Bedside Shift Report: Patient/Staff Engagement Improves Overall Communication, Satisfaction and Outcomes

Purpose:
Healthcare professionals communicate the patient plan of care numerous times during a shift, however often these discussions don't include the patient or family. Bedside shift report was implemented as a strategy to increase the inclusion of patients and families in establishing their plan of care.

Significance:
Current methods of reporting are often unstructured and lack "the full story" needed to provide patients with complete comprehensive care to ensure positive outcomes within a safe environment. Changing to bedside reporting allowed for improvement in continuity of care and patient safety.

Strategy and Implementation:
According to research, 80% of serious healthcare related patient injuries are from miscommunication between caregivers when care is handed off. Bedside shift report engages the nurse and patient in a discussion of the plan of care. A 30 bed medical unit was chosen to pilot bedside reporting. Unit Manager and Practice Chair met with leadership team to discuss proposed pilot and issue the challenge of making this implementation a success. A Reporting Champions team was chosen with representation from each shift. Staff meetings were arranged on all shifts for education and motivational purposes. Staff were surveyed for concerns and their perceived barriers to change were addressed. Champion team created a report template and scripting for report process. The pilot began with a kickoff celebration with plans of implementing changes on unit over a two week period. Secondary to the enthusiasm of the team, process change was successfully implemented over a two day period on entire unit.

Evaluation:
Multiple positive outcomes were noted; decline in nosocomial skin breakdown and falls (rate below NDNQI benchmark)and an increase in both patient and staff satisfaction. Patient satisfaction was measured by Press Ganey surveys and random patient interviews. Staff satisfaction was measured by survey.

Implications for Practice:
Based on research findings and promising results on our pilot unit, our hospital plans to change the reporting process housewide. Patient falls have decreased. Nosocomial skin breakdown rates have improved and satisfaction of both patient/staff have increased. Process encourages patient engagement.