With health care’s transformation, patient satisfaction is now considered a measure of quality and is at the forefront of medical facilities’ evaluations. That is, Medicare has tied reimbursement for hospitals to patient satisfaction scores.1
However, technological advances in health care and radiological imaging have led to increasingly complicated and lengthy procedures, performed on patients with more serious conditions and co-morbidities. Because many of those patients are unfamiliar with IR, they and their family may feel anxious and stressed out. If these feelings are not managed well, the patient may be correspondingly dissatisfied by their experience in the IR suite.
It is clear, then, that improving patient satisfaction is an important goal for any IR.
Finding a solution
In 2015, the leaders of the University of Illinois Hospital and Health Science System (UI Health) wanted to increase patient satisfaction scores for the fiscal year by 3–5 percent. Good communication with patients has been identified as a key factor in improving patient outcomes and nurturing patient satisfaction. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS®) and Press Ganey® surveys show communication, especially from a nurse, to be the factor most highly correlated to a positive health care experience.2 Furthermore, patients expect health care workers to provide safe care and to communicate with them about the care they receive; 95 percent of families who receive such updates rated the experience as a good one.3
UI Health determined that it could reduce anxiety levels of both the patient and their family by frequently providing information related to wait times, delays and procedural progression.4 A literature search quickly revealed a potential solution: the nurse liaison, who could offer support, answer questions, provide information during the procedural time and bridge the gap when delays occur. Although the concept had been practiced in many operating rooms and one diagnostic imaging department in Canada,5 it would be a unique approach for an IR department
Establishing the role
Departmental priorities and expectations for performance helped form the nurse liaison job description at UI Health. The radiology nurse liaison would require both awareness of the procedures performed in IR and strong verbal and nonverbal communication skills. In their role, they would be expected to:
- Work collaboratively with physicians, staff members and leadership
- Facilitate communication between the patient/family and IR, using a rounding tool
- Round every hour and place postprocedure phone calls to patients
- Assign and track hospitality pagers for families
Although this is the mix that worked for us, the exact specifications of the role will obviously vary from organization to organization with patient population needs, as well as with physician and staff preferences.
UI Health started the nurse liaison role on a pilot basis to establish the effectiveness of the role and identify potential improvements. Two volunteers from the IR staff were selected—one primary and one back-up. Education was to staff and physicians not on the task force regarding the nurse liaison responsibilities, the nurses who would be in the role and when the role would start.
Two weeks later, the primary radiology nurse liaison started in her role, with clipboard in hand, white lab coat on and a “Nurse Liaison” name tag. As she began rounding in the prep/recovery area, the rest of the staff clapped, cheered and wished her well.
Measuring success
Within two months of launching the nurse liaison role, patient satisfaction related to whether they felt informed about delays rose to 99 percent. The result moved the UI Health IR department’s overall satisfaction ranking to the 78th percentile among similar hospitals cited in Press Ganey reports. At the end of two quarters, the department maintained a 19th percentile ranking; the decrease stemmed from the conflicting need for a nurse in the procedure room and pulling our nurse liaison.
The postprocedure phone calls from the nurse liaison also resulted in increased patient satisfaction. Patients felt an instant connection during the call and later remembered talking to the energetic nurse. On several occasions, the nurse liaison was able to help patients connect with other health care providers for their needs. Many patients sent appreciative letters and comments. On two occasions, the primary nurse liaison was elected by the staff as employee of the month.
One challenge we encountered was conflicting needs, such as when staffing for the procedural rooms was low and there was a need for lunch relief. In reaction to such conflicts, the nurse liaison was frequently pulled from her role to fill in for the shortages. Since the position was in a pilot stage, we found a compromise: the nurse liaison would round for the outpatient procedures in the morning and would not round in the afternoon on the inpatients for procedures.
Conclusion
A patient’s unfamiliarity with IR can generate high levels of stress and anxiety, which is particularly important with patient satisfaction at the forefront of health care today. Strong communication has been identified as a key factor in improving patient outcomes and nurturing patient satisfaction. A nurse liaison can offer support, answer questions and provide information during the procedural time, bridging the gap when delays occur. Through frequent communication, the nurse liaison can help patients and their families manage stress, resulting in a more positive experience.
The demonstrated success of our radiology nurse liaison program points to the role’s potential for raising patient satisfaction in IR. By monitoring trends in patient feedback, a radiology department can easily ascertain the role’s impact and it is hoped that, over time, the role will expand across all interventional and diagnostic departments of radiology.
References
- Lang, EV. (2012). A better patient experience through better communication. J Radiol Nurse, vol. 31(4): p. 114–119.
- Herd, HA., Rieben, MA. (2014). Establishing the surgical nurse liaison role to improve patient and family member communication. AORN Journal, vol. 99(5): p. 594–599.
- Lerman, Y, Kara, I, Porat, N. (2011). Nurse liaison: The bridge between the perioperative department and patient accompaniers. AORN Journal, vol.94(4): p. 385–392.
- Brown, CD. (2012). Improving patient care in the diagnostic imaging department: The role of the nurse navigator. J Radiol Nurse, vol. 31(3): p. 97–100.
- Stefan, KA. (2010). The nurse liaison in perioperative services: A family-centered approach. AORN Journal, vol. 92(2): p. 150–157.
