Purpose: The purpose of this project is to promote patient-centered-care (PCC) on an acute care of the elderly (ACE) unit through use of a “get to know me” poster to increase patient satisfaction and nursing perception of providing PCC.
Rationale: As the geriatric population grows, their risk for acute hospitalizations also increases. Instituting PCC increases positive outcomes and satisfaction in geriatric patients. Despite the importance of PCC, adoption into routine acute care practice remains inconsistent (Moore et al., 2017). Older adults who are frail or have cognitive impairment can be easily overlooked in acute care settings. One strategy for implementing PCC is the use of a “get to know me” (GTKM) tool to help improve communication, identify patient values and personalize care interventions (Fick et al., 2013).
Framework: The IHI model for improvement was used as a foundation for the project as it guides development of the plan, do, study, act (PDSA) quality improvement (QI) process (IHI, 2022). Additionally, the IHI’s age-friendly health system provides a foundation for this project with use of the 4 Ms (what matters, medications, mobility, mentation) framework.
Methodology: This is a QI project that will be conducted over two months on an ACE unit in a community hospital. The GTKM poster will be completed using information from patients/family members and posted during the hospital stay. Patient satisfaction will be measured through Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores, specifically reviewing nursing communication percentages pre- and post-implementation of this QI project. Satisfaction with the project will be measured through interviews performed at random selection with 3-4 patients/family members weekly. We will utilize the person-centered care assessment tool (P-CAT) to describe nurse perceptions pre- and post-implementation. Additionally, nursing perceptions of the poster will be collected weekly during audits of completion.
Analysis: An aggregate of responses pre- and post- implementation will be collected for HCAHPS scores and from the P-CAT tool. Poster completion rates will be collected weekly and plotted on a run chart to monitor for trends in poster usage.
Results: The project is ongoing with a plan for completion by July 2023.
References
1) Fick, D. M., DiMeglio, B., McDowell, J. A., & Mathis-Halpin, J. (2013). Do you know your patient? Knowing individuals with dementia combined with evidence-based care promotes function and satisfaction in hospitalized older adults. Journal of gerontological nursing, 39(9), 2–4. https://doi.org/10.3928/00989134-20130809-89
Institute for Healthcare Improvement (2022). How to improve.
https://www.ihi.org/resources/Pages/HowtoImprove
2) Moore, L., Britten, N., Lydahl, D., Naldemirci, Ö., Elam, M., & Wolf, A. (2017). Barriers and facilitators to the implementation of person-centred care in different healthcare contexts. Scandinavian journal of caring sciences, 31(4), 662–673. https://doi.org/10.1111/scs.12376