GUEST COLUMN
Are your volunteers up to snuff?
They affect the quality of hospital functions
By Patrice Spath, ART
Brown-Spath Associates, Forest Grove, OR
Hospitals have become increasingly dependent on volunteers to assist in clinical and nonclinical service areas, including the guest relations departments. These volunteers may fall into two categories: casual or formal. Casual volunteers are people who offer, on an informal basis, to perform a specific task for a specific period apart from the organized volunteer program. Casual volunteers often are used for special occasions such as toy distribution during the holiday season. Formal volunteers are those who are specifically recruited, oriented, and trained as part of an organized volunteer program. Both classes of volunteer staff have a tremendous impact on the quality of hospital functions.
The ultimate authority and responsibility for the quality of volunteer services is vested with the hospital’s governing board, so it’s important to include volunteer performance measures in the hospital’s overall quality monitoring and evaluation program. The hospital-employed director of the volunteer services program also should oversee its quality review program. The director will share performance measurement results with the volunteer program’s executive board, but this group cannot assume ultimate responsibility because it is not composed of paid hospital workers.
The results of volunteer monitoring activities should be reported to the organization’s quality council. By sharing these performance measurement results, valuable multidisciplinary input can be obtained. In addition, this reporting will enhance the volunteers’ status as important members of the hospital’s health care team.
While components of volunteer staff activities may be monitored by individual departments, the volunteer services department should be responsible for evaluating functions not addressed at the department level. The volunteer services office should develop performance measures to evaluate those aspects of service they are responsible for providing. (Examples of measures for functions performed by the volunteer services office are inserted in this issue.)
The volunteer staff director, in consultation with the volunteer service executive board, should establish expected levels of quality for each performance measure. These levels represent the department’s definition of quality services. The volunteer office can develop several types of survey tools to assess satisfaction and the effectiveness of orientation and training. (A sample survey instrument is inserted in this issue.) Observation reviews are useful tools for the volunteer office — they can be used to assess volunteer compliance with basic training requirements such as wheelchair use, moving beds and large carts, and lifting. Volunteer compliance with fire emergencies can be obtained from facilitywide fire drill evaluations.
Volunteer staff who interact with patients must be trained in age-specific competencies. Those competencies should address each member’s ability to understand the needs of the population served and to communicate and perform tasks needed to meet those needs. For example, volunteer staff responsible for transporting frail elderly patients who are at higher risk of hypothermia should be aware that heavier blankets should be used and patients should not be transported until foot covering is provided. Volunteers who perform personal care services, such as hair washing, should understand that elderly patients may fight having their hair washed because they are cold and fear the prospect of becoming colder. Wet hair should be wrapped immediately in a towel to conserve the patient’s heat.
Volunteers who provide patient care assistance to the busy nursing and clinical staff should have the skills and abilities necessary to meet the needs of the population they are serving. Typical volunteer staff services include transporting and feeding patients, rocking infants, reading to and playing with children, delivering water and personal care items, listening to patients’ concerns, fielding calls for patients in special care units, and answering patients’ questions.
Following are some examples of age-specific competencies that may be required of volunteers before they assume specific patient care responsibilities:
• Recognizes patients’ fears by repeating information often.
• Understands the need to maintain warmth for elderly patients.
• Uses firm direct approach with toddlers.
• Uses play as a means of communication with toddlers.
• Makes actions clear to children (ages 3-6) before touching them.
• Knows how to empathize with geriatric patients about losses.
• Addresses elderly patients using "Mr." or "Mrs." and their last names.
The abilities of volunteers also should be regularly evaluated to ensure they continue to maintain their skills. The competencies listed are merely examples and do not apply to all volunteer staff. The population of patients served by volunteers and those volunteers’ duties would determine what skills and abilities are needed.
Develop and disseminate to volunteer staff educational materials and training on human growth and development stages, including how volunteers can apply this information when interacting with patients in various age categories. To reinforce that education, develop scenarios that offer solutions to age-related patient care issues volunteers might face. Education can be disseminated in volunteer newsletters or at formal meetings. Provide volunteer staff with opportunities to discuss problem areas with relevant clinicians. Also, be sure to periodically evaluate each volunteer’s relevant age-specific competencies through direct observation or clinical staff feedback.
Monitoring the performance of volunteer staff is an important component of the governing board’s responsibility to ensure quality patient care. Volunteers provide a variety of services within hospitals, and it is critical that volunteer performance standards be set and systems be established to evaluate compliance with these standards. Paid staff in the volunteer services department and the volunteer organization executive board should share responsibility for evaluating the results of quality monitors and making changes in orientation, training, and staffing practices where indicated.
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