The University of Chicago Medicine (UCM), an academic medical center located on the campus of the University of Chicago, employs nearly 10,000 practitioners and staff, and provides a full range of specialty and primary care services. At the forefront of medicine since 1927 and known worldwide for its medical science, the 550-bed facility recognized the need to elevate its patient service to match the quality of its science.
In 2012, UCM seized the opportunity of new leadership and a new state-of-the-art hospital building to launch an Office of Patient Experience and deploy innovative models of care to enhance patient experience. A key best practice implemented by the medical center was nurse leader rounding, supported by the Vocera® Care Rounds solution.
Taking an Evidence-Based Approach to Improving Patient Experience
UCM is a research center as well as a clinical provider, so its leadership understood the importance of using evidence to drive outcomes.
“UCM is in a fragmented and highly competitive market,” says Debra Albert MSN, MBS RN, NEA-BC Senior, Vice President, Patient Care Services for UCM. “We wanted to create differentiation and build patient and family loyalty.”
As part of an enterprise-wide commitment to improving patient experience, UCM outlined ambitious goals aimed at raising patient satisfaction scores as reported through Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and Press Ganey surveys. Goals included developing a continuous improvement model that infuses the voice of patients, families, staff and physicians, while unifying quality, safety, efficiency, and experience initiatives that improve outcomes and lowers cost.
UCM identified nurse leader rounding as a main strategy for achieving its goals and chose the Vocera Care Rounds application running on iPad® tablets to hardwire the process. The Care Rounds solution streamlines, manages, and monitors the practice of rounding, enabling UCM nurse leaders to conduct rounding more efficiently and with greater accountability, while providing meaningful and actionable data.
“Vocera provided us with both a powerful engagement solution and a robust data collection tool for reaching our goals,” says Albert. “The Vocera solution is ideal for capturing patients’ compliments and complaints, which is where we discover the real, valuable nuggets of information that lead to improved experience and outcomes.”
Using Vocera to Standardize Nurse Leader Rounding
UCM had practiced leadership rounding in the past, but the process was not standardized and used a paper form to collect data. By formalizing the rounding process with Vocera, UCM was able to set, achieve, and track concrete measures of improved patient experience and outcomes.
“With our paper-based rounding, there was a lack of clarity about what information should be captured, limited accountability, and no way to track and trend data,” says Sue Murphy RN BSN MS Chief Experience and Innovation Officer at UCM. “We are using the Vocera Care Rounds solution to hardwire purposeful rounding and to capture meaningful and actionable data.”
Nurse leader rounding with Vocera enables real-time capture of patients’ voice and feedback as well as family or visitor comments. UCM nurse leaders ask patients approximately 10 key questions designed specifically to drive improved outcomes. Answers are captured and used to measure and track progress in patient experience, identify best performers among staff, get ahead of service issues proactively, and pinpoint opportunities for improvement.
“Vocera Care Rounds is a powerful tool that provides a system-wide way to track patient feedback and recognize staff members,” says Murphy. “It was adopted quickly by nurse leaders because it’s easy, and it really makes a difference in outcomes.”
Achieving Rapid Success on Multiple Fronts
UCM rolled out the Vocera Care Rounds solution enterprise-wide to nurse leaders in 32 units. Within four months, UCM nurses had conducted nearly 12,000 rounds on more than 9,500 patients, yielding over 2,800 positive staff recognitions and significant increases in patient satisfaction.
In particular, Press Ganey surveys assessing patient satisfaction found that compared to the previous year, the “Likelihood to Recommend” response from UCM patients in the months following implementation of the rounding program rose dramatically (see Figure 1). Among all facilities currently contracted with Press Ganey, UCM’s scores increased from the 12th percentile to the 51st percentile. Within UCM’s peer group of 120 academic medical centers and 299 affiliated hospitals, UCM rose from the 17% to 44% ranking.
UCM attributes this improvement directly to the new nurse leader rounding process with Vocera.
“Since beginning with Vocera Care Rounds at UCM, we have altered leadership behavior and moved patient satisfaction outcomes upward,” says Murphy. “The care teams that round have provided suggestions to improve the process for specific patient groups, such as those in the intensive care unit. And our technology-driven leader rounding has become a catalyst for the formation of service councils and multidisciplinary patient experience committees throughout UCM.”
The success of the nurse leader rounding program has led to the creation of a pilot program pairing medical directors and nurse leaders. In addition, the nurse leader program is enabling nurses and physicians to work together more effectively in providing patient care.
“As physicians heard and saw what nurse leaders were doing with the Vocera and iPad technology—and the results we were getting—they have been increasingly interested in the process,” says Murphy. “Physicians are starting to shadow nurses during the care rounds to learn from them. It has enhanced the credibility, recognition, and appreciation of the nursing group at large. What’s more, the physicians are excited, and the patients love it.”