Performance improvement feedback can sometimes feel like a list of things that have gone wrong. But in reality, PI is critically important for identifying improvement opportunities, implementing concrete changes, and measuring whether those changes have made a difference for patients, the hospital and staff.
“PI matters to every single nurse that works in your emergency department in your hospital,” said Jamin Rankin, BSN, NREMT-B, CEN, CFRN, TCRN, CPEN, CTRN, trauma program manager at Ochsner LSU Monroe.
Jamie Florentine and Jamin Rankin discussed how to use PI feedback for making real, sustained improvements.
In yesterday’s session, “Not Them Again: How to Use Feedback from your Hospital PI Programs,” Rankin and Jamie Florentine, RN, CEN, TCRN, trauma PI coordinator at Ochsner LSU Monroe, showed that PI goes much deeper than simply identifying problems and opportunities for improvement. It’s also about taking action to correct those problems, ensuring those actions were effective, and sustaining positive change.
“Understanding the source of the opportunity helps in developing targeted interventions that address the actual problem and not just its symptoms,” Florentine said.
That includes identifying whether an issue is a “people problem” linked with a certain nurse, unit or even a shift within a unit, or a “process problem” with no discernable links to particular people but continues to occur.
Once the source of the issue is identified, PI programs should develop specific, targeted interventions to make corrections or improvements. For instance, people problems might be addressed with focused reviews or performance improvement plans, whereas process problems might be corrected with program-wide education or shoring up equipment and supplies.
However, PI work shouldn’t end there. It should also evaluate and measure whether the action has made a difference, ensuring that future similar patients are less likely to experience that issue.
“Compare the data from before you implement the actions to after to make sure you’re moving in the right direction or need to adjust,” Florentine said.
Bedside nurse involvement is crucial for implementing PI programs, Jamin Rankin and Jamie Florentine said during their session.
The session also emphasized that PI programs should not be punitive. Instead, they should encourage collaboration, open communication, and opportunities for learning and improvement by clearly tying them to patient outcomes and safety, rather than punishment.
“The front-line staff are often the first to see what needs to be changed and are key players in implementing those changes effectively,” Florentine said. “Nurses should feel empowered to communicate with PI staff on any issue. Honest feedback is everything.”
Attendees walked away with actionable ways to use PI program feedback in their own institutions.
Among them was Mindy Walters, MSN, RN, CCRN, a trauma program manager at CHI Health St. Francis in Nebraska and president-elect of the Nebraska ENA State Council, who said the session “turned on a switch” about how she can better communicate the need for better documentation by tying it to patient outcomes.
“I like the approach that they took where this was totally directed to bedside nursing,” she said.
Ultimately, PI programs are good for patients, nurses and institutions.
“Performance improvement is not just doing things,” Rankin said. “It’s doing things that make a difference and being able to prove that it’s making a difference.”