When Cara Beard, nurse manager in med/surg at Baptist Collierville, embarked on KATA training with the Baptist Management System in October of 2015, she couldn’t have envisioned where the training would take her team.
Having been at Baptist Collierville for more than a decade, this nurse leader had always worked in med/surg since graduating from nursing school. “I love it,” she said. When tasked with further KATA training and identifying a problem area, she thought of one continual challenge.
“Our ‘responsiveness of hospital staff’ domain scores have been in the 20th to 30th percentile for patient satisfaction,” she said. Essentially, patients were waiting too long from the time they pushed a nurse call button to the time a nurse arrived. During 2016, her team focused on a new goal of achieving 80 percent patient satisfaction.
As her team began to analyze the current condition, they knew the calls varied widely and included everything from IV pumps to bathroom calls. Historically, nurses and patient care assistants respond to their patients only, letting other calls roll to the assigned person. Cara, having been in bedside positions for years, completely understood the challenges facing floor nurses.
As she analyzed the call data of her current condition, one of her early assumptions was challenged. “We all thought pain and bathroom calls would be the reason patients called most. What we found was that IV beeping was four times higher than any other patient need. We quickly realized that most emergency room admissions come to the unit with an IV in the bed of their arm. When a patient bends their arm, the IV beeps and the patient calls the nurse to reset the pump to continue the medication infusion.”
After many experiments, Cara and her team first created a process for each call, how it would route and how team members would respond.
“We soon discovered this process was way too confusing, so we scrapped the whole thing.” Instead, Cara said they adopted a policy that was fairly basic. “Whoever was available would respond to the call, regardless to whom the patient was assigned. The idea was to simply acknowledge the patient’s call, even if our response was to tell the patient their nurse was on the way.”
Another change came with patient education. Most patients assumed their call went directly to a nurse, when in reality, the call is answered by an Ancillary Unit Coordinator (AUC) who then routes the call to a nurse’s or patient care assistant’s phone. The AUC rounds at the start of the shift to introduce themselves and let the patient know they are who will be answering the call light when they push the red assistance button.
“This helped AUCs better understand their role in patient care. It helped put a face with a name.”
In six months, Cara’s team now responds to 100 percent of calls in three minutes or less. “That includes both day and night shifts,” she said. Their patient satisfaction rating has soared to the 90th percentile, and another unforeseen stat changed. “Patient safety has improved. We’ve gone 38 days without a fall and it’s because when a patient needs to go to the bathroom and the response is slow, eventually the patient will try to get out of bed on their own…and will fall.”
In August, Cara spoke at the Tennessee Hospital Association quarterly meeting in Nashville, where she shared Baptist Collierville’s success story. Very hands-on, Cara knows active communication, coaching and listening to feedback all contributed to their success. “We performed experiments and coaching cycles every day and the staff would come up with more obstacles. With every challenge we met, we tracked it on our daily metric board.”
Cara will return to Nashville in October for a poster presentation of her KATA at a leadership summit.