Surfing the Waves of Patient Population Change: Neuroscience Collaborative Partnership

Purpose:
A year into a population shift, nurses caring for the surgical head and neck population, realized that expectations for a neuroscience continuum had yet to be actualized. Ease of communication and visibility between Physician teams and the RN developing the patient's plan of care need improvement.

Significance:
NDNQI RN Satisfaction Survey results in the areas of RN-MD interactions and Physician appreciation of what RNs do, demonstrated that attention was needed on building relationships and enhancing collaborative efforts between teams.

Strategy and Implementation:
After feedback of staff and meetings of Unit Leaders with Neuroscience Director was disseminated to Unit Council, an action plan developed. The first step addressed the lack of physician visibility in creation of a Neuroscience coverage list. This daily list includes all nueroscience patients, attending Physician, covering Resident and contact numbers. Interdisciplinary neuroscience rounds with team members to review the daily plan of care, as a second step, both increasing RN visibility to the physicians and facilitating direct lines of communication. In step three, the Unit Council adopted a practice of posting pictures of assigned care providers at patient doorways. Identification of the primary nurse to the rounding neuroscience team greatly improved recognition. Attendance at monthly neuroscience continuum meetings by unit leadership, step four, provided opportunities to exchange information with members of other neuroscience units.

Evaluation:
The 2009 RN Satisfaction Survey scores for RN-MD interaction increased from 57.95 to 60.54 and Physician appreciation of what RNs do increased from 60.41 to 63.79. Press Ganey Results, Staff worked together to care for you, have trended from 88% in FY08, 90% in FY09 and higher than 90% this year.

Implications for Practice:
These indicators of improvement have challenged team members to stay on course and further push the boundaries of the collaborative relationship with neuroscience department.