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A Quality Improvement Program to Enhance After‐Hours Telephone Communication Between Nurses and Physicians in a Long‐Term Care Facility
Author(s) -
Whitson Heather E.,
Hastings S. Nicole,
Lekan Deborah A.,
Sloane Richard,
White Heidi K.,
McConnell Eleanor S.
Publication year - 2008
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2008.01714.x
Subject(s) - medicine , veterans affairs , intervention (counseling) , psychological intervention , quality management , nursing , emergency department , patient satisfaction , health care , family medicine , program evaluation , medical emergency , management system , management , public administration , political science , economics , economic growth
OBJECTIVES: To determine whether satisfaction of on‐site nurses with after‐hours telephone communication with off‐site physicians improved in one long‐term care (LTC) facility after a nurse‐oriented intervention. DESIGN: Longitudinal quality improvement study. SETTING: Extended Care and Rehabilitation Center (ECRC), Durham Veterans Affairs Medical Center. PARTICIPANTS: Eighteen registered nurses. INTERVENTION: Communicating Health Assessments by Telephone (Project CHAT), a program of individualized training sessions and decision support tools to aid LTC nurses with symptom assessment and communication of health information over the telephone. MEASUREMENTS: Nurses completed six satisfaction surveys (three surveys in the 3 months before Project CHAT and three surveys in the 3 months after Project CHAT). RESULTS: The nurses' average satisfaction scores increased on several items, including those that assessed whether the nurse was pretty sure what pieces of information the physician was going to ask for ( P =.04), felt that the amount of patient information the physician asked for seemed reasonable ( P =.03), felt prepared to answer the questions the physician asked ( P =.01), and felt that the process of gathering patient information for the physician was easy ( P =.01). The percentage of calls that resulted in immediate evaluation by a physician (on‐site or in the emergency department) increased from 2.0% in the period before Project CHAT to 8.6% in the period after Project CHAT ( P =.01). CONCLUSION: Nurses' satisfaction with several aspects of after‐hours telephone medicine improved after an inexpensive, education‐based intervention in one LTC facility. Further research is needed to determine how similar interventions might affect other quality measures, including patient outcomes.