Understanding the Treatment Plan

A hospital stay can be an overwhelming experience, not only for patients but also for their loved ones. It's a time when clear communication and understanding are very important. Because of the complexity of healthcare and medicine, though, it is common to have challenges around communication. One way that organizations measure the effectiveness of their communication is through their Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey scores.  

Today, I am highlighting an initiative that involved excellent collaboration between residents and nurses on Unit 36, whose scores around physician communication revealed opportunities for improvement. Tristan Flack, DO, Medical Director – Unit 36, and Theresa Dupski, MSN, RN, Nurse Manager – Unit 36, worked together to explore the key drivers impacting the scores. As part of this research, the unit began conducting its own bedside surveys with patients and realized that staff members could make a real difference by focusing on the question, "Do you understand your treatment plan?"  

Hospital inpatients are given so much information to comprehend on a daily basis. They are in an unfamiliar environment dealing with a stressful health situation and being given tons of complicated medical information to digest on top of it.  

Dr. Flack and Theresa studied the literature to learn what other organizations have done to help patients better understand their treatment plans. The studies showed the most effective tool was a visual aid for patients to refer to as frequently as needed. Equipped with this knowledge, the unit decided to develop a communication card designed to provide structure to the way care teams convey treatment plans to patients. 

This 3-inch by 5-inch card is completed daily during rounds and breaks down complex medical information into four concise sections: 

• What you’re being treated for: This section explains the diagnosis in easy-to-understand terms, rather than standard medical jargon. 
• When the team expects you to be discharged: Although it isn’t always possible to say for sure when a patient will be ready for discharge, we can typically provide an estimated range of time so that patients get a sense for how long they are likely to be in the hospital 
• What your discharge is dependent upon: This section covers what is keeping the patient in the hospital or what needs to happen in order for a patient to be ready for discharge. 
• The plan for today: This section includes check boxes for common needs, such as consultations, imaging, lab work, physical or occupational therapy, as well as a fill-in-the-blank option that can be customized.

It takes only a minute or so to discuss the information with the patient and is a valuable reference point for patients and their loved ones, who also appreciate reading the card for quick updates when they stop in to visit.

I’m proud of the collaboration between the nursing and resident teams that breathed life into the project as well as the way they have engaged patients to develop this solution. Under Dr. Flack and Theresa’s leadership, nurses and residents felt empowered to share suggestions for modifications that would make the cards more effective. The residents have really embraced this tool and made it a part of their practice.  

While we will have to wait to see any official impact on HCAHPS results, initial feedback from patients and their families has been overwhelmingly positive. We have gathered immediate metrics through patient surveys at the bedside, which suggest that patients feel more informed about their treatment plans.

Most importantly, it's not just about HCAHPS scores; it's about making a real impact on the lives of our patients and their families. Thank you to Unit 36 for all of your hard work and for reminding us that seemingly small changes can yield significant results in patient experience!