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Service Excellence: Promptness Response to Call (A Lesson in Change) • TEAM MEMBERS – Service Excellence: Promptness Response to Call (A Lesson in Change) • TEAM MEMBERS – Debbie Casteel – Mary Morrow – All 3 NESW staff – Patients

Opportunity Statement: Answering patient call lights in a timely manner meets the requests and Opportunity Statement: Answering patient call lights in a timely manner meets the requests and needs of our patients. Despite implementation of a new electronic call light system, patient satisfaction scores with promptness response to call remain low. Project Goal: To answer call lights on 3 NESW within 1 minute. Press-Ganey patient satisfaction scores relating to Promptness Response to Call will increase to a mean of 85.

Most Likely Causes Identified Through Data • Open PCT and SC positions • Lack Most Likely Causes Identified Through Data • Open PCT and SC positions • Lack of knowledge among staff on hospital-wide Gold Standard to answer call lights within 1 minute. • Unit culture is to answer the call light in the patient room instead of at our nursing stations. • Lack of knowledge on “how” to answer the call light at the nurse’s station.

Solutions Implemented • Despite informing staff that the gold standard to answer the call Solutions Implemented • Despite informing staff that the gold standard to answer the call light was 1 minute, call lights were not being answered in a timely fashion. . • We decided to track our patient satisfaction scores against our Du. Kane Call light system data that we started to receive in April 2003. . • At that time we answered the call light 25% of the time within 1 minute. We discovered staff did not know how to use the phone at the desk. • 6/03 --All staff received additional inservice on the use of the phone/computer system to answer the call light at the nurse's station. Our scores began to show improvement (increase to 70%) • Light duty staff assigned to call light duty as a pilot for 6 months. Staff decided the best way to answer the call lights was to have someone assigned to the task and began to work out ways to accomplish this task.

Solutions Implemented • 4/04 -- All staff were asked to include this project as Solutions Implemented • 4/04 -- All staff were asked to include this project as a “Magis” goal in their annual performance review (“I will work together with the team, to increase our unit Du. Kane system scores of “answering standard call lights within 1 minute” to reach at least the 80 th percentile most of the time”). • 10/04– We began printing out graphs from the Du. Kane System daily so the charge nurses could see which shift was “winning” with the best scores. With this buy-in by staff, we were able to increase our scores to the 80 th percentile.

Patient Satisfaction Results 3 NESW_Promptness to Call Individuals UCL = 87. 78 85 Our Patient Satisfaction Results 3 NESW_Promptness to Call Individuals UCL = 87. 78 85 Our patient satisfaction scores have increased from a mean of 77. 49 to 82. 02. The process is in UCL = 84. 53 Mean = 82. 02 80 Mean = 79. 79 Mean = 77. 49 LCL = 76. 25 75 LCL = 70. 44 2 1 FY 05 Q 4 Q 05 FY FY 04 Q Q 3 2 04 FY FY 04 Q 1 4 FY 04 Q 3 FY 03 Q 2 Q FY 03 Q 1 03 FY FY 03 Q 4 3 FY 02 Q 2 FY 02 Q 1 Q Q 02 FY 01 FY Fy 01 Q 4 3 70 control even though we have reached our goal of a mean of 85 yet. Since Nov, 2004, we have been in the 80 th percentile or above for answering call lights within 1 minute

Conclusions • Answering the call lights at the nurse’s station desk is directly related Conclusions • Answering the call lights at the nurse’s station desk is directly related to successfully answering the call lights within 1 minute. • Answering call lights at the nurse's station within one minute is related to an increase in patient satisfaction mean scores. • Change in unit culture possible with: -- taking time to “dig down” into the detail of “why” staff didn’t answer call lights at the front desk. --sharing data in graph format with staff. --comparing our data with patient satisfaction data. --persistent vigilance for the first 30 days after a new change. --team approach to accountability.

Next Steps • We are now concentrating on change of shift. We page the Next Steps • We are now concentrating on change of shift. We page the RN’s before the end of the shift to remind the to do “pain medication” rounds and we also page PCT’s to remind them to do “toileting” rounds.