A HAPPY TEAM Leadership at Parkview SurgeryONE knows that a happy staff equals happy patients.

Parkview SurgeryONE in Fort Wayne, Ind., makes sure its patients have an outstanding experience at their facility. But the key behind this excellent care is a pretty simple philosophy, says Jeffra Kinniard, BSN, RN, CNOR, ONC, the center's director of operations: "Teamwork between doctors, nurses and staff."

The center created several committees dedicated to improving patients' experiences, including employee engagement, quality improvement, safety and education committees. These committees implemented new initiatives that raised the center's patient satisfaction survey scores from the 48th percentile to the 99th percentile, a jump high enough to earn Parkview this year's OR Excellence Award for Patient Satisfaction.

"Patients can sense when employees are engaged and it's obvious they love what they do," says Ms. Kinniard. "When patients come in, they don't have the background to truly know whether we're doing a good job. But we can show them that they can trust us to give them excellent care."

This attitude can be seen in a program called BONES ("Building ON Excellent Service"), which encourages staff members to push each other to go above and beyond while caring for patients. Staff members write something specific about a co-worker's positive actions on a bone-shaped piece of paper. Ms. Kinniard posts these on a large bulletin board in the break room. For each bone an employee receives, the reward is a piece of candy. Each month, Ms. Kinniard enters all the bones into a drawing and chooses one to receive a gift card.

The committee also started a program called "Passport." In this program, every staff member shadows the process that a patient goes through, from scheduling to discharge. This helped break down walls between the different departments, says Ms. Kinniard. Now, if staff members see another area of the center in need, they'll step in to ensure excellent patient care. "The program promoted further understanding, appreciation and respect for the role of each member of the team and how they affect the patient experience," says Ms. Kinniard. "This has increased staff willingness to work together for a common goal — the patient."

"When the team came together under BONES and Passport, it enhanced our patients' overall experience," adds Michelle Apt, RN, nurse leader and patient experience coordinator. "Pre-op works better with the front desk, the OR works better with PACU, PACU works better with pre-op. It comes full circle."

A CLOSE COMFORT
BSM Surgery Center Keeps Family Members Comfy as They Wait

BE OUR GUEST BSM Surgery Center staff offer patient escorts a seat in the renovated waiting room and a coupon for a free cup of coffee to use in the adjoining coffee shop.

At the BSM Surgery Center in Corvallis, Ore., patients and their loved ones are cared for throughout the perioperative process. Once patients have arrived and completed initial paperwork, the center has a goal to admit patients within 5 to 10 minutes, says Lisa Herder, RN, BSN, nurse manager.

As the patient heads back for surgery, the front desk gives the patient's escort a coupon for a free coffee beverage of his choice, which he can use at the adjoining coffee shop while waiting. "It's a warm and relaxing atmosphere, complete with a fireplace," says Ms. Herder.

If escorts decide to wait in the waiting room instead, they are still met with a comfortable and inviting environment. Since BSM takes its patient feedback very seriously, says Ms. Herder, it recently renovated its waiting room to make it cozier. "Patients stated in recent surveys that the waiting room chairs were uncomfortable for them," she explains. "So, we replaced the chairs with more comfortable seating."

Ms. Herder says that the goal of these initiatives is to keep everyone happy and calm throughout the taxing process. "From the moment a patient or family member first contacts our providers, we are focused on making what can be a stressful and scary experience as pleasant, convenient, personable and stress-free as possible," she says.

Checklists and communication
In addition to boosting staff and surgeons' teamwork, the center also looked for ways to improve basic aspects of patient care. For example, Ms. Kinniard notes that the safety and quality improvement committees recently revised the safe surgery checklist, which is a communication tool used to assist with patient handoffs in the perioperative process. "This has resulted in handoffs with more patient involvement, understanding and confidence in their care," she says.

The education and in-service committee organized IRELATE training (Introduce, Reassure, Explain, Listen, Answer, Take Action and Express Appreciation). "We're big on narrating your care," says Ms. Kinniard. "So, if you're giving the patient an IV, you tell them, 'Now we're cleaning your arm to start an IV to help prevent infection.' This explanation is very calming to the patient."

PAIN-FREE IVs
Southern Ohio Medical Center Has a Better Way to Start an IV

PRESSURE, NOT PAIN A lidocaine-sodium bicarbonate mixture numbs the site of the IV start.

The Same Day Surgery department at the Southern Ohio Medical Center focused on improving patient satisfaction in one particularly painful area: IV sticks. The department uses a mix of lidocaine and sodium bicarbonate to numb the area before sticking patients, says Jackie Knauff, BSN, RN, CAPA, clinical nurse educator.

Here's how it works. Each day, the hospital's pharmacy prepares the lidocaine-sodium bicarbonate mixture. Nurses draw up the mixture and insert it into the skin at the site where they're planning to start the IV. Any leftover mixture is discarded, and a fresh batch is made by the pharmacy each day.

"The site is numbed and the patient only feels pressure, if that, when the IV is started," says Ms. Knauff. "I have experienced this type of an IV start and can honestly say that it truly does not hurt."

This training has had a tangible effect, with Ms. Kinniard noting one example in particular. After leaving the center, the mother of a young patient had questions about how to apply a shoulder immobilizer on her daughter. When the staff called her on the first day post-op, she explained her concerns.

Even though staff had instructed the mother on how to apply the immobilizer, and had written down instructions, she was still concerned that she had re-applied it incorrectly. The nursing staff explained it over the phone, but the mother was still hesitant. Though the patient's home was 45 minutes away, a nurse offered to come meet with them to make sure the immobilizer was correct. However, another nurse had a better idea — staff could use a cell phone to send a how-to video.

"The mother was thrilled with this solution and texted a photo of the patient wearing the immobilizer correctly with a big smile on her face," says Ms. Kinniard. "Needless to say, this family rated our facility excellent in all areas."

Ms. Kinniard relays these stories to staff and surgeons. She shares patient experience and satisfaction survey data at weekly meetings and displays the updated data each week on 6 bulletin boards throughout the facility. The center exhibits all patient responses on these boards, and if there is disappointing feedback, leadership reviews the chart and shares the negative information with the staff members directly involved with the patient's care, with the goal of preventing similar issues in the future.

Thanks to these initiatives, the center has seen its patient satisfaction scores go through the roof. "When there's better teamwork, the patients just feel safer and more cared for," says Ms. Apt, "and that shows in the survey results." OSM