No Pass Zone: Improving Staff Responsiveness

Purpose:
Engage every hospital employee, clinical and non-clinical, to prioritize patient call bells by creating a “No Pass Zone”. Based on less than adequate HCAHPS survey scores on staff responsiveness, this program was initiated at UPMC Passavant Cranberry on a 31-bed unit in January, 2013.

Significance:
Improved staff responsiveness leads to patient requests being met faster, change of condition being noted sooner, and may lead to reduction in patient falls. Patient satisfaction is receiving greater attention as a result of pay-for-performance and the public release of data from HCAHPS surveys.

Strategy and Implementation:
The “No Pass Zone” sets the expectation that no one should walk past a call light. Work to implement the project began in December 2012. A training power point was developed to educate all employees about their role. The initial education was provided to the nursing, housekeeping, transportation, and food service staff. Demonstrations were provided for all staff on how to tell the call bell was on and how to turn the call bell off. Patient requests are broken into two categories, clinical needs and non-clinical needs. When answering a call bell, any employee may fulfill a non-clinical need such as obtaining a blanket for a patient. Clinical needs are items that involve direct care or positioning of a patient and must be delegated to the nursing staff. After the initial role out, further education was done with the remaining departments in the hospital.

Evaluation:
HCAHPS survey for staff responsiveness from September 2012 to November 2012 showed a score of 59%. After implementation, December 2012 to February 2013, the score increased to 68%. Call bell times decreased from 180 seconds to 120 seconds. Many different disciplines have been noted answering bells.

Implications for Practice:
The No Pass Zone provides additional support to ensure patient needs are being addressed as soon as possible. This initiative helps fosters team work among departments which will lead to improved patient outcomes.