Date of Graduation

Spring 5-20-2022

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

Program

MSN project

First Advisor

Mahmoud Kaddoura

Abstract

Problem: This quality improvement project implements AIDET (Acknowledge, Introduce, Duration, Explain, and Thank You), Commit to Sit, and cultural-competent care to improve patient satisfaction and communication between multidisciplinary health care team members and patients in a microsystem of a pediatric outpatient setting. The National Research Company (NRC) scores from the microsystem are below the 85th percentile, and this microsystem strives for excellence in the care provided to patients. The detractors from the patient satisfaction scores include patients scoring low on staff needing to work together, care providers not taking enough time to explain and listen, wanting to trust providers with care, procedures not beginning on time, and showing courtesy and respect by nurses. AIDET and Commit to Sit are evidence-based communication tools to improve patient care beyond bedside care. Culturally competent care allows one to recognize every patient and their family’s uniqueness and celebrate those differences by educating ourselves.

Context: The microsystem for this quality improvement project is an outpatient surgery unit where general surgeries are performed for the pediatric population. The pediatric population that the microsystem serves ranges from two years old to eighteen years old, along with the patient's families. The population served comes from diverse backgrounds Asians, African Americans, Hispanics, and American Indians. The microsystem encompasses a multidisciplinary team including specialized pediatric surgeons, operating room nurses, surgical technicians, child life specialists, and anesthesia specialists.

Interventions: The interventions for this quality improvement project include interactive PowerPoint education and three simulations role-play scenarios to implement AIDET, Commit to Sit, and culturally competent care intentionally with an emphasis on culture, language, and discharge instructions. The purpose is to standardize and sustain these communication tools and provide culturally competent care.

Measures: Measurement tools utilized to track data for this quality improvement project include NRC, pre-education surveys, and post-implementation surveys. The NRC scores were used to identify what changes needed to be made to increase patient satisfaction scores. The pre-implementation NRC data from September to September and post-implementation NRC data from March were compared and analyzed. Pre-education surveys were given to the staff via a QR code scan that the team scanned on their phone to assess their comfort with using the communication tools that were implemented six months prior and what barriers have come up in providing culturally competent care. Post-implementation surveys were given to the staff via a QR code scan that the team scanned on their phone to assess the staff’s input regarding the role-play simulation scenarios, feedback, and concerns regarding the changes.

Results: The implementation of AIDET, Commit to Sit, and culturally competent care is envisioned to increase patient satisfaction within the microsystem considerably. AIDET and Commit to Sit should significantly impact provider-patient communication and patients’ perception of care (Zamora et al., 2014). Patient satisfaction indicates the quality-of-care patients receive. When care is personal will result in better communication and more patient involvement. This can be done by becoming culturally competent when providing care. Carrying out education to staff on the tools to enhance their communication with patients guides the staff to become competent and confident for a sustainable change.

Conclusions: AIDET, Commit to Sit, and culturally competent care allows patients to feel visible and understood, increase compliance of care where patients can understand in simplified terms, and builds trust with the healthcare organization and its staff. These communication tools should be used as a foundation to build trusting relationships with patients and be extended to the macrosystem level where the institution works towards the same goal to reach excellence in patient care and increase patient satisfaction.

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