Video skit makes JCAHO survey preparation fun
Michigan agency produces tape for about $150
Who says reviewing policies for a Joint Commission survey can’t be fun?
When Huron Valley Visiting Nurses of Ann Arbor, MI, prepared for the survey three years ago, the staff put together an hour-long video of people reading policies and procedures. It was informative but dull.
So last year, when the agency again prepared for a survey by the Joint Commission on Accreditation of Healthcare Organizations of Oakbrook Terrace, IL, there was a different strategy.
"We thought if we made it entertaining and funny it’d be easier to watch," says Susan Johnson, director of quality management of Huron Valley, a private, nonprofit full-service agency that serves southeastern Michigan and parts of Ohio.
The new video did the trick. After seeing the video, the staff did well on a post-test. (See video post-test, p. 74-75.) Also, the agency received some positive feedback from its Joint Commission survey in February.
"The surveyor was very complimentary about how knowledgeable our staff was," Johnson says. "She said a staff nurse took her aside to talk about her role in improving quality performance, and that impressed her."
Although the video deserved only a portion of the credit for the agency’s success, Johnson says it played an important role in reminding staff why they needed to follow certain procedures.
The story evolved around a group of fictional characters who intentionally broke rules.
"We had a story of a bag lady who snuck into the office to become a nurse, and she did all the wrong things," Johnson says. "She’d been cheated by her significant other and ended up living on the street in a via duct. She wandered into the office because it was left unlocked."
The bag lady was called Ima Baadnurse, and her boyfriend, called Al Coholic, was a patient of the home care agency. The story evolved into a bizarre scenario in which the bag lady ended up visiting her old boyfriend after forging an identification badge and cheating on the orientation exam. (See sample video script, p. 71.)
Between each vignette of Ima Baadnurse, an agency nurse or supervisor would review lessons with a humorous mini-skit. These included the performance improvement plan, physical assessment, continuum of care policies, safety equipment use, and performance improvement program.
Johnson and Kim Jacobson, director of information systems, wrote the video script and asked for volunteer actors from among the staff. After the vignettes were finished, Johnson wrote a narration, which pulled the script pieces together.
"I was considering the script from the perspective of security and patient confidentiality issues," Jacobson explains.
Jacobson portrayed the bag lady who breached the imaginary agency’s confidentiality by breaking in and looking at patient records. She created the character because she had a Halloween costume of a bag lady that so completely transformed her that when she wore it to a party several years ago, her own brother thought she was a stranger who had crashed the party.
Jacobson also created a graphic that blended into the scenes, showing a written list of policies, while the actor recited them.
"We tossed ideas back and forth, and there were some things that didn’t fit in with the scheme of the bag lady, so that’s where we came up with the infomercials," Jacobson says.
The infomercials included characters such as Elvira, Hootie the Hip Hop Skateboard Home Care Professional, Julia Adult, Fanny Urbanite, Ezmarelda the Witch, Karen Miranda, and Madame Seance.
Keeping it short and to the point
"We tried to keep the scenes on the screen for no longer than two minutes because of people’s short attention spans," Johnson says. "So it would blend back and forth, and the text would fade in and out."
They contacted a local community television station and asked if someone there could help with the editing. One of the station’s employees agreed to help them with the narration and editing for $15 an hour. This compares with an estimate of $80 an hour they had received from a professional video company.
"He billed us for five hours, although he spent more time than that," Johnson recalls. "Three of us worked on the production, and we brought him sandwiches, and I think he considered part of it social time."
They took the edited tape back to Huron Valley’s quality council members, who reviewed it and made some suggestions for changes. Then they returned to the studio and completed one more round of editing and added voice-overs. The total cost of making the video was about $150. Johnson had 10 copies made for about $100, so the total cost was $250.
Two frivolous scenes, which the staff enjoyed, were of Hootie, the hip-hop skate-boarding home care professional, who talked about the physical assessment, and of a character called Ms. Goodenurse who put on every piece of safety equipment available and then did a striptease while lecturing about what each safety device was for and how to use it.
Another popular scene was of the agency’s director of clinical services showing nurses how to do the Macarena while teaching them the continuum of care policy. The six tools of continuum of care were melded with the six movements to the Macarena. (See Macarena skit, p. 72.)
To demonstrate care, treatment, and service, the script had two "great chefs," Julia Adult and Fanny Urbanite, who explained their recipe that has all the ingredients for excellent home care.
"The video was really so silly," Johnson says. "There was a lot of information packed into it, and it was much longer than I wanted it to be 55 minutes long. But the staff pretty much told us that they couldn’t believe some of us were making such fools of ourselves, and they watched it to see what we would do next."
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