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Posted June 14, 2012

A Focus on Nurse Communication: The Most Powerful Composite of All

As a nurse, you can make or break a patient's experience with one encounter. Nurses help control pain, manage medications and side effects, ensure patients receive help as soon as they request it and help build relationships with physicians – all of which have a direct effect on the overall satisfaction and care of the patient. That is why when we look at HCAHPS, the Nurse Communication domain is the greatest influencer of the patients overall experience.

At Studer Group®, we have seen the impact of nurses acting as "connectors" for the patient and their families. We understand their role in keeping patients informed, reducing their anxiety and managing their clinical care. Our work in organizations across the US and beyond has allowed us to collect some of the most impactful tactics that they hardwire to consistently communicate well with patients and their families.
Some of those best practices include:

  • Narrating the care – being more verbal with patients. Focus on explaining the "what" and the "why" when treating patients. When we share our knowledge, skills and expertise, we build credibility with our patients.
  • Hardwire AIDET® and Key Words at Key Times. By using the communication framework of AIDET®, we can impact the patient's perception of care by addressing their needs and focusing on courtesy and respect. A few tips include knocking before entering the room, acknowledging the patient and their family before moving to treatment and properly introducing yourself and the purpose of your visit.
  • Hardwire the use of whiteboards. Whiteboards provide visual communication for not only patients, but for their families and staff as well. Ensure that whiteboards are accurate and completely updated 100% of the time.
  • Utilize the Patient Care Model in its entirety. This model includes 4 best practices, all of which focus on communication.
    • Hourly Rounding®. By rounding on the patient hourly, you can ease anxiety, proactively address the patients' needs and reduce the need for call lights.
    • Individualized Patient Care. Ask your patients "what are the 2 or 3 things we can focus on to ensure you receive the best possible care?" Write these items on the whiteboard to show the patient that you heard what they said and you care enough to remember.
    • Bedside Shift Report. At Studer Group, we have found this is one of the best strategies to drive communication. We work with organizations to implement this at the patient's bedside and include the patient in the dialogue. Introduce the nurses and staff that will assist with caring for your patient. Ask the patient specific questions like "Can you explain to Sharon why we changed your medication dosage?" Not only will the patient feel like part of their treatment plan, but the staff will also gain important information about the patient.
    • Post visit Phone Calls. By asking the patient questions after they have left the hospital, we can extend our care outside the hospital walls. It allows us to check on how they are feeling, verify follow up medication and appointment needs, and validate the level of care they received. These clinical follow up calls also serve as a valuable tool to decrease preventable readmissions.

My experiences as a nurse have taught me that listening plays a vital role in the patient's perception of care. We can demonstrate our listening skills by using key words such as "I heard you state some concerns about your medication. Let me address them and explain why we changed your dosage."

By actively listening, acknowledging and answering their questions, we can further ease their anxiety. Explaining the "what" and the "why" during treatment will help build credibility. And by using factors of engagement, such as eye contact, tone of voice and physical positioning, you can build better relationships with patients and their families.

For more HCAHPS communication domains as well as tactics for improvement, we recommend The HCAHPS Handbook 2nd Edition released by Fire Starter Publishing.

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