1. Ashleigh Thomas, BSN, RN, OCN and Deatra Josiah, MSN, RN-BC, OCN
The Sacred Moment
Ashleigh Thomas, BSN, RN, OCN and Deatra Josiah, MSN, RN-BC, OCN
Background
The Sacred Moment initiative was developed to improve the HCAHPS scores in the “Communication with Nurses” domain. The initiative is evidence-based and supported by nine articles. The initiative integrates mindful communication techniques from the COMFORT acronym created by palliative care healthcare workers. COMFORT teaches nurses how to communicate with patients in a compassionate manner that is patient-centered and addresses biophysical needs. Accordingly, The Sacred Moment encourages nurses to participate in non-task oriented and non-scripted dialogue with patients and caregivers that focuses on psychosocial needs, such as fears and concerns. Evidence-based projects using Sacred Moment-like interventions demonstrated improvements of HCAHPS scores in multiple domains, including “Communication with Nurses”.
Cause & Effect
Promotes improved communication and relationships between 9D staff and patients/caregivers
People
Environment
Evaluation
Intervention
Not Educated on COMFORT
Oncology and Transplant Patients
New Coworkers
Develop Staff-Patient Relationships
Share Stories
Positive Reinforcement
EncourageDialogue Addressing Concerns
Supports Collaboration
Avoids “one more task”
Focus on Relationships
Emontionally Demanding
Busy Work Environment
Many Initiatives
New Patient Population
Encourage Relationship Building
Process Flow
Post-Intervention Patient Comments
“All was very good thanks to God, nothing to complain about & I can recommend you with all my family & friends.”
“I had the best experience from my doctor anesthesiologist & other doctors & nurses all take great care to give the best & make us patients feel as if we were at home with our own family… #1, very good.”
“Excellent care, all the way around!”
“The people were very nice and efficient.”
Post-intervention Data
Sacred Moment Example Story
One of the nurses on 9D had a Sacred Moment with her patient. During the nurse’s conversation with the patient, she learned that the patient’s daughter would be celebrating her birthday that week. The nurse shared this story with our technician. The technician came up with the idea of throwing a small birthday celebration for the girl. Another nurse became involved and the three coordinated buying cupcakes, balloons, and a card. On the girl’s birthday the three nurses gathered up the 9D staff members and physicians who then sang Happy Birthday and gave the girl and patient the cupcakes, balloons, and card. The patient and birthday girl both expressed gratitude to the staff for throwing this celebration, saying how thoughtful, meaningful, and memorable the birthday celebration was to them. Staff members on also expressed that the experience was personally rewarding.
Problem Statement
Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS) scores in the domain “Communication with Nurses” began a downward trend in October 2016 on 9D Transplant/Oncology/Gynecology and continued to stay at or below the internal benchmark of 83.2% consistently thereafter.
Aim Statement
To improve HCAHPS scores in the domain “Communication with Nurses” to meet or exceed the internal benchmark target of 83.2%% by August 2017.
Results/Conclusion
Next Steps
References
Bramley, L. & Matiti, M. (2014). How does it really feel to be in my shoes? Patients’ experiences of compassion within nursing care and their perceptions of developing compassionate nurses. Journal of Clinical Nursing, 23, doi: /jocn.12537
Burden, M. (2016). Using a change model to reduce the risk of surgical site infection. British Journal of Nursing, 25(7), Retrieved from
Butcher, L. (2014). Lets talk: Making time for a ‘sacred moment’. Hospitals & Health Networks, 88(7), Retrieved from
Frank-Bader, M., Rondald, K., Rumohr, G., & Sritharan, S. (2016). Strengthen nurse-patient communication with the “Social 10”. Nursing Management, 47(9), doi: /01.NUMA
Goldsmith, J. & Wittenberg-Lyles, E. (2013). COMFORT: Evaluating a new communication curriculum with nurse leaders. Journal of Professional Nursing, 29(6), doi:
The Sacred Moment initiative shows promising results that positively impact relationships with patients
More time is needed to evaluate the full effect on HCAHPS scores
HCAHPS “Communication with Nurses” had 100% “always” May 2017, the highest score to date for 9D
Organizations should consider implementing COMFORT communication techniques and The Sacred Moment initiative
Continue to trend HCAHPS data for 6 to 12 months
Continue to collect and share patient comments and Sacred Moment stories
Consider training other inpatient units
Interventions
Train 9D staff on COMFORT mindful communication.
Train 9D staff on The Sacred Moment
Provide weekly feedback to staff including: HCAHPS scores, patient comments, and patient outcomes related Sacred Moment conversations.
Lead by example: Project leaders participate in The Sacred Moment and provide examples to staff.