Dear Editor,
In your recent issue, the article "Enhanced Communication Performance Improvement and Patient Satisfaction in an Endoscopy/Ambulatory Surgery Unit" (Griffiths, 2015) was quite concerning to me. I have worked in the area of endoscopy/ambulatory surgery within hospitals for the past 20 years. We must improve the safety of our patients by obtaining an accurate history and medication profile. As educated healthcare providers, we often forget that the average literacy level in America is that of approximately a seventh grader (Bendycki, 2008). Medical forms are often too complicated for our patients to understand. To offer insight to others with this same dilemma, I will tell you our resolution at this point.
We do a preoperative phone interview with patients to obtain their medical history. This can be done while they are at home and relaxed. Anxiety on the morning of the procedure makes concentrating difficult and often important issues can be left out. We inquire about medications so that we can confirm whether patients have been given appropriate instructions (such as stopping a blood thinner), but we then insist that they bring the actual bottles with them. We have found many errors when patients hand write a list. Often, patients have a list they carry that is not updated. If patients get admitted, their inpatient medication would then be based upon these errors. This again can be dangerous.
A form is quicker and more convenient for the admitting nurse if it is accurate. I don't believe that a form is ever perceived more positive than a caring person who actually talks to the patient. According to Duffy (2013), what patients really want is to feel cared for. I would love to see the Griffiths (2015) quality improvement project replicated with a control group of forms versus telephone interview for obtaining a patient history.
Personal conversations do take more time, but it can definitely be worth it in the long run in the prevention of costly errors. Besides, the personal touch and intuitive questioning is what makes nursing care genuine. And I believe that genuine care increases HCAHPS scores far beyond what even the very best form ever could!
Schantile McCray, BSN, RN, CGRN
Supervisor, Peri-operative Services
Texas Health Harris Methodist Hospital Southwest
Fort Worth, Texas
([email protected])
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