Whiteboards Key to Improved Communication

Karen M. Cheung, May 6, 2010

Patient satisfaction is undoubtedly on the minds of hospital administrators in an increasingly consumer-driven healthcare system. With patient satisfaction tied to reimbursements, many wonder how their institutions could improve patient satisfaction.

"Organizations are consistently looking at ways to help do that," said Niraj L. Sehgal, MD, MPH, associate professor of clinical medicine and associate chair for quality improvement and patient safety at the University of California, San Francisco (UCSF). "One of things that patients value is good communication. The whiteboards seem like an intuitive way to do that," he said.

Although there's no exact data correlating whiteboards with better patient satisfaction scores, whiteboards can improve communication among the healthcare team, providers, and patients, according to a new study, "Patient whiteboards as a communication tool in the hospital setting: A survey of practices and recommendations," published in the April issue of Journal of Hospital Medicine. Researchers at the UCSF surveyed 104 nurses, 118 internal medicine housestaff, and 31 hospitalists at their facility. Although they varied in what information was most valuable, most respondents agreed on their importance as a tool to improve teamwork, communication, and patient care.

Taking recommendations from its survey, UCSF is now its fourth month of it pilot program of the revitalized whiteboard system.

Whiteboards white out communication gaps
The Joint Commission states that 65% of reported sentinel events were caused by communication errors, according to the study. In 2007, The Joint Commission declared that one of the National Patient Safety Goals is to engage patients in their care.

With endorsement from Kaiser Permanente's Nurse Knowledge Exchange program and the Institute for Healthcare Improvement's Transforming Care at the Bedside initiative, more organizations are recognizing the importance of whiteboards.

Whiteboards, or dry-erase boards, are typically available at most medical institutions, according to Sehgal. "Whiteboards are ubiquitous… I'm not sure I've been to a hospital that hasn't had a whiteboard," he said.

The problem is that not all institutions use whiteboards to the fullest.

For example, at UCSF before the system was revamped, there was confusion about who the whiteboard was for – the provider or for the patient. "It wasn't very clear what the goal of the whiteboard was," said Sehgal. After the study, UCSF adopted recommendations from its survey. Now UCSF's whiteboard system is driven by a clear focus on the patient, rather than for the provider.

That means the whiteboards are installed so that patients can see them from their bed. Patients and their family members also have the opportunity to write questions for their providers on the whiteboard, which triggers a dialogue.

At UCSF, the bedside nurse manages writing and updating the whiteboard each day. Using a templated board, the displayed information includes day and date, the names of the patient, bedside nurse, and primary physician, attending, resident, and/or intern, and the family member's phone number.

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