If you are laying in a hospital bed there is a good chance you will spend a good bit of time looking at the board on the wall. Just about every inpatient room at Mary Greeley has one and, in many ways it is as important as the bed. The communication board, or “white board” as it is informally known, is an easy-to-take-for-granted tool for communication between the patient, the patient’s family and the care team, as well as between care team members.
What might be surprising, though, is how much consideration is given to the development of the board, and how it is subject to constant improvement. In this Q & A, Matt Aitchison, BSN, RN, executive director of Inpatient Nursing, explains why Mary Greeley takes this patient room feature so seriously.
What is the role of the communication board in patient care?
It is an important communication tool. It allows a care team to convey to a patient the plan of care on a day-to-day basis, including goals and pain management plans. It also serves as a way of introducing members of the care team to the patient, and the patient to members of the team. It’s important for everyone to have this information readily available as a lot of people come and go out of patient rooms every day.
Are nurses and others trained in filling out the board?
Yes. Senior staff will go over the board with newer staff. An instructional video was recently created. When filling out the board, a nurse will go over each section with a patient. Nurses should avoid acronyms. The care team might know what PCT or PT stands for, but a patient and a patient’s family members won’t necessarily. (FYI: PCT stands for Patient Care Tech and PT stands for Physical Therapist.) Also, a nurse should not write that “people” or “persons” will help a patient. For example, “2 people will help patient get up and walk.” “People” could mean anyone, and helping a patient get up and walk requires a trained member of the hospital staff. In these cases, nurses are instructed to write “nurses” or “staff.”
When were communication boards introduced?
Mary Greeley’s Patient Satisfaction team began developing a communication board in 2007. The first version included the date and day of week, and listed the names of the patient’s physician, nurse and other caregivers. It was updated in 2011 to include more information, including goals for the day and pain medication schedule. It was basically a dry-erase board with information sections designated with stick on letters. Physicians would sometimes use it as a note board when explaining things to patients. This made for a messy, hard to maintain communication tool.
In 2014, the Patient Satisfaction team issued a new, more detailed board, with a detailed template and a plastic cover that could be written on. It is easy to update, clean and replace if necessary.
How does a communication board personalize care?
The most obvious is that all the information written on the board relates to the patient in the bed. Beyond that, a nurse doesn’t just write the patient’s name, but what the patient prefers to be called. For example, if a patient’s name is Robert, but they prefer to be called “Robbie,” then “Robbie” it is. We don’t take for granted that that a patient might like to be addressed by something other than their legal name. There is also a Patient Priority section. Here, a patient can make sure that any special requests, like always having their door closed, is noted.
There is also a box in the lower right hand corner of the board. An “M” written in this box alerts staff that the patient is taking a medication that the patient has not taken before. Staff are informed of potential side effects of the medication and let the patient know what to watch for. Once the patient can accurately describe potential side effects, the M is erased from the board.
How do you know when updates are needed?
Patient feedback is important when it comes to these boards. For example, a patient recently shared with a nurse that the white board in her room stated that her next pain medication was due at 2 a.m., but nobody brought it. What the patient didn’t realize, was that she needed to request it. That wasn’t clear from the board, however. As a result, a slightly revised board is being piloted in several patient rooms. It reads “Next Pain Medication can be requested at:” This wording was reviewed by several patients. It will
eventually be used on boards throughout the hospital