Improving

Nurse
Responsiveness
Madelyn McLain, Kayla Myers, Allison
Brown, Bethany Zimmerman, Morgan
Tolbert
Description of the Issue: Macro
● Nursing responsiveness is primarily based on the perception of how quickly the nurse responds to
call bell requests (Michell, Lavenberg, Trotta, & Umscheid, 2015).
● Hourly rounding has been shown to increase patient and nurse satisfaction by reducing call light
use. hourly rounding programs also improve perception of nurse responsiveness (Michell et al., 2015).
● Patient Surveys look at patient perception of nurse responsiveness and hourly rounding. The
response to HCAHPS surveys affect hospital reimbursement.
Description of the Issue: Micro
● HCAHPS scores are low on patient satisfaction to nurse responsiveness
○ Within the past year HCAHPS scores have range from 49-83%
● Lack of understanding from the patients and the staff on effective hourly
rounding
○ Education of staff and patients
● Ineffective communication between team members slows responsiveness
● Ineffective teamwork and shared responsibility in answering the call bells and
patients are waiting longer.
Analysis of the Issue
Our goal is to understand patient perception of responsiveness of staff and how it
relates to patients’ needs being met and HCAHPS scores. Three themes emerged
when we collected data from nursing staff and patients on the unit:
● Lack of effective communication
● Ineffective teamwork
● Non intentional hourly rounding.
Root Cause
We believe the root cause is ineffective communication between team members in
response to patient needs and/or requests.

This communication breakdown causes a delay in meeting patient expectations

and is reflected in this unit’s low HCAHPS scores (Williams, 2014).
Suggested Solution(s)
In our two step solution, if call bells rang to a desk where a secretary relayed the
message to staff via a hands free device, then this will prevent delay in nurse
responsiveness and improve patient satisfaction, thus increasing HCAHPS scores
by 10% within 12 months of implementation of a hands free device.
For the purpose of our presentation, we have selected the Vocera device to
demonstrate the effectiveness of a hands free device
(Richardson & Ash, 2010)

Using Vocera hands free device helped to reduce nursing staff steps by over
2,000 per shift
(Pemmasani et al., 2014)

Vocera hands free device is a more direct route of communication and easier
route of locating staff
(Pemmasani et al., 2014)
Logistics
● Online Vocera education of all staff
● Educating all secretaries on proper delegation to nurse or patient care
technician
● Purchasing Voceras
● Purchasing Vocera badges
● Electrical configuration of call bell system to secretary desk
Stakeholders
● Hospital
● Unit Secretaries
● Nurses
● Patient care
technicians
● Nurse Leaders
Cost
● Education to staff and secretaries
● Rewiring call bells to secretary desk
● 20 Voceras
● Extra individual badges if needed for vocera
● Supporting equipment (wireless controllers, servers, charging port, etc)
Timeline
● Rewiring the call bells to the secretary desk
○ Within 3 months
● Purchasing Voceras and providing staff education
○ 6 months
● Implement Voceras on the floor
○ 8-10 months
Collection Data
● Management will survey nursing staff about communication via voceras
● Management will survey nursing staff for satisfaction on vocera use
● Management will survey nursing staff for satisfaction on new call bell system
● Management will survey patients on nurse response time
● Review changes in HCAHPS scores
Questions?
References
Mitchell, M. D., Lavenberg J. G., Trotta, R. L., & Umscheid, C. A. (2014). Hourly
rounding to improve nursing responsiveness: a systematic review. The Journal of
nursing administration, 44(9), 462-72.

Pemmasani, V., Paget, T., Minamareddy, P., Pemmasani, S., & Van Woerden,
H.(2014). Hands-free communication free up nursing time.Nursing Times. 110. 12-
14.

Richardson, J. E., & Ash, J. S. (2010). The Effects of Hands Free Communication
Devices on Clinical Communication: Balancing Communication Access Needs
with User Control.

Williams, D. B. (2014, December 12). Improving Staff Responsiveness to Patient-

Initiated Call Lights.