Emily Bunnell, RN, BSN is the Acute Care Director at Charles Cole Memorial Hospital in Coudersport, PA. Last month in April, Cole Memorial learned that they moved up into the top 5% for Press Ganey scores nationally. Emily spoke to us about their journey toward that achievement.
Q: Cole Memorial only started working with Qualaris three months ago at the beginning of February 2015. What was the situation with patient satisfaction prior to that partnership?
A: Our scores were not where we wanted them to be. I was repeatedly asked to explain the gap between our Patient Rounding audit results and our Press Ganey and HCAHPS scores. According to our non-structured rounding audits we were doing at the time, we felt we were doing very well but that was not reflected in our outcomes scores. It was really frustrating and I was under pressure to turn the situation around, but I didn’t have the time for one more project or initiative, so QualarisAudit came along at the perfect time.
Q: Your hospital came out of the starting gate really fast – in just three months you’ve collected over 3,000 audits and doubled your compliance scores from a low of 48% to a high of 98%. How did you do it?
A: We had really struggled in the past to get our rounds done. Paper audits were too hard and the amount of time it took to collect data, input it to the computer, analyze it and get the information back to the units was a huge barrier, so I was really motivated to take advantage of Qualaris! Our Nurse Supervisors and Manager, who were trialing the tool, were skeptical at first. They are all so crazy-busy and this looked like just one more project that they didn’t have time for; but soon they saw the benefits of the tool and that it would both save them time and improve their patient care and patient satisfaction.
Q: How did you get buy-in from everyone to make it happen?
A: Soon after implementation we quickly realized that our rounding audit results were not as good as we thought – it was a real eye-opener for all of us! Nursing Supervisors and the Manager were now equipped and enabled to collect data in the Audit tool daily and then gave immediate feedback to their unit staff using the Dashboard tool and Cause Pie Charts. This raised staff awareness quickly, which helped us make a lot of rapid improvements that we were able to share between the unit leaders. As we began to share the improvements and results different units were achieving, suddenly everyone was really on board and working hard to move the needle toward improved patient satisfaction. Change is a challenge for everybody, but it’s all about perseverance.
Q: Let’s fast-forward to today. How is Qualaris being used and what are Unit and Nurse leaders doing?
A: On every shift, every day, Supervisors will collect data on the units and then review their results in the Dashboard tool to get an understanding of what needs to be improved. They share these results and give feedback to the staff, then create a plan of correction and make it happen. It’s all real-time and accomplished very quickly; they are managing - and leading - quality improvements on a daily basis with every shift.
Q: What advice would you give to your colleagues at other organizations trying to make improvements, particularly with patient satisfaction and HCAHPS scores?
A: I highly recommend taking a close look at the questions on the audits. All of our questions are basically looking at two sides; for example we want to know if the whiteboard is complete (hourly rounding done, goal for day set) and we also want to know if the patient remembers or perceives that the whiteboard is complete (that hourly rounding was done, that a goal for the day was set). Once you have metrics, dicing the data is key – knowing specifically where, when and what problems are happening allows you to very quickly focus attention where it’s needed. Finally, take action to improve on that same shift. Don’t wait a day or two, or even until the next week when you get the Qualaris reports in your email. Be proactive, use the Dashboards every day and then use the weekly Reports to validate what you achieved the week before.
Q: Congratulations on your success with Patient Rounding, you must be very pleased.
A: Thank you, it’s been very empowering for everyone at Cole Memorial to have improved so quickly and I feel that Qualaris has been a big part of that success.