In October 2008, staff members at Riverside Methodist Hospital (RMH) in Columbus, OH, approached Sheryl Tripp, MSN, RN-BC, nurse manager for the gynecology/gynecology-oncology (gyn/gyn-onc) surgical unit, in hopes of changing the way nurses were issuing patient reports.
Tripp reviewed the current process on the gyn/gyn-onc surgical unit for patient reports, along with the unit's Press Ganey patient satisfaction scores, and decided it was time to implement a new process for patient reports and end-of-shift reports. Press Ganey scores help facilities measure patient satisfaction with their care and offers guidance to help provide a higher level of healthcare.
Tripp led an effort to implement a new reporting process, Transferring Accountability at the Bedside (TABS), that includes an interaction between nurses ending and beginning shifts. Both nurses visit the patient's bedside together, as opposed to each nurse reporting separately.
The new process has improved the unit's Press Ganey scores dramatically, Tripp says.
Time for a change
For as long as Tripp could remember, nurses on her unit used tape recorders to create patient reports. At the end of each shift, the nurse would go into the designated recording room to record patient reports. The nurse coming in for the next shift would listen to that report and attend to patients and daily tasks.
"This process is all right, but most of the time nurses would end up doing verbal reports because the tape recorder would fail, or they had problems understanding what the nurse was saying on the recording," says Tripp.
The unit's Press Ganey scores were hovering around 50% for nurse-to-patient communication and safety during the patient's stay. Tripp knew it was time to honor her nursing staff members' requests to help improve patient safety and nurse communication.
To start, Tripp ran a series of two-week trial methods on her unit that involved doing a few different types of reports: with the tape recorder, a written report, a verbal report, and a bedside report.
"We told the staff members each week the style of reporting we would do, and then asked them to report back to us with any feedback," says Tripp.
While the trial period was going on, Tripp would visit patients' rooms and talk with them about each of the reports, specifically the bedside reporting.
On RMH's gyn/gyn-onc surgical unit, semi-private and private rooms are available, and there are patients who share rooms. Tripp wanted to make sure patients did not have any problems with bedside reporting with respect to fear of violating the patient's privacy.
"During this trial period, a majority of the patients I talked with liked the bedside process, so I decided this was the right process to move forward with and focus on developing," Tripp says.