Improving service by listening to parents

Detailed, clear communication about when and why hospitalized kids will be awakened—for tests or medication—helps boost inpatient pediatrics service scores

FRIDAY, FEBRUARY 26, 2010

Taking the time for personal explanations

The team set monthly benchmarks for improvement and took steps—including personal explanations and notes on in-room care boards—to help parents understand when each interruption would be scheduled and why it was necessary (for instance, to give the child medication or check vital signs). Staff members also noted the location of their young patients’ identification bands so nurses could find them easily and children would be disturbed as little as possible.

UBT members also realized that most parents didn’t like having their own sleep disturbed, so they began asking, “Would you like us to wake you when we wake your child?”

Within a few months, the department’s score exceeded the initial target. When they faced a drop in scores in May, they came together to reinforce the effective behaviors. By October, they hit 100%.

Shukla Sen, the department administrator, says improved communication with parents about when and why their kids are awakened has enriched the overall clinical relationship.

“It’s about building trust with the parent and the child,” she says. “When they open up, you start getting the information you need.”

Lowest score, highest effort

The team members look monthly at several indicators of their performance. They then go to work on their lowest ranked measure.

“We are very data-driven,” Sen says. A rich source for inpatient units like Sen’s are so-called Avatar scores, named for the company that analyzes and synthesizes Kaiser Permanente’s survey data on service. Sen and Bowers keep the team up to date by sharing the numbers monthly.

In addition, Dennis Benton, Panorama City’s executive director, prepares graphs on departments’ service scores and trends and emails them to managers. “We’re very invested in using the data,” says Benton. “It allows teams to pick which initiatives will have the most impact.”

The pediatrics UBT is now running tests of change to improve its score on the food patients are served—aiming for 75% satisfaction by June 2010, up from 65% in November 2009.