When properly implemented, nursing bundles can improve the consistency and quality of patient experience, even across large, multiple-hospital systems.
Geisinger Health System, a physician-led system covering over three million residents in Pennsylvania and New Jersey, successfully adopted and refined a nursing bundle over the course of four years, according to a case study in NEJM Catalyst. The program not only generated a more consistent patient experience across the system, but also raised overall patient satisfaction scores.
The program complements a broader initiative aimed at improving patient satisfaction, under which Geisinger has paid out refunds to dissatisfied patients. The concept of a nursing bundle comes from the Institute for Healthcare Improvement and involves adopting a relatively small number of practices proven to support improved patient outcomes.
Having found that between a quarter and a third of the system’s complaints stemmed from failures of communication, Geisinger focused on that area when developing its bundle. Chief nursing officers and other key nursing staff identified and adopted practices intended to improve communication between patients and hospital staff, and among nurses themselves, via a combination of activities such as proactive rounding, including patients in shift handoffs, and communication protocols geared toward better dialog with patients.
Geisinger identifies several keys to success when implementing a nursing bundle:
- Involve and support both executive leadership and front-line staff, providing frequent feedback. The article underscores the need for executive leadership to buy into and act upon strategic priorities geared toward cultural change.
- Establish a baseline and a clear, understandable set of metrics to gauge progress, and to ensure that all hospitals aim for the same endpoint, regardless of their position at implementation. Geisinger shares results and progress regularly with all levels of leadership from the CEO on down, as well as with front-line employees.
- Focus on the long term. Cultural change takes time, patience, and consistent feedback that rewards compliance and encourages constant improvement, according to the article.