Clinical leaders at Hunt Regional Medical Center in Northeast Texas understand the importance of connecting with patients and engaging with them during and after their hospital stay. Establishing a trusted relationship and providing consistent communication across the patient journey can impact patient compliance, which in turn can affect outcomes, satisfaction and loyalty. That’s why the hospital initiated two best practices: nurse leader rounding and discharge follow-up calls to reinforce treatment plans.
The philosophy at Hunt Regional unifies compassion, respect, collaboration, and advocacy for patients and their families. Nurses partner with patients and their families to plan, deliver, and evaluate individualized care to achieve optimal outcomes. The foundation of this approach is effective communication – during a patient’s hospital stay and after discharge.
The hospital sought to strengthen that nursing partnership even further by elevating the paper-based rounding process that made it difficult to track patient comments and follow up on requests quickly. Paper-based rounding also was not conducive to monitoring trends, identifying potential gaps in processes, or reporting timely performance metrics. Hospital leaders knew they needed a solution to simplify and standardize nurse rounding. They also needed a tool to extend patient engagement after a hospital stay to improve satisfaction, ensure care plan compliance, and reduce readmissions.
Hunt Regional is a long-time Vocera customer. Care teams have used the Vocera Platform for clinical communication for many years. So, when the leadership team learned about Vocera Rounds and Vocera Care Calls, applications that would address their patient engagement and experience goals, they were eager to implement them.
Three designated nurses, equipped with the Vocera Rounds application on an iPad, conduct rounds throughout five units. They talk with patients to identify their personal goals, assess their needs, determine readmission risks, and understand details of nurse call requests. After performing daily rounds and capturing patient feedback in the Rounds app, they lead central huddle board discussions to help team members understand common trends discovered through patient comments and collaborate on ways to make immediate improvements.
“The request-tracking capabilities and service recovery interventions made possible with Vocera Rounds have made a huge difference in patient satisfaction,” said Debby Clack, Chief Nursing Officer at Hunt Regional. “We’re able to expedite responses to patient needs, which has dramatically reduced patient complaints.”
After implementing Vocera Rounds and Care Calls, Hunt Regional reported a thirteen percent increase in its overall HCAHPS rating. The hospital also reported an eight percent increase in the “likelihood to recommend” domain. Building on this success, Hunt expanded their rounding practices to capture and track patient feedback about their experience with specific physicians. The hospital has named the survey “Physician Care Round.”
“While HCAHPS scores measure a patient’s general perception of hospital care, the physician survey within Vocera Rounds gives us a way to directly acknowledge individual doctors for providing exceptional service to our patients,” said Reese Hurley, Assistant Chief Nursing Officer. “In turn, physicians see substantial value in receiving real-time patient feedback from the Physician Care Round survey.”
To gain a holistic view of a patient’s experience, the hospital also set up questions in Vocera Rounds about nutritional, environmental, and other services. Managers from the departments delivering those services conduct individual rounds throughout the hospital focusing on how they can improve the patient experience. Nutrition leaders ask questions about quality of food, while environmental service leaders ask about cleanliness and comfort of the room.
“In addition to receiving excellent clinical care, it’s very important for our patients’ well-being to be in a healing environment with great food and a comfortable, clean room,” said Hurley. “Things like noise levels and room temperature can drastically affect a patient’s stay. So, receiving immediate feedback on nutritional and housekeeping services allows us to quickly address requests and amend issues proactively, helping us avoid service recover issues later.”
After leaving the hospital, it can be difficult for a patient to address lingering concerns or questions. That’s why follow-up calls within 24-72 hours post hospitalization are keys to improving patient engagement, satisfaction, and care plan compliance. The same three nurses who conduct patient rounds during the hospital stay also make follow-up calls.
“Patient care no longer ends when patients leave our hospital doors,” said Christy Hider, Discharge Coordinator.
“It’s a comforting experience for our patients. The nurse who met with the patient daily during rounds in the hospital is the same nurse who conducts the patient follow-up care calls,” said Hurley. “It’s reassuring for the patient to hear a familiar voice on the phone, someone who understands their entire experience, and is now checking-in on their aftercare.”
Using the Vocera Care Calls solution to guide the follow-up process, these nurses have access to call scripts as well as the patient’s verbatim feedback shared during nurse leader rounding. They are able to have meaningful conversations with patients about care plans, follow-up appointments, and medications.
They are able to leverage the rounding information to address potential risks identified, address any questions the patient may have had during the hospital stay, provide a resolution if needed, and close the communication loop.
“If I learn during a care call that the patient is not taking their prescribed home medication because they cannot afford it, I contact their doctor to have the medication changed to a brand that they can afford. This prevents any complications or readmissions due to not complying fully with aftercare instructions.” said Emily King, Clinical Coordinator
Truly listening to the voice of patients is essential to addressing their fears and concerns and improving compliance. Technologies like Vocera Rounds and Vocera Care Calls are designed to easily and securely capture that important voice and help hospitals like Hunt Regional extend patient care beyond the facility.
Building trusted relationships is a key to transforming the healthcare experience for patients, families, and staff. Positive and negative comments, complaints, and compliments all help determine a person’s perception of care or the health of a relationship. Leaders at Hunt Regional use aggregated rounding and follow-up call data to identify potential gaps, prioritize where improvements may be needed, and celebrate people and areas of excellence.
“The ability to rapidly report to our board and give kudos to the staff using data from the Vocera application is very valuable,” said Clack.
In addition to tracking patient experience, Hunt Regional uses Vocera Rounds to capture employee feedback and assess satisfaction. Hospital leadership conducts weekly staff rounds to check in with team members in clinical and non-clinical areas, and across inpatient and outpatient settings.
“Rounding on staff fosters a culture of open communication,” said King. “Leadership can understand our day-to-day concerns and experiences; and we’re able to work together to cultivate best practices to improve employee engagement, relationships, and well-being.”
As rounding and call initiatives evolve at Hunt Regional and new areas need to be assessed with patients, Vocera makes it easy to adapt. “We recently started a new process with bedside reporting, and change is always a challenge,” said Hurley. “With Vocera, it was simple to add the new questions to our existing rounding survey to garner the patient and family perspective on bedside reporting. Now we can evaluate how impactful we are at bedside reporting.” Since adding the additional questions to Vocera Rounds, Hunt Regional has received and celebrated numerous positive comments about bedside reporting throughout the organization.
“Vocera technology has drastically improved communication throughout the entire Hunt Regional facility over the past several years,” said Clack. “Our leaders have made it clear they would fight to keep Vocera products.”
Over the course of 18 months, Hunt Regional Medical Center experienced the following patient and family engagement through Vocera Rounds and Vocera Care Calls:
Hunt Regional Medical Center saw a significant increase in Key HCAHPS Domain scores as well. Between 2014 and 2017:
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