EP - Exemplary Professional Practice

EP35EO:  Describe and demonstrate the patient satisfaction data aggregated at the organizational level outperform the mean of the database used.  Provide analysis and evaluation of data and resultant  action plan related to patient satisfaction addressing four (4) of the following:  Pain, Education, Courtesy and respect from nurses, careful listening by nurses, response time and other related questions.

 Jersey City Medical Center utilizes Press Ganey as its vendor for measuring patient satisfaction for our inpatient, emergency department, ambulatory and psychiatric units.  Our data obtained through Press Ganey is benchmarked against a national average.

The nursing patient satisfaction indicators we are tracking for each area are shown in the table below:

EP35EO-Analysis of Patient Satisfaction

EP35EO-Table 1

The graphs that follow display Jersey City medical Centers performance on patient satisfaction for the past eight quarters.

Discussion and Action Plans for Patient Satisfaction

Friendliness and Courtesy of the nurse

The Intensive Care Unit (ICU) has been at or above the national benchmark on seven out of the eight quarters.  Ambulatory Care also has been at or above the benchmark for eight quarters.  The Postpartum Unit (4 east), Medical-Surgical units and the Emergency Department continue to be challenged by this indicator.

The organization has reinvigorated the AIDET process (Acknowledge/Introduce/

Duration/Explain/Thank You).  This form of customer service communication provides the patients with much needed information and helps to reduce anxiety.  The white boards are also utilized for communication purposes.  The patients know their caregiver’s names, when their next medication is due or when a vital test is scheduled.

On 6 East, a Medical-Surgical unit, Ingrid Lopez, a Patient Care Technician (PCT), functions as a customer service representative on the unit.  She visits each patient on a daily basis and asks specific questions, in addition to the three P’s ( Pain, Position, Personal-Bathroom) she asks:

  • Do you have any cultural or religious needs?
  • Have we been sensitive to your emotional needs?
  • Is your room clean?
  • Is there anything I can get for you or help you with?

Please review Appendix 35EO-A for the completed tool.

Another strategy utilized to improve patient satisfaction on 7 East and 7 West, Medical- Surgical units, is that we have stationed a Patient Engagement Manager there for a pilot study.  Yvonne Selleroli BSN, RN, is a newly acquired Manager.  She partners with Raul Pamploma, Patient Advocate, to round on all the patients on the seventh floor.  They address issues in “real time” during the rounding process. They utilize the monthly Press Ganey trends as their monitoring tool.  They are posting current scores on the units and performing “huddles” with staff members to strategize on how to improve patient satisfaction. 

Vice President rounding is another initiative utilized to improve patient satisfaction.  Each senior leader is assigned to a specific unit that they visit on a weekly basis.  They huddle with the staff on their units for at least five minutes and discuss issues/problems that may hinder or be barriers to patient care.  The Vice Presidents assist in resolving issues immediately, if possible.  These issues are trended and aggregated into a monthly report (Appendix EP35-B).

Promptness response to call/nurses kept you informed

The Intensive Care Unit remained at or above the benchmark eight out of eight quarters on this indicator and postpartum was at or above the benchmark four out of the eight quarters.  Inpatient Psychiatry nurses prompt response to requests has been at or above the benchmark six quarters out of eight.  The ICU was also at or above the benchmark six out of eight quarters with the indicator of nurses kept you informed.

In order to address these indicators, the organization has instituted an hourly rounding initiative.  Rounding is performed on each unit to detect whether patients need pain medication, need to be turned or change their position, and/or personal needs such as assisting the patient to the bathroom and insuring that personal items are within easy reach.  These rounds are usually performed on the unit and the Patient Care Technician and the Staff Nurse usually perform these rounds.  These are an effective proactive method of attending to the patient’s needs.

In order to keep patients and family informed, our nurses perform bedside hand-offs on all the units.  This process allows the patient and the family members to participate and ask questions about the care being delivered. 

Skill of the Nurses

This indicator is being addressed primarily by having an educator available on the Medical Surgical Units that oversees skill level and addresses issues immediately as they occur.  Ebony Samuel MSN, RN, Nurse Educator oversees the seventh floor for educational purposes.  She has developed programs such as Nursing Delegation and Shift Report Review (Appendix EP35EO-B) and Continuous Bladder Irrigation (Reference EP35EO-A).  She is currently working with four (4) new RNs, two (2) of which are assigned to Medical-Surgical units.  The new nurses have received a Clinical Skills course via the EMS Simulation Laboratory, a Critical Thinking course, Documentation Review, and an EKG course, which is available to all RNs hospital-wide.  She further conducts all the in-services, for example, atrium chest drainage system, flexiseal and a urine collection system.

Maylene Laguna BS, RN, Nurse Educator for 6 East and 6 west has overseen several programs, such as, ECG review, Rapid Response/Mock Code Review in the Simulation Laboratory and has also given the above named in-services to her units.  She has also done some post rapid response debriefings on a one-on-one basis with staff, particularly new staff.  She further oversees the Charge Nurse Development Workshop and the Preceptor Development Workshop.

Emergency Room Action Plan

Khulud Adem is the recently employed Patient Engagement Coordinator in the Emergency Department.  She makes rounds on patients on a daily basis and also makes quite a few discharge telephone calls.  Between the months of July and August, she has telephoned 261 patients and is in the process of gathering and aggregating this data.  The ED has recently changed vendors from Press Ganey to Navio which is a survey conducted via telephone.  In August of 2012, patients were surveyed to understand what degree of importance they attributed to each of the questions being rated.  The following Table shows the rank order of each question and how the Emergency Department performs against each attribute:

EP35EO-Table 2

After data analysis, the following was added to the action plan:

EP35EO-Table 3