A gap was identified in quality of care around a safe exit from the building. The focus of our study surrounded optimal patient safety and satisfaction in relation to the discharge exit. The goal was that by the end of September there would be no more than one negative patient comment regarding unsafe exits from the building.
Successful applicants to the ASGE Endoscopy Unit Recognition Program (EURP) submit a summary of a recently conducted quality improvement (QI) project as part of the application process. The QI project in the spotlight this month looked at safe exiting from the building.
DEFINE
A gap was identified in quality of care around a safe exit from the building. The focus of our study surrounded optimal patient safety and satisfaction in relation to the discharge exit. The goal was that by the end of September there would be no more than one negative patient comment regarding unsafe exits from the building.
MEASURE
The Plan-Do-Study-Act study began when we received a complaint from a patient in June 2022. She was concerned about exiting the building without an escort. She voiced feeling unsteady, stumbling and almost entering the incorrect vehicle. We easily reviewed the patient satisfaction survey comments for similar themes. We identified that from January to June we had seven incidents in which patients commented negatively about exiting the building unaccompanied. This was a 1.16% average of incidents within six months. Our goal was to decrease this to 0.3% or less. There would be no more than one complaint in three months.
ANALYZE
A review of anesthesia guidelines supported that patients are not discharged unescorted. Direct observation and staff interviews demonstrated that the staffing design, physical location, misinterpretation of patient needs and visitation restrictions all played a role in our current process. The current process was driver-focused. Drivers pulled to the door, and patients walked out independently to meet them.
IMPROVE
The intervention the staff developed was patient-centered. The driver parks and walks inside to meet the patient and escorts the patient out of the building. We used our daily huddles to gather progress, provide feedback and educate as needed.
CONTROL
The intervention was overwhelmingly successful. There were zero events or complaints in the following three months. We surprisingly exceeded our goal. A noted added benefit was the heightened awareness that the driver was more actively engaged. Information-sharing was ongoing through daily staff huddles. The updated process was instituted with similar success in an adjacent facility.
We hope sharing this project summary will be useful to you and your practice. Learn more about gaining honoree status in the ASGE Endoscopy Unit Recognition Program. EURP honoree units may use the ASGE Quality Star logo in promotion of their units, receive premium educational content bimonthly via an exclusive e-newsletter The Huddle and enjoy a range of additional benefits. Questions should be directed to eurp@asge.org.