Purpose for the Program
In the fall of 2011, the Press Ganey patient satisfaction scores reflected that there were areas for improvement, specifically in communication between physicians and nurses, pain medication accessibility, and lactation education. This trend was noted throughout the hospital. Having the patients actively participate in their care has been cited as an important part of ensuring patient safety.
The entire hospital ventured on the path of creating unit-specific whiteboards to address this issue. We had small plain whiteboards in every room for a few years. There was no standardized and consistent approach to what was written on the whiteboards. Staff in the mother–baby unit worked on several templates that were devised and shared with the staff. The whiteboards were divided into several sections, including information that was important to our patients.
Implementation, Outcomes, and Evaluation
In the early January 2012, new obstetric whiteboards were hung in each of the rooms. They are large, easy to read, colorful, and patient centered. The entire hospital staff received in-service training on the use of the whiteboards, how to help patients achieve their goals by using the whiteboards, and the expectation that whiteboards should be updated. At each shift, the oncoming nurse updates the whiteboard with new information, names, and goals that are created in conjunction with the patient. Managers round on all of the patients on a daily basis and audit the whiteboards during that time. When whiteboards are being inconsistently filled out staff are addressed accordingly. The outcomes, using the Press Ganey and the Hospital Consumer Assessment of Healthcare Providers and System (HCAHPS) surveys, reflect that patients love the whiteboards and note improved communication. We are currently working on using magnets with pictures of the healthcare team so that the patient can identify a face along with a staff name.
Implications for Nursing Practice
Overall, because communication is related to patient safety, it has always been cited as an area that has opportunities for improvement. Patients do not always remember names of healthcare providers and uniforms do not help patients distinguish who is a nurse or nurse technician. Patients cannot remember telephone numbers, what time their pain medication is available again, and when they need to walk or pump their breasts. This patient-centered tool has been acclaimed as wonderful, by other health professionals visiting our hospital, by patients and their family members, and by members of the Perinatal Listserv.