During a six-night stay at Mercy Hospital Ada in October for a bowel obstruction, Michael McCoy was impressed with the nursing staff’s communication skills and ability to provide high-quality care in a comfortable setting.
In August, all departments at the hospital adopted a new bedside reporting process between the outgoing nurse and the nurse coming on duty at shift change. Nurses meet in the patient’s room and discuss their treatment and any concerns with the patient.
“You are the main focus, which you are supposed to be, instead of on the outside looking in,” McCoy said about the new reporting process. “It makes it a whole lot easier on the patient because you are hearing what is going on firsthand.”
Through this process, he said he knew what to expect for the day, including when he could eat and when he would receive more medications. It also helped him stay informed as to whether or not he would need surgery, which he happily avoided by getting the right combination of medication and monitoring.
“They did an excellent job,” said McCoy, of Holdenville, Oklahoma. “This is my first time in the hospital and they made me immediately comfortable.”
About Bedside Reporting
Earlier this year, the nursing staff at Mercy Hospital Ada recognized that their previous handoff process between nurses was an antiquated system since it kept the nurses away from their patients while they discussed their care plans.
“We felt like it was an opportunity to increase patient safety and patient satisfaction, as well as decrease the time we were spending in nursing report because not every nurse needs to know everything about every patient in the unit,” said Liz Klingensmith, vice president of nursing at Mercy Hospital Ada.
The team, led by Klingensmith and Wendy Potter, director of quality at Mercy Hospital Ada, researched the best practices in nursing handoffs to create the evidence-based bedside reporting process, which was piloted in July on the surgical floor.
Before launching throughout the hospital, nurses participated in role-playing events where Mercy co-workers posed as patients so they could practice the new process and determine the most comfortable way to conduct the handoff in the patient’s room.
During the reporting process, the outgoing nurse introduces the patient to the nurse coming on duty; discusses the patient’s pain levels and medication administration; discusses any tests needed or recent test results; and reviews their treatment goals. Throughout this process, patients can ask questions and provide any feedback or reflections on the care they hope to receive that day.
Although the bedside reporting process among nurses is not new around the country, Klingensmith believes it is how the staff at Mercy Hospital Ada implemented the process that made it a standout.
“We think that really spending the time in the beginning on researching the strengths and weaknesses of similar programs at other hospitals helped us build those findings into our plan, giving us a higher probability of success,” she said.
The project was awarded a top honor at Mercy’s annual Innovation Awards this fall, which recognizes forward-thinking initiatives across Mercy’s 45 hospitals and more than 700 clinics in four states.
Potter believes it was the role-playing component of the implementation that made the project so innovative.
“I think it took a lot of the fear and anxiety away that often comes with a lot of change,” she said.
Results in Action
In October, Ada resident Terra Peters also went to the emergency department at Mercy Hospital Ada for a bowel blockage. She stayed at the hospital for three nights and experienced the bedside reporting process.
Peters, a registered nurse in the Ada area, said she uses the same process in her job and got a firsthand look at it from the patient perspective.
“I think it’s very important to the patient because they feel like they aren’t just a person in a bed,” said Peters. “They get to feel like they’re part of their care and it helps them understand a little more. Being a nurse myself, bedside reporting is really important and I think every hospital should do it.”
Since implementing the new reporting process, patient satisfaction scores have improved in the areas of nurse communication, pain control and medication management.
Additionally, the average nursing handoff time for each nurse was reduced from 51 minutes to 34 minutes each day, thus saving time so nurses can be at the patient’s bedside more often, which can also lead to safer care.
“Through the bedside reporting process, patients are able to identify that they have a team taking care of them that is all on the same page and they are included in that team,” said Potter. “They are not just observers. Instead, they are active participants in their care. After all, this is their health care and their hospital and we are here for them.”