Business Plan Implementing Bedside Hand-Off in the Emergency Department

10 August 2024

Business Plan: Implementing Bedside Hand-Off in the Emergency Department

Chamberlain College of Nursing

NUR 533: Financial Management in Healthcare Organizations

Dr. Sandra Welling

August 11, 2024

Executive Summary

This business plan proposes the implementation of a bedside hand-off process in the Emergency Department (ED) at Conneaut Medical Center. The objective is to improve patient satisfaction scores, which have been suboptimal as per recent Press-Ganey surveys. The bedside hand-off process involves nurses conducting patient hand-offs at the patient’s bedside during shift changes, thereby enhancing communication, patient engagement, and overall satisfaction. This proposal outlines the rationale, costs, implementation strategy, and expected outcomes of the project.

Introduction

Patient satisfaction is a critical component of quality healthcare and is closely monitored through various metrics, including Press-Ganey surveys. In the ED at Conneaut Medical Center, recent survey results indicate a need for improvement in patient satisfaction, particularly in the areas of communication and involvement in care. The bedside hand-off process has been identified as a potential solution to address these issues.

Proposal Cover Letter

158 West Main Road

Conneaut, OH 44030

(440) 593-0123

Ami.bennett@uhhospitals.org

August 11, 2024

Jason Glowczewski, PharmD, MBA, FASHP, COO

Conneaut Medical Center

158 West Main Road

Conneaut, OH 44030

Dear Mr. Glowczewski,

My name is Ami Bennett, and I currently serve as the Assistant Nurse Manager in the Emergency Department. I am writing to seek your approval for a new initiative aimed at enhancing our patient satisfaction scores, which have consistently been below our target benchmarks, as evidenced by recent Press-Ganey surveys.

Over the past six months, I have been closely monitoring our patient satisfaction scores and analyzing the feedback provided by patients through the Press-Ganey surveys. This analysis has revealed recurring concerns regarding communication and patient involvement in their care. To gain further insight, I have consulted with other managers across our healthcare system who have successfully implemented strategies to improve patient satisfaction. Additionally, I have conducted an extensive literature review to identify evidence-based practices that could be applied to our department.

Based on this research, I propose the implementation of a bedside hand-off process during shift changes. This process will involve nurses conducting hand-offs at the patient’s bedside, actively involving both the patient and their families in the exchange of information. The aim is to improve communication, ensure continuity of care, and increase patient satisfaction.

Cost and Resources: The implementation of the bedside hand-off process is cost-effective. The primary expense will be the time allocated for staff education and the ongoing auditing of compliance. There will be no need for additional equipment or materials, as the existing tools and resources within our system will be sufficient to support this process.

Implementation Plan: The first step will involve educating the nursing staff on the importance of bedside hand-offs and providing them with the necessary training to perform these hand-offs effectively. This will include role-playing exercises, review of best practices, and addressing any concerns or barriers to implementation. Compliance with the new process will be monitored through regular audits, and feedback will be provided to both staff and leadership on a bi-weekly basis. Adjustments to the process will be made as needed to ensure its success.

Financial Impact: Failure to address our current patient satisfaction scores could have significant financial implications for the department and the organization. Lower patient satisfaction can lead to decreased patient retention, lower reimbursement rates, and potentially increased operational costs due to extended lengths of stay and higher readmission rates. By improving patient satisfaction through bedside hand-offs, we anticipate not only an increase in patient loyalty but also an enhancement in our overall financial performance.

I am confident that with your support, we can implement this initiative effectively and achieve measurable improvements in our patient satisfaction scores. Thank you for your consideration of this proposal.

Sincerely,

Ami Bennett Assistant Nurse Manager Emergency Department Conneaut Medical Center

PICOT Question

In emergency department (ED) patients, what is the effect of implementing a bedside hand-off compared to the current standard practice of reporting at the nurse’s station on patient satisfaction scores, as measured by Press Ganey surveys, over one quarter?

Rationale for the Project

The rationale behind this initiative stems from the recognition that patient satisfaction is a key indicator of quality care. Current standard practice in the ED involves nurse-to-nurse hand-offs at the nurse’s station, which excludes patients and families from the exchange of critical information. This can lead to misunderstandings, gaps in care, and decreased patient satisfaction. Research supports that bedside hand-offs improve communication, enhance patient safety, and increase patient satisfaction by involving them directly in their care.

Project Goals and Objectives

  1. Increase Patient Satisfaction Scores: Achieve a 10% increase in patient satisfaction scores related to communication and involvement in care within one quarter of implementation.
  2. Improve Communication: Ensure that patients and their families are actively involved in the hand-off process, thereby improving their understanding of care plans and reducing anxiety.
  3. Enhance Patient Safety: Reduce the potential for communication errors during hand-offs, thus enhancing overall patient safety and continuity of care.

Implementation Strategy

Phase 1: Preparation and Staff Education (Weeks 1-2)

  • Develop training materials and conduct educational sessions for nursing staff on the benefits and procedures of bedside hand-offs.
  • Engage staff in role-playing scenarios to practice bedside hand-offs, focusing on effective communication techniques.

Phase 2: Pilot Implementation (Weeks 3-4)

  • Begin the bedside hand-off process with a selected group of nurses and patients to test the approach and identify any challenges.
  • Collect initial feedback from both staff and patients to refine the process.

Phase 3: Full Implementation and Monitoring (Weeks 5-12)

  • Roll out the bedside hand-off process across the entire ED.
  • Conduct regular audits to monitor compliance and effectiveness.
  • Provide bi-weekly feedback to staff and leadership on patient satisfaction trends and areas for improvement.

Budget and Financial Analysis

Cost Analysis: The costs associated with this initiative are minimal and primarily involve the time required for staff education and compliance monitoring. The financial investment is expected to yield significant returns in the form of improved patient satisfaction, which is directly linked to higher patient retention rates, better reimbursement from insurance providers, and overall enhanced financial performance.

Financial Benefits: By improving patient satisfaction scores, the ED is likely to see an increase in patient volumes, a reduction in the length of stay, and a decrease in readmission rates, all of which contribute to a more favorable financial outlook for the department.

Evaluation and Outcomes

Key Performance Indicators (KPIs):

  • Patient satisfaction scores related to communication and care involvement (target: 10% increase within one quarter).
  • Compliance rates with the bedside hand-off process (target: 95% compliance within the first quarter).
  • Reduction in communication-related errors (target: 20% reduction within one quarter).

Outcome Evaluation: The success of the bedside hand-off initiative will be evaluated based on the achievement of the above KPIs. Regular feedback will be collected from both patients and staff, and the process will be continuously refined to ensure ongoing improvement.

Conclusion

The implementation of bedside hand-offs in the ED at Conneaut Medical Center represents a strategic initiative aimed at enhancing patient satisfaction, improving communication, and ensuring patient safety. With minimal costs and the potential for significant financial and operational benefits, this initiative aligns with our commitment to providing high-quality care and improving the patient experience.

Approval of this proposal will allow us to move forward with the implementation, and I am confident that it will lead to measurable improvements in our patient satisfaction scores and overall department performance.