OR Excellence Awards – Patient Satisfaction: Unforgettable Education

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Staff at White Rock Medical Center provide patients with memorable post-op care instructions.


How do you ensure patients will remember their post-op care instructions and push your patient experience scores from good to great? You do a deep dive and find out where you’re lagging, just like the staff at White Rock Medical Center in the Dallas area did. When the team realized their patient education practices needed a minor improvement, the staff dug in and implemented a simple teaching mnemonic to help address questions about post-op care. Their efforts earned them this year’s OR Excellence Award for Patient Satisfaction.

“Our patients might have rated us high and would recommend the facility to others, but our satisfaction survey scores weren’t reflecting all of the work that we were putting in for the communication and education domain,” says Brittney Williams, RN, director of surgical services. “I knew we could do more.”

She took it upon herself to print out copies of every survey they received in one month and passed them out to the staff. They focused specifically on questions pertaining to the patient experience. “I said, ‘Raise your hand if you have a good survey.’ Everybody raised their hand, so I decided to go question by question. When we got to the question that asked patients if someone from the facility discussed their post-op care in detail, the answer was frequently ‘no.’ While the staff was educating patients prior to discharge, patients were not recalling the pertinent information,” says Ms. Williams.

POST-OP CARE POSTERS The mnemonic is posted in each pre-op holding room so nurses can refer to it while educating patients about what to expect after surgery.   |  White Rock Medical Center

Ms. Williams recalls a project she developed with Jordan Fulton-Buckner, RN, at her previous job that bumped the facility’s patient satisfaction scores to the 90th percentile. They created a mnemonic that’s easy for patients to remember after they’ve been discharged. “We created B.A.N.D.A.I.D.S. (see below), a teaching mnemonic to help address all the questions patients may have regarding their post-op care.” 

Instead of simply verbalizing the instructions, patients now receive a handout with the easy-to-remember mnemonic and corresponding descriptions. “We’ve also hung posters in each pre-op holding room that the nurses refer to while educating the patients about common post-op care worries,” says Ms. Williams. 

The mnemonic is printed on discharge instructions along with additional procedure-specific information. “The day after surgery, patients also receive a phone call from the post-op nurse reminding them about their B.A.N.D.A.I.D.S. education,” says Ms. Williams.

After the implementation of this education, Ms. Williams noticed a significant increase in the facility’s patient experience scores. “Our scores currently hover around 95% in the area of post-op education and communication,” she says.

Ms. Williams believes this simple and easy education idea is helpful for all patients and hopes that any facility struggling with patient education adopts the tool. “By listening to our patients, we were able to increase our patient education, which has led to even greater patient satisfaction,” she says. OSM

BLEEDING/BANDAGES: Depending on the surgery, some post-procedure bleeding can be normal. If you begin to have unexpected bleeding, call the physician. For uncontrolled bleeding, dial 911.

ACTIVITY: Go home and rest for the remainder of the day, no heavy lifting or strenuous activity.

NAUSEA: If nausea and vomiting develop after going home, stop eating and drinking for one hour and use over-the-counter anti-nausea medication. After one hour, start with clear liquids and only progress diet as tolerated. If nausea and vomiting does not stop after this, call the physician. 

DIET: The first meal after surgery should be light, non-greasy and not spicy. Advance to your pre-procedure diet as tolerated, unless otherwise specified by your physician.

ACCEPTABLE PAIN: Pain after surgery is expected. Our goal is to have your pain at an acceptable level, not pain-free. Your doctor may prescribe you pain medication to take at home. If pain medication is not prescribed, use over-the-counter pain medication if allowed by your physician. 

INFECTION PREVENTION: Notify the physician if you develop any signs of infection such as fever, severe nausea and vomiting, uncontrolled or abnormal bleeding, green or yellow drainage, or uncontrolled pain.

DO NOTS AFTER SURGERY: If you received anesthesia or procedural sedation, do not consume alcohol, operate heavy machinery, make any legal decisions, or drive for the next 24 hours. Do not do any of these things while taking prescribed narcotics. 

SCHEDULED FOLLOW-UP APPOINTMENT: Set up a time with your surgeon.

Taking Time to Connect With Patients
HONORABLE MENTION
PERSONAL CALL Courtney Anderson, RN, reaches out to patients after their procedures to check on the progress of their recovery.  |  Juan F. Jimenez

When patients take the time to send your staff thank you notes for the care they received at your facility, you know you are doing something right. But that does not mean there isn’t a little room for improvement. 

The Charles George VA Medical Center in Asheville, N.C., provides inpatient and outpatient surgical services for orthopedic, vascular, urology, general, ophthalmology, ENT, gynecology, podiatry and thoracic veteran patients. The busy facility houses seven ORs. “We have always had good patient satisfaction scores,” says Christie Anderson, MSN, RN, CNOR, nurse manager of the OR, PACU and day surgery. “But we had several instances where there was some confusion about who would be communicating with patients’ loved ones and keep them updated throughout the surgical process.”

With that in mind, surgical leaders decided to create a family liaison position. Fifteen different OR nurses rotate through the role, which is responsible for contacting designated family members when surgeries start, throughout procedures at established times and when cases are completed.

Having a dedicated team member serve as the go-between for families and surgeons has streamlined the surgical process. “Now, if the family liaison speaks to the family who has some concerns, they can go directly to the operating room and talk to the surgeon and the staff in the OR,” says Ms. Anderson.

The staff has also implemented a care card for each patient, which looks like a postcard and is personally signed by each staff member who cares for them. “This card allows staff to offer encouraging words for recovery and it gives the patients a personalized thank you for letting us care for them,” says Ms. Anderson. “We have received several thank you notes from patients with personalized messages for the staff who made their experience memorable and helped ease their anxiety during the perioperative process.”

The OR also gives out birthday cards embossed with an artistic rendering of the American flag to each veteran who comes in for surgery near their birthday. Every member of the surgical team signs the card.

The care cards and birthday cards that patients receive were designed by the surgery staff, making the patient-friendly gestures fun and creative. “It was an innovative project that got the staff excited about improving patient satisfaction,” says Ms. Anderson. 

Danielle Bouchat-Friedman

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