Surveys help gauge nursing concerns
Hotlines a better solution for physicians
Anonymous surveys can help nurses report their concerns without any fear of retaliation, says Cole Edmonson, RN, MS, director of nursing operations at Medical City Dallas Hospital and North Texas Hospital for Children in Dallas. Edmonson has been working for years to encourage nurses to report their concerns about quality of care, and he says it should be an ongoing effort. No one tool or strategy will achieve the goal.
Edmonson’s institutions recently implemented a system of regular surveys of nursing staff, along with a physician hotline. The first survey was done six months ago, and the quality improvement professionals are in the process of reviewing the results. The hospitals send out surveys to a random portion of the nursing staff, selected from various units and using other factors to make the sample representative. Nurses fill out the survey anonymously and drop it off or mail it back to the quality department.
"The survey helps us determine what kind of interventions we need to make a safer environment," he says. "We ask if they feel comfortable reporting an error or a dangerous situation to their supervisors. We also ask if they think the institution supports a nonpunitive reporting environment and whether there are any systems in place to facilitate reporting. It’s important to know what awareness they have of the methods we’ve already made available."
The initial analysis of the survey results indicated that some nurses still think there is a punitive environment and that there could be negative consequences for reporting their concerns. That was somewhat of a surprise, since hospital leaders were confident that they had promoted a nonpunitive environment.
"We went back and looked at some policies and saw that there were still some words in there that could scare off someone who is afraid of the consequences," Edmonson says. "We need to revise those policies so that any words related to a punitive reaction are removed. It’s really a change in wording more than a change in policy."
For physicians, the Dallas hospitals recently implemented a hotline. According to Edmonson, the phone hotline can be a better solution for physicians because they come and go frequently and it is easier for them to pick up the phone than to track down the right person in the hospital. The hospitals promote the hotline number to physicians and promise that an appropriate hospital representative will respond to every hotline message within 24 hours. The medical staff also review all the hotline comments on a monthly basis.
[For more information, contact:
• Cole Edmonson, RN, MS, Director of Nursing Operations, Medical City Dallas Hospital, 7777 Forest Lane, Dallas, TX 75230. Telephone: (972) 566-7000.] n
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