Plan of Care Whiteboards Post 1: Natividad Medical Center Co-Designs For Non-English Speakers

February, 2014

What do you do when your hospital serves a highly diverse, multi-lingual population, but you need to create a standard patient whiteboard that can be used by all staff?  If you are Natividad Medical Center, safety net provider in Salinas, CA, you start by asking patients what they want.  Before undertaking a redesign of its Plan of Care boards, Natividad held focus groups with patients, where they learned that patients were clear in their preferences.  They want a simpler, three-part pain scale.  They want more color and word pictures to make it easier to understand.  They want their expected discharge date written on the board.  And they want their preferred language and the number of the appropriate interpreter for their language needs clearly written on the board (Natividad has already pioneered a program to engage the local community in providing ).

Armed with patient input, together with insights from physicians, nurses, and other frontline staff, Andrea Rosenberg, Assistant Administrator, Operations and Support Services led a team to redesign the traditional plan of care board.  The team is still iterating on the new board, to ensure that it provides patients and families with easy-to-understand icons that highlight key elements of the plan of care, including:

• Care Team and contact information (MD, RN, Interpreter)
• Expected Discharge Date
• Today’s Date
• Preferred Language
• Food Plan
• Pain Scale
• Activity Tracker (bed rest, walk with help, sit in chair, no restrictions)
• Daily Itinerary and key indicators (e.g., X-Ray, EKG, O2, Respiratory, Fall Risk, etc.)

Once the design is finalized, Andrea and team will undertake a training program to ensure all staff members understand the importance and use the boards consistently.  But having successfully engaged patients and staff to understand each stakeholder’s needs, they are confident this solution will enable patients, families, staff and physicians to better communicate and engage in care planning.