Five Steps to Communication Introduce Duration Acknowledge Explanation Thank You A.I.D.E.T. Emma Broussard Jaclyn Hirohama Michelle Marks Sheryl Sato Five Steps to Communication

What is AIDET? AIDET is a communication framework created to help staff communicate more efficiently with patients and with each other, thereby resulting in higher patient satisfaction, and more effective communication. Coupled with bedside rounding, it keeps the patient informed and part of the care team. A: Acknowledge I: Introduction D: Duration E: Explanation T: Thank you

AIDET ROOT CAUSE ANALYSIS WHERE? Radiology WHAT? Patient is upset because he had to wait longer than he was told. Only Radiology has Xray machine. HOW? Nurse will revisit Patient and update wait time. WHY? All X-ray machines were being used causing the Patient to have to wait. WHEN? Tuesday. Wait complaints every Tuesday. Staffing issue? Increase staff on Tuesday. Equipment shortage? Purchase more equipment.

Major influences on the priorities for quality improvement To improve clinical outcomes/ patients’ perception of care HCAHPS Reimbursement

National Indicators

QI Tools needed for Root Cause Analysis Form panel of employees who experience issue with AIDET. Group discussion and census of problem occurrence. Create flow chart of AIDET process at bedside rounding. Identify problem. Determine “What” “Why” “Where” “How” and “When” Resolve corrective action.

Quality Improvement Tools and Processes Plan: Analyze existing shift report communication Do: Implement AIDET/bedside report Study: Survey patients and nurses on satisfaction, monitor sentinel events Act: ID barriers to change, review AIDET expectations

Recommendations for Improvement Bedside rounding should be coupled with AIDET Bedside rounding encourages the patient to be part of their own healthcare solutions and healthcare team Patients want to understand their care plan so they know what to expect. Bedside rounding also shows a degree of transparency that patients crave

Near Miss/Adverse Events Joan Morris (a pseudonym) is a 67-year-old woman admitted to a teaching hospital for cerebral angiography. The day after that procedure, she mistakenly underwent an invasive cardiac electrophysiology study. Reporting to the Joint Commission is voluntary; the database contains 17 reports of an invasive procedure done on the wrong patient over the past 7 years Ms. Morris was a native English speaker and fully coherent. Bedside rounding most likely could have prevented this mistake.

Data on AIDET success and implementation

References The Official U.S. Government Site for Medicare (2015). Hospital Compare. Retrieved February 15, 2015, from http://www.medicare.gov/hospitalcompare/ Anderson, C. D., & Mangino, R. R. (2006). Nurse shift report: Who says you can’t talk in front of the patient? Nursing Administration Quarterly, 30(2), 112-122. Laws, D., & Amato, S. (2010). Incorporating Bedside Reporting into Change-of-Shift Report. Rehabilitation Nursing, 35(2), 70-74. Agency for Healthcare Research and Quality (AHRQ) Patient Safety Network. Patient Safety Primer: Teamwork Training. Available at http://psnet.ahrq.gov/primer.aspx?primerID=8 Centers for Disease Control and Prevention. Available at http://www.cdc.gov Institute for Healthcare Improvement. Improvement Map: from here to excellence Available at http://app.ihi.org/imap/tool Institute of Medicine. To Err Is Human, 1999 Journal of Patient Safety, Vol. 9, Number 3, September 2013. St. Elizabeth Healthcare Universal Fall Protection/Prevention Program Policy ACLINF 0110/1/10 revision The StuderGroup AIDET Implementation Guide. Available at http://www.studergroup.com/Aidet/AIDET-implementation-Guide-Sample.pdfThe Joint Commission. The Joint Commission Comprehensive Accreditation and Certification Manual, 2012. .  Agency for Healthcare Research and Quality (AHRQ) Patient Safety Network. Patient Safety Primer: Teamwork Training. Available at http://psnet.ahrq.gov/primer.aspx?primerID=8 Centers for Disease Control and Prevention. Available at http://www.cdc.gov Institute for Healthcare Improvement. Improvement Map: from here to excellence . Available at http://app.ihi.org/imap/tool Institute of Medicine. To Err Is Human, 1999 Journal of Patient Safety, Vol. 9, Number 3, September 2013. St . Elizabeth Healthcare Universal Fall Protection/Prevention Program Policy # ACLIN - F 01 10/1/10 revision The StuderGroup . AIDET Implementation Guide. Available at http :// www.studergroup.com/Aidet/AIDET implementation Guide Sample.pdf The Joint Commission. The Joint Commission Comprehensive Accreditation and Certification Manual, 2012.