Using the After-Visit Summary to Facilitate Education, Guide Care, and Reduce Nurse Call Volume: A Quality Improvement Project
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Date
2023-05
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Publisher
The Ohio State University
Abstract
The purpose of this quality improvement project was to implement a practice change of using the after-visit summary (AVS) to facilitate patient education, guide care, and reduce nurse call volume in an ambulatory pediatric orthopedic practice. Nurse calls from patients/families reached an all-time high within the orthopedic practice which led to prolonged wait for return calls leading to unnecessary ED visits, inappropriately self-scheduled patients in clinic, decreased patient outcomes, and decreased patient satisfaction. A critical appraisal of evidence clearly demonstrated that appropriate patient education after provider visits was correlated with fewer questions from patients and caregivers. Reduction of calls to the nurse call line allows for prioritization of the patient/parent questions the patient/parent questions that have a higher level of critical need and may require provider intervention. Implementation of this project had the potential to improve patient satisfaction as well as patient outcomes because of the impact on the nurse call line volume. The model used to guide this quality improvement project was the IHI Model for Improvement; the Plan, Do, Study, Act (PDSA) cycle proposed for this project is an implementation of a team-based, best practice use of the AVS with patient education. Pre- and post-data collected included an analysis of call logs and AVS use. Results showed significantly increased compliance with providing the AVS to patients by 26%, however only 2% reduction of education related calls. Patient satisfaction scores did increase over time on average by 7%. Limitations of this project includes the short time frame and specialty specific location of the implementation.
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Keywords
After-Visit Summary, AVS, Patient Education, Orthopedics, Nurse Calls, Call Volume, Discharge Education