Nurse Knowledge Exchange Plus: Human-Centered Implementation for Spread and Sustainability.

Area of Science:

• Nursing Communication
• Healthcare Quality Improvement
• Human-Centered Design

Background:

• Kaiser Permanente introduced the Nurse Knowledge Exchange (NKE) for nursing shift changes in 2004.
• Variations in NKE's spread and sustainability were observed across medical centers five years later.

Purpose of the Study:

• To implement and evaluate the NKEplus model using human-centered design principles.
• To improve nursing communication and standardize handoff processes.

Main Methods:

• NKEplus incorporated six core elements, including team rounding, pre-shift assignments, and patient collaboration.
• Human-centered design principles were applied, emphasizing shared understanding, minimum specifications, and staff customization.
• Implementation involved pilot testing, phased rollouts, and traditional performance improvement strategies.

Main Results:

• By May 2013, NKEplus was implemented in 100% of medical/surgical units and 77% of specialty units.
• The NKEplus nursing behavior bundle score increased from 65.9% to 71.3% between 2010 and 2014.
• Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores for nurse communication improved significantly (p < .001).

Conclusions:

• Human-centered implementation facilitated the spread of the NKEplus model.
• The approach appeared to positively influence the culture of professional nursing practice during shift changes.