Improving collegial nurse-physician relations within a new service line

Purpose:
In 2010, the hospital created a new unit. It had new and experienced nurses working with a new service line. Due to miscommunication on many levels, this change resulted in a decrease in the NDNQI RN Satisfaction survey and in the patient/family surveys. The goal was to increase both survey scores.

Significance:
This issue has proven to be very important because of its impact on patient care. Whenever there is miscommunication between the physicians and nurses, it creates miscommunication with the patients and families, increases frustration, and ultimately hinders care.

Strategy and Implementation:
In order to work on this unit concern, we wanted to create an open line of communication between nurses and physicians. First, we identified a Neurology physician champion. This physician would meet with the nurse manager on a monthly basis to discuss concerns/improvements. The next step was to gather baseline data. A survey monkey with 7 simple questions was created using 0-5 ratings and comment boxes. The survey was sent to the nursing staff and the physicians. This data was then collected and shared with the team. Some of the changes that occurred were: a. a Meet&Greet was set up for the nursing staff and physicians, b. the attending notified the charge nurse prior to the start of rounds, c. the attending/fellow updated the charge nurse at the time of afternoon checkout, d. nursing communicated family concerns in real-time to allow for immediate follow-up, e. further Neurology education was provided for the nursing staff, and f. updates were made to the unit's welcome packet.

Evaluation:
By utilizing these techniques, we were able to create a more positive experience for the nurses/physicians/patients/families. The improvement in communication and understanding of the Neurology diagnoses and plan of care, ultimately increased the NDNQI RN Satisfaction and patient/family surveys.

Implications for Practice:
These changes positively changed our practice. We were able to improve communication between nurses and physicians and the patients/families. By improving the communication and having a greater understanding of Neurology, we were also able to create more consistency in work flow.