaction for patients placed in hallway beds in the emergency department
4 PICO QUESTION PICO Question Do hallway patients who receive information on approximate wait times for diagnostic studies experience increased patient satisfaction compared to patients that do not receive this communication? P- hallway patients I providing informational cards on approximate wait times C current practices O increased patient satisfaction
5 TRIGGER? Knowledge v. Problem IOWA Model Trigger Observed patient dissatisfaction for those placed in hallway beds Increasing use of hallway beds in the ED Press-Ganey Scores below target Daily ED Census repeatedly above target
6 TRIGGER (Cont.) Trigger Significance Increased ED census places more stress on staff and requires an increase use of hallway beds Lower Press-Ganey scores provide room for improvement Unsatisfied patients provide increased stress for staff and other patients
7 BARRIERS & STRATEGIES Barrier: -Patients unable to comprehend reason for wait/hallway placement regardless of information given -Nursing compliance with handouts -Patient participation in study -ED census and acuity (causing change in assessment/lab/result times) -Nurse/physician communication -Lab/radiology/computer/etc. downtime. Strategy to Overcome: -Core group of nurses to participate -Communicate from the beginning they will be in hallway -Therapeutic communication about uncontrollable factors such as down times
8 EVIDENCE Search Process: online articles were obtained via Google scholar and Ebsco host Key Words: hallway, patient satisfaction, emergency department, emergency department crowding, nontraditional beds
9 EVIDENCE Patients who receive information regarding flow/times of ED care are more satisfied with care Hallway placement was a significant predictor of a lower likelihood of recommending the ED to others. Longer delay for hallways assessments/diagnostics tests Longer wait times=lower likelihood of recommending ED. Crowding in rooms and halls caused patients, nurses, and physicians to feel that care was compromised in some way.
10 Current Practice at LVHN There are 17 hallway beds in the Cedar Crest ED. During long waits, additional hallway beds are added Patients are slotted for hallway beds based on triage scale and acuity The charge nurse and triage nurse work together to determine which patients are appropriate for hallway beds
11 Current Practice at LVHN Hallway patients frequently request to be placed in a room Patients are placed in a room as rooms become available Patients and families frequently voice complaints related to length of stay, lack of communication, lack of privacy, and busy environment in the department Hallway beds do not provide certain care requirements Example: suction canisters, room for supplies such as airway or code carts, room for family members
12 Practice Change Provide hallway patients with informative card containing wait times of common procedures for ED patients CAT Scans, XRAY, Lab Results Increase therapeutic communication with patients in hallway beds, using the cards as a facilitator
13 EXPECTED RESULTS Pt satisfaction will increase with use of information cards Pt s will have a greater understanding of why they are waiting. Pt s will have less questions for providers and nurses. Pt s will be less angry and frustrated with waiting. Overall morale of the ER will increase.
14 RESULTS Next Steps Use cards for all patients, not just hallways Encourage use of cards among staff members Encourage physicians to reference cards when discussing plan of care with patients
15 Suggestions for the Future Provide cards in Spanish or additional languages Add more diagnostic tests as staff sees fit
16 Implications for LVHN Hallway beds are a necessary requirement to facilitate flow in the ED and ensure patients are able to be seen by the care team in an appropriate time By increasing patient satisfaction, patients and families will be more likely to recommend our ED, even if they were placed in a hallway bed
17 Lessons Learned (expected) Communication from initial contact with pt s will drastically increase satisfaction. Therapeutic relationships increase with greater communication. There will always be people who will be angry and dissatisfied no matter what the circumstances.
18 References Effect of emergency department information on patient satisfaction. (1993). Krishel, S., and Baraff, L. Annals of Emergency Medicine. The Effect of Emergency Department Crowding on Patient Satisfaction for Admitted Patients Pines, J. M., Iyer, S., Disbot, M., Hollander, J. E., Shofer, F. S., Datner, E. M. (2008). The Society for Academic Emergency Medicine ED crowding and the use of nontraditional beds McNaughton, C., Self, W., Jones, I.D., Arbogast, P.G., Chen, N., Dittus, R.S., Russ, S American Journal of Emergency Medicine ED Crowding Is Associated with Variable Perceptions of Care Compromise Pines, J., Garson, C., Baxt, W., Rhodes, K., Shofer, F., Hollander, J Society for Academic Emergency Medicine
19 Strategic Dissemination of Results to inform ED staff of results Lead by example use cards when providing care to hallway patients
20 Questions/Comments? Make It Happen Contact Information: Donald Hoff Tracy Woodruff Shelbi McGraw
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