Brooke Army Medical Center is implementing a new nurse initiative to improve communication and interaction with patients.
“We want to provide an environment that enhances patient care through purposeful engagement and empowerment,” said U.S. Army Col. Dana Munari, chief nursing officer. “We can achieve this through staff development, leadership engagement and coaching.”
The new initiative is based on the AIDET® communication model, and includes purposeful patient interactions, nurse leader rounding and purposeful hourly rounding.
According to the licensor’s website, AIDET® is a communication framework for healthcare professionals to communicate with patients and each other in a way that decreases patient anxiety, increases patient cooperation, and improves clinical outcomes. The acronym AIDET® stands for five communication behaviors: Acknowledge, Introduce, Duration, Explanation, and Thank You.
When entering a patient’s room, the staff member acknowledges the patient and all others in the room. They introduce themselves by telling the patient their name, skill set and experience.
The staff member also should provide an accurate time expectation for procedures such as tests, physician arrival, and any additional steps needed. They should explain what to expect, answer patients’ questions and let the patient know how to contact them, such as a nurse call button. When the visit is concluded, the staff member should thank the patient and family members.
“By acknowledging the patient, the patient knows that they are being recognized,” said U.S. Army Col. Daniel Thompson, deputy commander for inpatient services. “That introduction provides an opportunity for the patient to know who they are talking to. By knowing how long something is going to take and what the expectations are and the timeframe, allows us to provide a consistent product for our patients. As a leader, that makes me more comfortable.”
Munari agrees. “This model outlines expectations for our nurses and for patients,” he said. “Once our staff members embrace this model their interactions with patients will become more standardized and predictable, leading to better outcomes.”
Currently, unit patient experience champions are learning to apply these communication skills through simulation. The model will be rolled out to inpatient nursing staff beginning in February.
“I think the heart of health care is connecting with patients,” said Air Force Maj. Danielle Merritt, clinical nurse. “This model allows us to get to know our patient population better and actually go back to the art of health care -- elevating the experience not only for our patients, but for the staff as well.”
Leader Patient Rounding
Leader patient rounding is an additional tool to improve patient experience and enhance staff development.
“Leader patient rounding requires leaders at all levels to have interaction with patients in an area of their supervision,” Munari explained. “By interacting with patients and their family members, leaders can help manage the patients’ expectations, learn about areas that need improvement, and help to identify staff members who deserve recognition.”
After rounding, leaders should provide feedback to their staff regarding behaviors the patient identified as positive and coach staff members where communication can be improved. If the organization fails to meet patients’ expectations, this provides an opportunity for leaders to apologize and resolve the situation.
Purposeful Hourly Rounding®
AIDET® encourages nursing staff to engage in purposeful hourly rounding using the communication model to establish a positive connection between themselves and their patients and family members.
In addition, staff members will address the four “P’s” that are important to their patient: pain, personal needs, position and their possessions.
“Addressing the four P’s helps alleviate the patient’s anxiety, which leads to a more positive experience and enhances patient cooperation and improves patient satisfaction,” Munari said.
“Purposeful rounding is important for BAMC because it provides an opportunity for every one of our staff members to engage patients in a way that improves communication,” Thompson said. “It also improves patient satisfaction, reduces falls and injury for our patients, and it facilitates the ability to provide better care and better patient outcomes.”
Purposeful Hourly Rounding® also gives staff members the opportunity to conduct an environmental assessment, find out if the patients’ needs are being met, and if there are any concerns that need to be addressed.
“The AIDET® framework allows me to know that my staff is engaging a patient in a way that meets their communication needs,” Thompson said. “I use the AIDET® communication model when connecting with my patients because it provides me the opportunity to get to know my patients and very quickly improves that relationship and communication.”
Once the model is rolled out to the nursing staff, leaders hope to expand the concept to other areas, including primary care and the emergency department.
“This is a great evidence-based model that will truly enhance the communication between our providers and our patients across all of team BAMC,” said BAMC Commanding General U.S. Army Brig. Gen. Wendy Harter. “This model will improve quality and safety throughout this facility and patient satisfaction, which is also critical to our patients getting better over time and part of our journey as a high reliable organization. Clear, purposeful communication inspires a culture of trust and that’s key and critical to everything we do, and it’s paramount to where we move forward as team BAMC.”
NOTE: This article does not imply official endorsement from Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, Defense Health Agency, the Department of the Air Force, the Department of the Army, or the Department of Defense or the U.S. Government.