The Quest for Excellence: A Quality Improvement Project on the Effects of a Standardized PACU/Phase II Bedside Report in a High Turnover Pediatric Ambulatory Surgery Center.

ABSTRACT

PURPOSE: To evaluate the impact of an evidence-based standardized bedside report within a pediatric ambulatory surgery center on length of handoff time, registered nurse (RN) workflow, and patient and family satisfaction. DESIGN: Quality improvement project using an evidence-based standardized bedside report intervention with pre- and postimplementation evaluation of process and outcome measures. METHODS: In January 2019, a unit-based task force evaluated ways to improve current report process and consistency of communication between staff and families. Time from admit into Phase II until nursing handoff was measured pre- and postimplementation. Nursing workflow was measured by time to first RN assessment after admit to Phase II and the postimplementation nursing survey. Patient and family satisfaction were measured pre- and postimplementation from National Research Council Health. FINDINGS: Postimplementation, average handoff times decreased by 30%; average time from admit to the Phase II unit until the nursing handoff decreased by 28%. From the postimplementation RN survey, 100% RNs (1) felt standardized bedside report had a positive impact on their workflow, (2) expressed confidence in giving and receiving reports, and (3) reported they had critical information to safely care for patients. Overall patient satisfaction was measured by How likely would you be to recommend this facility to your family and friends; 11.6% improvement over baseline scores was reported. Improved percentages of score improvement from baseline included nurses explained things (4.42%), nurses listened carefully (4.3%), patient and family received consistent information (2.46%), care providers explained things (2.22%), and patient and family trusted nurses with care (1.74%). CONCLUSIONS: Implementation of standardized bedside report resulted in (1) more expeditious times to handoff and first RN assessment, (2) overall positive impact on nursing workflow, and (3) improvements in patient and family satisfaction.