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The Importance of Patient & Peer Feedback

Becker’s Nursing Leadership Event
Lisa Romano, MSN, RN
Chief Nursing Officer, CipherHealth

Staff Wellbeing: An Alarming Crisis

  • Staff nationwide are at their breaking point
  • Stunning increases in reports of burnout and PTSD
  • Many have suffered with personal illness and caring for loved ones
  • Rising early retirements and departures of experienced clinicians
  • These changes contribute to an environment conducive to reduced job performance/quality of care

Increased Risk of Adverse Outcomes

  • Exhausted staff are at higher risk of making medical errors
  • Mental and physical health declines are aligned with lower staff wellbeing 

Mental Health Impact

  • Staff and leaders are emotionally exhausted
  • Anxiety, depression, and increased incidences of suicide

Staff Shortages and High Turnover

  • Health systems are facing a crushing financial burden associated with turnover, compounding financial difficulties 
  • Systems also struggle with loss of experienced clinicians and worry over students and new graduate competency 

Burnout Syndrome

  • Emotional exhaustion – feeling “overwhelmed” is an early sign
  • May progress to “depersonalization” – impersonal feelings towards those receiving care
  • Often there is a perceived lack of personal accomplishment and negative self-evaluation despite heroic work
  • Can quickly escalate to PTSD with the need for urgent intervention
  • This trend is already already resulting in an alarming numbers of experienced nurses and doctors are leaving the profession
  • Devastating increases in nurse and physician suicides

Key Questions for Staff Rounding

  • Have you been getting enough rest?
  • Are you getting sufficient breaks during your shift?
  • Have you been asked to work excessive overtime shifts to the point that it is affecting your mental and/or physical health and performance?
  • Do you have family care needs or concerns about their health?
  • What can leadership do to ensure you have everything you need during your shift?
  • Do you have the necessary resources and supplies to manage your patient load?
  • Do you have the proper hygiene equipment and PPE for you and your unit?
  • Have you seen or experienced any incidents regarding staff or patient safety that you would like to share?
  • Are there members of the care team you would like to recognize for exceptional service or performance?

Consistent Themes Emerging from Patient Feedback 

Emerged after 400 “Caregrams”, or patient written notes with positive feedback for staff  

  • Heavy emphasis on making patients feel safe
  • It’s the little things that have the most impact:
    • Warm blankets
    • Hair care
    • Sports
    • Smiles
  • Empathy and caring go a long way, especially when extended to family members as well
  • Effective Communication is key; taking time, listening, answering questions, providing education, explaining next steps are all highly impactful for patients 
  • Interactions don’t feel rushed also emerged as a theme
    • “Took time with me”
    • “Made me feel I wasn’t a bother”