SIBR rounds as part of the ACU care model can broadly increase HCAHPS
Top Results
Overview
St Tammany Parish Hospital were excited to bring a new patient-centered model to their hospital for their patients to experience on their hospitalist units. St Tammany contracted us to help them implement the ACU care model with Nurses First and SIBR rounds in an efficient way, as they realized the complexity of brining all of the different disciplines together and coordinated to the new processes.
Objectives
Hospital leaders at St Tammany Parish Hospital were keen to implement a patient-centered care model with unit c-leadership to help drive improvements across all unit stakeholder groups: physicians, nurses, patients and their families, pharmacists, therapists and discharge coordinators.
Methods
1Unit supported ACU implementation on four hospitalist led units:
Online training was provided to all nurses for the Nurse First Change of Shift Huddle and Bedside Handover,
Online training was provided to all care team staff on the fundamentals of SIBR rounds,
1Unit facilitated customization of the Nurses First and SIBR templates and job aids,
Onsite training was then provided to all staff on their new processes, including simulation scenarios, role plays and advanced best practices,
Process monitoring and data collection were used to support long-term implementation success, and
Weekly mentoring meetings were facilitated by 1Unit to identify challenges, barriers and opportunities for success.
Results
Significant improvements in HCAHPS scores were observed in the months following implementation:
'Rate the hospital' increased from the 49th percentile to the 94th
'Would recommend facility' increased from the 49th percentile to the 99th
'Communication with nurses' increased from the 4th percentile to the 86th
'Responsiveness of hospital staff' increased from the 9th percentile to the 99th
'Communication with doctors' increased from the 5th percentile to the 99th
'Communication about medicines' increased from the 23rd percentile to the 99th
'Discharge information' increased from the 54th percentile to the 91st
'Care transitions' increased from the 66th percentile to the 99th
This quote from the Hospitalist Group Leader is an example of the difference in experience:ness
"During my first week SIBRing, I was most surprised by how much the patients and families liked it.
We had one patient, obese with obstructive sleep apnea, uncontrolled diabetes, profoundly hypothyroid – he’d stopped taking his Synthroid – he was admitted with confusion. We got him back on CPAP, got his Synthroid restarted, and started a stimulant.
I’m seeing him before SIBR one day and he says: ‘Doc, you and your team coming in every day, no one has ever done that, you guys are unbelievable, really. I’m a pretty tough guy, but I almost want to cry.’"
Conclusion
Implementation of the ACU care model with Nurses First and SIBR rounds programs resulted in significant broad increases in HCAHPS scores. Hospital executives, unit leaders and frontline staff were impressed with the changes in culture and care delivery after ACU implementation and were looking forward to continuing to succeed with the new care model into the future.
