Aims Our aim is to improve communication with patients and parents on our general paediatric ward. We have a large multidisciplinary team who have frequent patient contact. Plans on ward rounds are discussed by the medical team and quickly communicated to the family. However, there is often no reference point for this family and young person to refer back to later. The focus of the work involved capturing these interactions and communicating the daily plan for each individual clearly.
Method Using the model for improvement we tested out the use of bedside whiteboards to record daily plans. Small whiteboards above each bed existed to record ‘patient name, consultant, nurse, allergies’ but were seldom used. Our play specialists laminated decorated card to fix to the boards. A dry marker was used to summarise the daily plan from the medical ward round and encourage conversation with nurses and patients/parents to clarify or review this plan. Posters show a picture of the whiteboards, explaining their and encouraging both families and staff to use them, promoted with the slogan, 'BETTER COMMUNICATION BETTER CARE'.
Results Patients/parents on the first PDSA cycle (week 1) said they found the board empowering but wanted space to record their feelings and visiting times. We laminated larger card and spread for PDSA cycle 2 but the nursing staff were concerned about confidentiality on the open ward. We asked the parents and they didn't agree since only the information discussed with them is recorded (i.e. they can determine what is written). One consultant, although at first sceptical, noticed it helped organise a busy ward.
Feedback forms, given out to patients and staff, filled in anonymously and posted into our ward feedback box, showed:
75% of patients found the boards helpful (agreed/strongly agreed)
25% were neutral. Reasons: they already felt they had good face to face communication with staff.
Comments included: 'Helps a lot to know plan for the day', 'Both me and my husband know what is happening', 'The staff know the families plan', 'Everyone is on the same page', 'know how long we gonna be here'
The rest of our department have become interested in our white boards and our Special Care Baby Unit has asked if we will help them implement it.
Conclusion This system helps make the patients experience a more positive one. When rolling out this type of project it is important to have all multi-disciplines engaged and appoint champions to promote it.
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