Out the Door Dinosaur

Loma Linda University Children’s Hospital (Loma Linda, California)

CSI Summary

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CSI Presentation

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CSI Toolkit

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Project Topic:

Health literacy

Hospital Unit(s):

Pediatric Cardiovascular Intensive Care Unit (CVICU)

CSI Participants:

  • Emily Garcia de la Vega, BSN, RN
  • Maureen Hokama, BSN, RN, CCRN
  • Jennifer Newcombe, DNP, MSN, CNS-BC, CPNP-PC/AC
  • Joanne Ramirez, ADN, RN

Project Goals/Objectives:

  1. Increase NRC patient satisfaction score to 90%
  2. Decrease 30-day hospital readmission rates by 3%
  3. Reach 90% compliance with health literacy screening of all surgical admissions

Project Outcomes:

  1. Increased NRC patient satisfaction score 78.6%
  2. Decreased 30-day hospital readmission rate 20% (from five readmissions to four)
  3. Achieved 95% compliance with health literacy screening of all surgical admissions
  4. These project outcomes resulted in an estimated annual fiscal impact of $97,692.

Project Overview:

Health literacy is the ability to read, understand and act upon health information. Low economic status and minority populations have been found to be at risk for low health literacy. At Loma Linda University Children’s Hospital (LLUCH), more than 11% of the population we serve within San Bernardino and Riverside Counties lives in poverty, and 85% of the surgical patients receive public health insurance.

Our CSI team observed that LLUCH was not using a screening tool for health literacy and that the hospital had low scores on the question to families, “During your stay, how often did your child’s nurse explain things to you in a way that was easy to understand?” We also noted that hospital readmissions within 30 days of surgery were above the national benchmark of 10%.

Through screening, we identified that over 30% of our caregivers scored as having low or limited health literacy. To help overcome this challenge and reduce associated readmissions, the CSI team implemented and educated team members on a validated health literacy tool. In addition, we created a standardized discharge teaching toolkit specific to health literacy needs. We also introduced a protocol to use upon admission where the bedside nurse asks family members (caregivers) how they learn best and assesses their learning ability through a standardized script. Together, these efforts resulted in measureable improvements.

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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.