In 2017 Nova Scotia Health joined the National Surgical Quality Improvement Program (NSQIP) with the aim to identify areas for improvement in surgical care.
Flash forward three years and Perioperative (Surgical) Services teams now have better information and insights about how patients did during and after surgery, to support planning.
And they are also actively engaging with surgery patients to learn from their experiences.
Recently, NSQIP teams kicked-off a new effort to improve and standardize communication with surgical patients.
Registered nurse, Alison Horne, who is based out of St. Martha’s Regional Hospital in Antigonish, is co-leading patient education efforts that will help respond to some of the more common concerns she and her colleagues hear as they connect with surgical patients.
“Patients want clear information on what they need to do once they leave hospital to support their recovery, things they should watch for that could signal a problem, and they want to know what they should do, who they should call if they have questions or concerns,” she said.
Horne is one of twelve registered nurses serving as Nova Scotia Health’s NSQIP surgical clinical nurse reviewers, at each of its regional hospitals. These roles are vital to the program, allowing Nova Scotia Health to collect information on surgical patients’ experiences and their recoveries.
The surgical clinical nurse reviewers’ role is to follow-up on a sample of patients at each regional hospital 30 days following their surgery and to input information into the NSQIP database.
They gather information from patient charts, through follow-up with their health care providers and by speaking with patients themselves.
They also work closely with other Perioperative (Surgical) Services team members to support the program, including NSQIP surgeon champions, to help keep their colleagues up-to-date, sharing data and encouraging ongoing quality improvement efforts.
The NSQIP program requires that certain types of data be collected and entered in the system, but no identifying information is entered related to the patient.
Nova Scotia Health has taken the program a step further, with nurses also asking patients if they:
1) Were given instructions at discharge about what do to help their recovery.
2) Were provided a contact number to call if they had questions or concerns.
The team won a 2019 Nova Scotia Health Quality Award for this effort to engage patients and share information with those supporting their care.
“We are so proud of our NSQIP team for the level of energy and dedication they have put into leading these quality initiatives,” said Dr. Greg Hirsch, senior medical director of Nova Scotia Health’s Perioperative (Surgical) Services Network.
“These were the types of benefits we imagined when we signed-on to NSQIP and it is wonderful to be translating our newfound knowledge into meaningful, patient-centered improvements.”
The team has formed a patient education working group, with patient representation, that is now developing new website content, education for providers, handouts that can be used to support communication at discharge and more.
Both projects have received support through Nova Scotia Health’s Nurse-led Innovation Fund Grants, funding available to encourage nurses to lead initiatives that promote innovation in nursing and clinical practice.
And the NSQIP team isn’t stopping there.
In December Nova Scotia Health’s Perioperative (Surgical) Services Network launched the NSQIP Patient Experience Survey – to help them collect even more information from surgery patients about what they experience.
Each month NSQIP nurses seek to complete a brief phone survey, with 10 patients from each regional hospital. Questions cover things such as how satisfied they were with staff’s attentiveness to their needs, communication, pain management, and whether their expectations of surgery were met. More than 120 patients took part in the first month.
“We are excited to keep learning from our patients and finding new ways to improve their experiences and help them to get the best possible results from their surgery,” said Horne.
Patients have so far been receptive to taking part in the survey, or as one patient put it – ‘it’s great that you follow-up because it means that you really are interested in providing quality care.’