Implementation of a Unit-based Nurse Practitioner Led Hourly-rounding Program Utilizing the AIDET Too

Background: The result of poor patient satisfaction scores can significantly affect hospitals financially by withholding reimbursement if patient satisfaction scores are not met. According to Robbins, A (2015). Beginning in October 2012, the Affordable Care Act implemented a policy withholding 1% of total Medicare reimbursements---approximately $850 million---from hospitals (Robbins, 2015). The author also implied that this percentage will double in the year 2017 if patient satisfaction scores are not met. Additionally, the Center for Medicare and Medicaid allowed the hospital scores to be visible on the internet. This increased visibility enables patients to "shop" for care as consumers rather than going to the nearest hospital by default. This creates patient growth and retention opportunities for hospitals that perform well but threatens the success of those that fall behind (Health Forum, 2017). It is imperative that hospitals work unilaterally to improve patient satisfaction scores.;Methods: This project was a pre-post intervention design measuring patient satisfaction scores quarterly using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). The implementation of the intervention was divided into four phases: Exploratory (Q12017), pre-implementation (Q2 2017), implementation (Q3 2017), and post-implementation (Q4 2017).;Intervention: All Unit based Nurse Practitioners(UBNP's) designated to the identified unit were educated on purposeful rounding using the AIDETRTM (Acknowledge, Introduce, Duration, Explanation and Thank you) communication tool. The nurse practitioners performed purposeful rounding for 12 weeks. After the research project was completed, a post-analytical review of the patient satisfaction scores was conducted and compared to the results from unstructured rounding.;Results: Initial results comparing the exploratory to pre-implementation resulted in an improvement from the 1st to 63rd percentile for communication with nurses, but a decrease from the 7 th to 5th percentile for communication with doctors. Unfortunately, the increasing trend was not sustained post-implementation with communications with nurses and doctors.;Conclusions: Improving communication with both nurses and doctors is important to ensure patients receive safe and effective care. Initial results using the AIDETRTM tool for nurse practitioners resulted in an increase in nurse communication with doctor's communication decreasing. With all interventions, the key to success is sustainability. Nurse practitioners were floated off the unit post-implementation and communication scores returned to baseline.