Together We Can: Pep for PIP

Massachusetts General Hospital (Boston, Massachusetts)

CSI Summary

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CSI Presentation

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CSI Toolkit

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Added to Collection

Project Topic

Teamwork and communication

Hospital Unit

Wang 3 Center for Perioperative Care

CSI Participants

Katherine Fay, BSN, RN
Justine King, APRN-MSN, FNP-BC
Sarah Mauzy, BSN, RN
Michelle Vassilopoulos, RN

Project Goals/Objectives

  1. To improve communication and teamwork among staff members improving our National Database of Nursing Quality Indictors (NDNQI) survey score 7%
  2. To create and sustain utilization of a standardized communication handoff tool with 80% staff compliance
  3. To decrease average length of stay in Phase II recovery for day surgery patients 8% (4.30 minutes)

Project Outcomes

  1. Increased NDNQI survey score 7%
  2. Decreased average length of stay in Phase II recovery 15% (8 minutes)
  3. These outcomes resulted in an estimated annual fiscal impact of $540,000.

Project Overview

As patient volume and acuity continued to increase in our unit, there was a noted decline in communication and teamwork, resulting in decreased patient and staff satisfaction. To address this issue, we developed a communication tool (“PIP” sheet) utilizing a bed management platform and incorporating the American Society of PeriAnesthesia Nurses’ guidelines for handoff. We provided education on effective use of the handoff tool and phases of post-anesthesia care in hopes of streamlining transfers and, ultimately, decreasing patient length of stay in Phase II recovery.

Six months after implementing the standardized handoff sheet, average patient length of stay in Phase II had decreased eight minutes, saving $40 per patient or $540,000 annually. A satisfaction survey midway through our project displayed evidence of increased staff satisfaction, and randomized audits showed 80% compliance with the handoff tool.

The results from both the survey scores and decreased length of stay offer compelling evidence that education and utilization of a standardized hand off tool increases teamwork, guards against missed communication, and increases staff satisfaction. Moving forward, our goal is to share our communication tool and results from our project with other post-anesthesia care units within our institution.

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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.

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.