CSI Summary
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Project Topic:
Peer feedback and skilled communication
Hospital, City and State:
ChristianaCare, Newark, Delaware
Unit:
3E Medical Intensive Care Unit
CSI Participants:
- Ellen Alvarez, MEd, BSN, RN, CCRN, WTA
- Amber Hiltner BSN, RN, CCRN, WTA-C
- Jennifer Papi MSN, RN, CCRN
Project Goals/Objectives:
- Implement a structured framework for nurses to give and/or receive peer feedback
- Promote improved interdisciplinary team communication and collaboration
- Decrease turnover
- Increase the Healthy Work Environment Assessment Tool (HWEAT) Skilled Communication score
- Increase HWEAT True Collaboration score
- Increase Workplace Civility Index (WCI) score
Project Outcomes:
- Decreased turnover from 9.92% to 6.9% Increased Healthy Work Environment Assessment Tool (HWEAT) aggregate score from 4.02 to 4.11
- Increased HWEAT Skilled Communication score from 3.64 to 3.97
- Increased HWEAT True Collaboration score from 3.64 to 3.71
- All HWEAT standards improved
- Increased Workplace Civility (WCI) score from 89.4 to 93
- These outcomes resulted in a positive estimated annual fiscal impact of $563,000
Project Overview:
In 2023, MICU had the highest turnover rate at 9.92% among intensive care units on the ChristianaCare Newark campus. The CSI team identified an immediate need for improved communication particularly giving and receiving peer feedback to facilitate direct communication and meaningful dialogue. The purpose of this project was to improve skilled communication, to promote true collaboration and workplace civility to decrease turnover.
The team developed peer feedback education with a content expert to target communication skills using a structured framework. Education occurred during project kickoff and at the midpoint about the types of feedback and feedback frameworks: Situation, Behavior, Impact, and Future frameworks along with feedback strategies to facilitate conversation. There was ongoing project support through bulletin boards, monthly one-pager education, and monthly raffles. In addition, staff wore badge reels with the project logo and badge buddies with feedback strategies and examples. Project participants attended staff meetings to share project content and reinforce concepts to promote continued implementation.
Overall, the outcomes of the project were positive. The aggregate HWEAT score improved as well as every HWE standard. Skilled Communication and True Collaboration scored higher at 3.97 and 3.71, respectively. In addition, the WCI increased above the target goal to 93 indicating a very civil work environment. A decreased turnover rate of 6.9% also showed the success of the project and its impact on the unit’s culture of communication, collaboration, and civility.
Creating a healthy work environment where nurses confidently communicate and feel safe giving and receiving feedback can help them stay engaged in their bedside role, speak up about patient care, and foster a workplace hallmarked by true collaboration. In turn, this promotes a civil workplace that is associated with decreased turnover.
Permission to Reuse Materials
The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.
Disclaimer
The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.