Background of the Project:
As technology is significantly advancing in healthcare, people live longer while burdening with non communicable diseases. The parallel increase in life expectancy and co morbidities has a direct impact in the healthcare economy while adding new challenges to the health care professionals. In 21st century, transformative healthcare approaches, patients are considered consumers who expect much more higher from healthcare compared to before.
Health care professional plays a pivotal role in enhancing patient education to take care of themselves. Studies have shown that there is co-relation between imparting education to patient and family with improving patient satisfaction. The need for health care professionals to educate patient and family is highlighted as a “rights” and become a standard by accreditation bodies like NABH, JCIA, etc…which meant to “enhance the patient’s knowledge, skills, and behaviors necessary to fully benefit from the health-care interventions provided by the health care organization.”
Patient education and satisfaction are known to be very important measures in the current healthcare environment that will have a financial impact on healthcare. In the past, healthcare facilities had no way of directly measuring the satisfaction level of patients in the form of service delivery.
Patient always prefer health care organization who respects patient’s time and inform everything to the patient in timely manner. E.g. if a patient is made aware of the time frame of a test or procedure may take, he/she is more likely to wait patiently. If the time frame has to be extended, information to the patient will make him or her more tolerant of delays
Deming Cycle for Quality Improvement:
Plan
- To systematically review the VOCs for identifying the problems related to patient satisfaction.
- Find different strategies for improving patient satisfaction.
Methodology:
Setting: Apollo Hospitals, Guwahati.
Period: June to November 2019.
Sampling Technique: Convenient sampling.
Data Collection Tool:
Data were collected from:
- Patient feedback online portal (Voice of Customer)
- Daily chairman round report.
Result (Pre-intervention):
During analysis following issues were identified:
- Patient and family members were not satisfied with overall care as the treatment plan, procedures; ongoing medications were not explained well to them.
- Patient and family education was not provided in regular basis as required.
- Language barrier were found between patient and nursing staff as many nurses do not speak local language.
- Time constraint of nurses was found as they are busy for many clinical activities.
Analysis of Data (pre-intervention):
Fig-2: Number of complaints for nursing department (VOC)
Fig-3: shows the number of compliments for nursing department -VOC
Fig-4: shows the number of complaints during chairperson for nursing department
Do/ Perform:
The following steps were introduced to enhance knowledge and understanding of the patient and their family members.
- Leaflets for educating patient and families were prepared to impart more knowledge on few important subjects (e.g. safe medication practices for pediatric, vaccination etc.).
- Nurses emphasized lots on providing patient and family education in simplified manner in their level of understanding of the subjects.
- Checklist was prepared for nurses to educate patient as “What to Orient to the Patient” in beginning of each shift.
Pediatric Patient Family Education Pamphlet
Pamphlet for Adult Patient & Family Education
Act
- Trainings were conducted in both the classroom as well as in the clinical areas.
- SOP on Patient Family Education (PFE) was learned by each staff in the month of Oct, 2019 as a corporate project.
- PFE were performed in different units to improve patient satisfaction.
Check/Monitor
- Data were again analyzed after the intervention.
- All the above mentioned interventions were carried out and VOCs were assessed.
- Chairman rounds report were monitored continuously.
Fig-5: shows the number of complaints for nursing department -VOC
Fig-6: shows the number of complements for nursing department -VOC
Fig-7: Shows the number of complaints for nursing department during chairman round
Act/Improve
- Continuous emphasis on daily education to the patient and family.
- Periodic reinforcement training to all nurses on the subject.
- Periodic audit by NS & other senior nursing leaders about patient orientation by staff as per the checklist.
- Instant reporting of any incidence of dissatisfaction/ complaint.
Recommendation:
- Since, PFE is important activity to enhance the satisfaction level of the customer, a dedicated nursing team can be formed who can perform this activity in regular basis.
- A dedicated nurse can work as a ‘Care Companion’ nurse who can assist patients from admission to discharge including follow-up after discharge as per requirement.
Author:
Ms Pinaki Bayan
Nursing Superintendant, Apollo Hospital Guwahati.
Ms Oinam Bidyalaxmi
Nursing Quality Officer, Apollo Hospital Guwahati.
Ms Karishma Khaund,
Nursing Learning Officer, Apollo Hospital Guwahati.
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