ABSTRACT
Many models and approaches are available to manage change and plan for the future. Large group intervention is one approach to tapping the collective wisdom of a nursing system facing formidable adaptive challenges. Large group interventions involve many people, and they include open sharing of information, group problem-solving, participation, and sharing of power to create a shared future. One model for creating a vision for the future is called "Future Search". In this article, we describe the methodology of Future Search as a model to plan for change. A case study illustrates the use of a Nursing Future Search by an integrated, not-for-profit healthcare organization in northern Virginia. Results and the outcomes of a 6-month follow-up conference reveal nine planning groups that are moving a community of nurses to action.
Subject(s)
Delivery of Health Care, Integrated/trends , Forecasting , Nursing Staff, Hospital/trends , Delivery of Health Care, Integrated/organization & administration , Hospitals, Voluntary/organization & administration , Hospitals, Voluntary/trends , Humans , Models, Nursing , Models, Organizational , Nurse Administrators , Nursing Staff, Hospital/organization & administration , Organizational Innovation , Planning Techniques , VirginiaABSTRACT
Customer service initiatives in healthcare have become a popular way of attempting to improve patient satisfaction. This study investigates the effect of clinically focused customer service training on patient satisfaction in the setting of a 62,000-visit emergency department and level I trauma center. Analysis of patient complaints, patient compliments, and a statistically verified patient-satisfaction survey indicate that (1) all 14 key quality characteristics identified in the survey increased dramatically in the study period; (2) patient complaints decreased by over 70 percent from 2.6 per 1,000 emergency department (ED) visits to 0.6 per 1,000 ED visits following customer service training; and (3) patient compliments increased more than 100 percent from 1.1 per 1,000 ED visits to 2.3 per 1,000 ED visits. The most dramatic improvement in the patient satisfaction survey came in ratings of skill of the emergency physician, likelihood of returning, skill of the emergency department nurse, and overall satisfaction. These results show that clinically focused customer service training improves patient satisfaction and ratings of physician and nurse skill. They also suggest that such training may offer a substantial competitive market advantage, as well as improve the patients' perception of quality and outcome.
Subject(s)
Emergency Service, Hospital/standards , Inservice Training , Patient Satisfaction/statistics & numerical data , Professional-Patient Relations , Clinical Competence , Emergency Service, Hospital/organization & administration , Emergency Service, Hospital/statistics & numerical data , Health Care Surveys , Hospital Bed Capacity, 500 and over , Hospital-Patient Relations , Hospitals, Teaching/standards , Medical Staff, Hospital , Nursing Staff, Hospital , Organizational Case Studies , Research Design , Time Management , Time and Motion Studies , Trauma Centers/standards , VirginiaABSTRACT
Customer demands and financial pressures have forced hospitals to reassess the quality of their services and the efficiency with which they are delivered. A number of institutions have turned to continuous quality improvement methods to help streamline specific processes. For institutions to survive, however, they must look beyond specific processes to broader issues of scope of practice. One hospital's use of Juran's BPQM framework helped position the institution for future economic demands.
Subject(s)
Nursing Service, Hospital/organization & administration , Total Quality Management/organization & administration , Commerce , Efficiency, Organizational , Humans , Models, Organizational , Outcome and Process Assessment, Health CareABSTRACT
UNLABELLED: The redesign of the nursing delivery process at Fairfax Hospital is occurring from the top down and the bottom up. Nursing leaders have identified improvement opportunities that all units are addressing, such as reevaluating skill mix. At the same time, each inpatient nursing unit is redesigning its own processes to meet customer requirements. For example, the postpartum unit shifted to a "wellness" approach. Nurses reduced the amount of time spent in reassessing patients and are focusing instead on those things their patients are concerned about, such as teaching new mothers how to care for their babies. RESULTS: Customer research revealed that patients, physicians, and nurses wanted family-centered care from competent, caring clinicians. Flow charts identified many improvement opportunities that were common across all nursing units, such as reducing the time nurses spend reporting between shifts. Nurses are more empowered to make local decisions. Additional quantitative results are being tracked for this relatively recent effort.
