When the COVID-19 outbreak became widespread at the beginning of March, Susan Murphy, RN, BSN, knew she’d have to revamp how the patient experience team at U Chicago Medicine addresses patient health concerns.
Through her work as a nurse and as the hospital’s chief experience officer, Murphy has zeroed in on patient rounding procedures. Patient rounding helps clinicians assess patient sentiment and needs to make changes in real-time, and has been a core part of Murphy’s understanding of improving patient experience.
“One of the main tactics that I’ve learned in my career being a nurse and being in the experience arena for many years, is to round with and talk to patients and create conversations with them about their stay while they’re here,” she told PatientEngagementHIT in an interview.
For the past six years, U Chicago Medicine has utilized a nurse rounding platform from Vocera to understand how patients are experiencing their hospital stay in real-time. The platform lists questions that spark conversations between patient experience leaders and patients about the level of care. Clinicians take this feedback to the care team to make improvements.
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A variety of workers are involved in this process, from patient experience staff to frontline clinicians and leaders.
But like so many other factors, the COVID-19 pandemic changed all of that. The highly contagious disease pushed numerous healthcare organizations across the country to limit the number of people interacting with patients, including both family visitors and some hospital staff.
“In early March we found out that patients were not going to be able to have visitors until further notice, and that we wanted to limit the time with encounters in the room,” Murphy said. “We quickly thought about how we were going to continue those conversations with patients, which probably are more important than ever.”
This pushed Murphy and her team to entirely retool their nurse rounding system altogether. The healthcare organization virtualized their rounding program using the phones found in every patient room. The patient experience team conducted two daily phone call rounds with every patient room, working to understand patient needs and sentiment during their stay, whether the patient was COVID-positive or not. Nurses took notes using the platform via their iPads.
That system was a boon for U Chicago Medicine. As of the end of April, the hospital had conducted 420 virtual rounds with nine key patient experience leaders.
But that’s not where the success story ended, Murphy said.
At the beginning of the pandemic, these rounding sessions looked a lot like they did before, except they became distanced and virtual. Patient experience leaders still used the rounds to understand patient needs during the visit, almost like an audit to ensure U Chicago Medicine was doing what it needed to promote a positive patient experience.
“But the communications that we’re doing virtually is about that human connection,” Murphy said. “We knew that the idea of healing starts right here right now when the patients are still with us in their care.”
To that end, clinicians conducted patient rounding sessions with a high level of empathy and human connection. It was important that the care team treat patients with compassion, Murphy said, and that shone through during virtual rounds.
And eventually, that compassionate care snowballed into a deeper patient experience.
“But what happened, which was very interesting to us as we started doing these calls, is that since the patients are alone, that the human connection was vital for patients,” Murphy stated. “Patients liked having someone in the organization who wasn’t walking in with a mask on or with gloves or a gown on, and having a connection with them about how are they doing.”
And so, U Chicago Medicine began using patient rounding not just as a way to capture patient sentiment, but also as a way to forge deep connections with patients who otherwise may not have anyone to connect with during their stay.
“It also became clear that patients were able to open up with the people who were doing their rounds,” Murphy said.
And to that end, Murphy and her team retooled their system again, this time to ensure the same patient experience leader rounded with the same patient. This was a daunting task, Murphy said, but a worthwhile one for providing comfort to the patient throughout their length of stay.
“At first, leaders are asking the questions on the tablet, but then it evolves to, ‘How’s your mom doing? What vacation are you looking forward to?’” Murphy explained. “Being in a hospital is a scary time right now. With the virtual rounds, until we started them we did not realize the strong impact that human connection would have.”
This evolution of nurse rounding may reflect changes in how hospitals like U Chicago Medicine measure patient experience going forward. Murphy said the hospital is still measuring patient satisfaction using HCAHPS and other key process measures, but because of COVID-19 she predicted qualitative measures are going to begin to carry more weight.
“We’ve been measuring through Press Ganey and our HCAHPS for inpatient surveys for years, which we still do, but what we’re noticing is how important the comments are going to be now more than ever,” Murphy noted.
For one thing, U Chicago Medicine has seen a drop in survey return rates, in large part because of the cut in elective surgeries.
“But on the return rate that we were getting, we are noticing a shift of positivity, especially with the patients that were discharged.”
Between the middle of March and the end of April, Murphy and her team have observed a serious uptick in patient outcomes scores.
“We’re also seeing many more comments, and we are doing a sentiment analysis of the comments to make sure that we’re understanding what patients are saying,” she added. “The gratefulness of patients is coming through much louder and clearer than sentiments about their food or if they liked their room.”
“What we’re seeing is a shift in what is important to patients,” Murphy continued, noting that this might reshape patient experience measurement and surveying. “What does a survey look like? What is important to measure and how do we keep improving on that? This is what’s important to the patient but also for those that are caring.”
This circles back to Murphy’s point about creating a human experience. Understanding patient sentiment — whether it be through rounding, through surveying, and during COVID or non-COVID cases — is evolving to look more at the human touch and less at the amenities that some have defined as a good experience.
“The most important part is creating a human connection, making sure the patient knows that we care about them and their thoughts and their opinions, not just an audit of behavior,” Murphy concluded.
Source: PatientEngagement HIT