Implementing and Sustaining Bedside Shift Report for Quality Patient-Centered Care.

Area of Science:

• Nursing Quality Improvement
• Evidence-Based Practice Implementation
• Healthcare Communication Strategies

Background:

• Lack of standardized bedside shift report (BSR) processes led to poor Veteran involvement in care planning and nurse dissatisfaction.
• Missed communication of pertinent patient information was a significant issue without a structured handover protocol.
• Existing evidence-based practice projects and an innovative model informed the BSR quality improvement initiative.

Purpose of the Study:

• To implement and sustain a standardized bedside shift report (BSR) process.
• To improve Veteran involvement in care planning decisions.
• To enhance nurse satisfaction by addressing communication gaps.

Main Methods:

• Identification and mitigation of facilitators and barriers to BSR implementation.
• Incorporation of key elements of bedside shift report into the standardized process.
• Phased unit-by-unit implementation supported by shared governance, unit champions, and leadership.

Main Results:

• Successful implementation across 11 units within 4 months.
• Achieved consistent BSR on 82% of units after 15 months.
• Reported improved patient satisfaction, specifically noting nurses taking time to listen.

Conclusions:

• Best evidence, strong unit-based champions, and leadership support are essential for successful BSR implementation.
• Dedicated project coordinators and persistence are critical for sustaining practice changes.
• Standardized BSR positively impacts patient engagement and nurse satisfaction, contributing to overall quality improvement.