What do you need to consider when preparing the staff for the process change?
1. Provide adequate information. Each coach should meet with the designated staff member and review prepared information related to the new reporting process. This includes best practice evidence for bedside reporting, lessons learned from the trials, benefits for patients and staff, reporting tools and standard work. The staff should be provided with an opportunity to ask questions and explore their concerns. Depending on the individual learning styles, the staff member may benefit from reading, observing or role-playing the new process prior to proceeding with the actual steps in the clinical setting.
2. Step-by-step approach. Depending on the current reporting process and unit culture, a graduated approach to bedside reporting may be appropriate. For example, if the current reporting process consists of taped report, the staff may require additional time and support to develop comfort and skill in communicating a shift report face-to-face with another staff member prior to completing the report at the patient’s bedside.
3. Provide adequate staffing resources. Review unit staffing to ensure appropriate or additional resources are available during the coaching and implementation process. The staff should be aware that the initial change process will likely feel awkward, cumbersome and time-consuming and be aware of available supports.
4. Support just-in-time learning. Utilize support of leadership, educators and other change champions to work alongside individuals to provide feedback, guidance and support, and to reinforce positive behaviour and solidify progress.
The step-by-step approach was quite effective in building staff’s confidence with completing report at the bedside. The oncoming staff were asked to assemble in the conference room at the beginning of the shift and the outgoing charge nurse began the shift report with a 2-3 minute shift huddle. The tape recorder was removed and staff were asked to provide face-to-face shift report to oncoming staff in the conference room. After a period of time, the report was supported by the coach or change champion and conducted at the patient’s bedside. Involving patients and families in the report process became integrated and accepted as part of the reporting process.
