When is it time to implement the new process?
Determine a go-live date. In collaboration with the core leadership team, a go-live date for implementation of the new bedside reporting process should be determined. Appropriate communication to patients and staff should be established. The coaching and educational rollout for staff should be well established prior to the actual go-live date. The go-live date can be used as a starting point for timing of progress check or audits of the new process.
When do audits take place?
Perform periodic evaluations to monitor effectiveness of new process. Determining the type and timing of audits should be done in collaboration with the core leadership team to ensure that appropriate data is measured and evaluated. Use the established audit tool to monitor progress and compliance as well as to evaluate effectiveness and provide just-in-time feedback of the new bedside reporting process. The tool should be used to identify whether or not the key elements of the safety criteria are incorporated into the new shift-to-shift reporting process. The audits should be scheduled in advance and participants made aware of these dates and times. The data for the audit should be collected by observing the individuals during reporting process and the results made available to staff as ongoing positive reinforcement of progress and a way to sustain change. After initial implementation of the new process, the progress checks should occur more frequently as a way of reinforcing correct behavior and for reviewing and revising the process as needed. Ongoing audits will be dependent on overall progress and organizational perspective. Patient satisfaction surveys and safety reports should be part of this ongoing feedback.
How do you create an audit tool?
Consider the purpose. Various methods and modes for data collection are available and beyond the scope of this blog. A sample of a basic audit tool is available in the resource section of this blog. In creating an audit tool, you should consider the following:
- What is the purpose of the audit?
- What data needs to be measured?
- What data will be most meaningful?
- How frequently is the data collected?
- Who will collect the data?
- How will the staff be incorporated into data collection?
- How will the data be evaluated?
- Who will evaluate the data?
- How will the results be used?
- How will the results be communicated?
- How will the data collection meet organizational goals and vision?
Initial progress checks occurred one week after the completion of the project and progress was monitored three days per week, at varying shift change times. This continued for the next 30 days, followed by weekly audits for the next 30 and 60 days. At the end of 90 days, the data was reviewed and based on the results, the core leadership team made a decision regarding ongoing timing of audits and data collection. The results were made available to staff and used as ongoing positive reinforcement of progress.
