The scenario describes a year-long campaign initiated by the inpatient geriatric medical nursing unit to improve patient satisfaction scores related to pain management. The unit received the lowest performance score on the Hospital Consumer Assessment of Healthcare Providers (HCAPHS) survey among all divisions in the hospital. The interprofessional team working in the unit might have experienced issues with clear purpose definition or communication, causing poor performance outcomes (Yoder-Wise, 2019). Spath (2018) states that benchmarking can be used to compare the performance results of a healthcare provider with organizations recognized as exemplary and superior in the industry. A run chart is another tool that explains how the changes impact the improvement process over time (Perla et al., 2011). The run chart reveals that the unit’s patient satisfaction results increased from the low 70s to the upper 90s, while the national benchmark for similar Med/Surg units was 85%. The results of the performance assessment indicate that patient satisfaction with pain management required improvements.
The range of interventions and strategies was implemented to address the unit’s concerns with patient satisfaction scores. Training on the importance of patient satisfaction, lectures on pain management, and article reviews proved to be ineffective as they did not improve the score. However, the introduction of the PDSA model and education on different aspects of pain management in the elderly positively affected patient satisfaction results. Quantitative improvement tools were selected to implement the model and included the run chart and patient surveys that helped evaluate the outcomes. Qualitative techniques were not mentioned in the action plan, but the unit could have employed multi-voting, brainstorming, or flowcharts to analyze current practice and storyboards to review the results and measure success.
The run chart had a limited predictive ability because it estimated patient satisfaction scores during a relatively short period of two years. The progress appeared to be consistent and steady from the first quarter of 2015, which might be interpreted as a sign of a successful performance improvement strategy. The findings suggest that the set of strategies and interventions used during the first year of the improvement campaign were inadequate, while the measures introduced in 2015 created a sustainable change. Notably, the survey response rate of 25% was insufficient, considering that 100% of eligible inpatients were surveyed. Thus, the nursing unit’s decision to celebrate was premature, and the stability of the performance improvement trend cannot be guaranteed without an adequate survey response rate. The nurse manager may observe consistent results in the next quarter but should not expect the unit to exceed the national benchmark in the next year.
Perla, R. J., Provost, L. P., & Murray, S. K. (2011). The run chart: A simple analytical tool for learning from variation in healthcare processes. BMJ Quality and Safety, 20(1), 46–51.
Spath, P. (2018). Introduction to healthcare quality management (3rd ed.). Health Administration Press.
Yoder-Wise, P. S. (2019). Leading and managing in nursing (7th ed.). Mosby.