Communication for Evidence Based Process Improvement

Abstract Problem: Interdepartmental communication between nurses and all ancillary staff impacts the patient flow of the post-anesthesia care unit (PACU). Individual approaches to communication and lack of consistency between staff methods creates extended lengths of stay and patient delays to critical units. IVOS’ for increased length of stay represent cost to the system in staffing. Context: The PACU is a receiving department for patients receiving anesthesia or sedation from operating room, endoscopy, interventional radiology, and cardiac catheter lab when necessary. Intervention: Multiple projects were attempted for this prospectus. Initially an emergency department alteration in workflow and combining of roles, and a new communication flowsheet for PACU and ancillary departments. For this paper, a quantitative and qualitative survey was disseminated to nurses, doctors, phlebotomists, radiography technicians, patient care technicians, and physician assistants to assess communication in the workplace to determine if process improvement would be effective. Measures: Multiple choice and essay survey questions regarding communication in the workplace. Review of HCHAPS scores for hospital involved for study. Result: Staff responses to survey questions posed on communication are indicators of the level of satisfaction in the PACU. Verbal debriefing with multiple departments and feedback from new hire employees was factored into the necessity of examining the nature of communication in the peri-operative sphere and how it relates to process improvement. Conclusion: The results of the survey show that communication is important to those who work in the peri-operative sphere and that communication is not effective between departments or management. It is my position that this must be rectified prior to implementing a process improvement initiative