Date of Graduation

Spring 5-20-2022

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions


MSN project

First Advisor

Scout Hebinck


Problem: This quality improvement initiative aims to implement AIDET, Commit to Sit, and culturally competent care in a pediatric outpatient surgery clinic to increase patient satisfaction. The microsystem falls beneath the 85th percentile of patient satisfaction scores on their unit. They have a pre-intervention Net Promoter Score (NPS) of 80.7, indicating about 80% of patients were "promoters" and would likely return to the clinic, and 20% of patients were "detractors" and unlikely to return (Appendix F). "Detractors" were found in areas including patients trusting providers with care, care providers listening, care providers explaining things, and patients recommending the facility to others.

Context: The microsystem provides outpatient perioperative surgical services to pediatric patients while incorporating their families in their care. On assessment of microsystem patterns, factors that may cause lower patient satisfaction NRC scores and limited use of AIDET and Commit to Sit include time restraints, language barriers, lack of stools for sitting, and a lack of interpreters.

Interventions: The intervention had two major components: 1) Re-education of AIDET and Commit to Sit with culturally competent care, and 2) application of knowledge through role-play and simulation. Following the initial presentation of AIDET, Commit to Sit, and cultural competency, the staff had the opportunity to apply theory to practice in role-play and simulation-based scenarios that reflected typical diverse patient populations who came to the clinic. Takeaways were discussed in staff debriefing.

Measures: Pre-intervention and post-intervention surveys were sent out to staff to collect data on staff knowledge, attitudes, and comfort levels on AIDET, Commit to Sit, and simulation-based learning. Patient satisfaction scores from the National Research Corporation (NRC) were obtained from September 2020 to September 2021 for baseline data. NRC scores were collected in the post-implementation period and compared to baseline data to assess the change project's effectiveness.

Results: The quality improvement initiative significantly impacted the microsystem staff's attitudes towards AIDET and Commit to Sit. An increase of 85.7% to 100% of staff felt the presented information was useful in improving patient satisfaction. After the intervention, the NRC reported that the outpatient clinic had an NPS of 83.3%, approximately a 2.6% increase in patient satisfaction scores from the baseline data.

Conclusion: By incorporating AIDET, Commit to Sit, and cultural competency into standard practice, every microsystem has the potential to improve the overall quality of patient-centered care and increase microsystem revenue. As patient satisfaction is linked to increased compliance, decreased patient anxiety, and improved clinical outcomes, AIDET and Commit to Sit should be implemented across all care providers to promote high-quality patient-centered care.

Available for download on Monday, May 19, 2025

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