When CMS first implemented the Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey in 2008, scores have become increasingly important as hospitals work to maintain market share and avoid losing reimbursements. With patients’ increasing involvement in choosing their hospital, quality care is expected from hospitals; a positive experience may be what differentiates your hospital from another.
One of the foundations of a positive patient experience is communication. According to a Joint Commission study, communication errors contribute to 65% of reported sentinel events*. Indeed, several questions on the HCAHPS survey specifically address communication. While efforts targeted at improving communication among clinicians have included multidisciplinary rounds, improved systems for handoffs, care coordination, and care checklists, most have not succeeded in engaging patients and families. Achieving this lofty goal requires a focus on improving communication between clinicians and the patient and family members, while positively affecting quality, safety, and satisfaction.
Research has found that the use of whiteboards in patient rooms facilitates communication between hospital staff and patients, while engaging patients and family in their care. The whiteboards have been shown to provide as much as a 50 percent reduction in errors, and a 73 percent increase in patient and family understanding of the treatment being given*. The improvement in communication is leading to improvement in HCAHPS scores nationwide. Jennifer Kreisner, BSN, MSM, of Sentara Bayside Hospital says of the whiteboards, “We have seen a 17% increase in our HCAHPS scores and recently achieved 75% in nurse communication scores. The implementation of our communication boards is definitely making a difference in the scores.”* Barbara Griffin, BSM of Our Lady of the Lake Regional Medical Center says, “As a result of the efforts, there has been a 7% increase in the nurse communication score for the percent of survey respondents who said nurses ‘always’ communicate effectively. There have been even larger improvements in other domains: a 19% bump for pain management, and a 26% increase for medication instruction.”*
This manual process of updating the boards not only takes away from patient care, it relies on staff to be the ones to update the whiteboards throughout the shift.
While whiteboards have turned into a best practice, the use of the boards has proven to be highly variable and sporadic as patient care teams strive to keep the boards updated but succumb to more immediate and pressing patient needs. The problem laid out is common in hospitals, where multiple information systems, people, and tools function in a fractioned and sometimes inefficient manner. This culminates into a problem of keeping the whiteboards up to date 24/7. A large portion of the information on the whiteboard has already been entered electronically into an information system. Unfortunately, these systems have not been integrated with the whiteboards and therefore the care team must manually interact with the boards to update them. The information is not always transcribed correctly, or legibly. This manual process of updating the boards not only takes away from patient care, it relies on staff to be the ones to update the whiteboards throughout the shift.
A less commonly discussed issue in regards to the use of whiteboards is found with patients who don’t speak or read English. Most translation services are available only over the phone, leaving the hospital with no systematic mechanism for filling in whiteboard information. These patients very often lose out on the benefits of this important communication tool because of their language barrier.
The whiteboard in each patient room is presently being leveraged to improve the patient experience and engage patients in their care. The future in whiteboard technology holds promise through the integration of information systems and electronic health records. A more interactive whiteboard which further engages patients and families is now a very real possibility to those who are ready to make the next big step.
*Sources:
Journal of Hospital Medicine – Patient Whiteboards as a Communication Tool in the Hospital Setting: A Survey of Practices and Recommendations
HealthResearchFunding.org – Why Whiteboards Improve Patient Communication
The Advisory Board Company – Harnessing the power of the simple whiteboard: A shout-out to Sentara Bayside Hospital
Center Focus – Jan/Feb 2012 Volume 3 Number 1 – Achieving Patient Satisfaction: What Works