Nurses Returning to the Forefront of Patient Care

Purpose:
A deficit in our OBGYN clinic was lack of face to face contact between nurses and patients. Historically, many nurses were in isolated in their roles in phone triage, non-stress test, refill management, or other miscellaneous tasks. The nurses were not working at the top of their scope.

Relevance/Significance:
In healthcare there is increased emphasis on the patient experience. To adapt to a more discerning patient consumer, the pod model has supported a patient centered environment. A positive side effect of this transformation has been increased nurse, staff and provider engagement and satisfaction. We anticipate that as we continue implementing the pod model we will see further increases in satisfaction.

Strategy and Implementation:
Annually, our practice sees approximately 45,000 patients and includes a team of 15 nurses and over 100 providers. There were two existing subgroups within the practice that were used as a foundation to create the “Pod” model. This model mimics a small practice with a core team of people (providers, nurse, administrative and medical assistant staff) facilitating care in a large practice setting. To accomplish this, designated nurses were physically moved into the clinic and paired with predetermined clinic subgroups. The implementation was rolled out in waves. The first wave lasted 6 months with routine feedback and adjustments for improvement. The nurses are responsible for face to face education, coordinating inter-clinic care and supporting patients through all of the challenges of women's healthcare needs. The Pod model helped to solidify a team approach with the nurse at the center, guiding and coordinating each patient's care and providing improved continuity

Evaluation:
After implementation between 10/2014-2/2015 call volume decreased by 17.6% in the first 5 months. Annually our facility completes a NDNQI survey, additionally a pulse survey was conducted in 2/2015 to measure progress. The pulse survey indicated that nurse/provider relations satisfaction increased by 25% and nurse leadership satisfaction increased by 47%.

Implications for Practice:
The Pod model allows nurses more face time with patients which empowers and supports the patient, creating a stronger a nurse/patient relationship. This restructuring has allowed for better continuity of care, increased nurse presence, which resulted in increased job satisfaction.