• Nicholas Anders Kuehnel, Andrea K Morrison, and Catherine C Ferguson.
• Department of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
• BMJ Open Qual. 2019 Jan 1; 8 (3): e000504.

BackgroundGood communication with families improves safety and drives patient/family satisfaction. Rapid cycle improvement for the communication is difficult in our emergency department as current mailed surveys provide little and delayed data. We had two aims in this quality improvement study: (1) to increase proportion of families responding 'always' when asked if they received consistent communication from nurses and providers from 52% to 80% and (2) increase families reporting their visit as excellent, reflecting higher family satisfaction.MethodsKey drivers of the consistent communication were determined using the model for improvement. Interventions focused on interprovider communication and parental knowledge of communication processes. Eight Plan-Do-Study-Act ramps were conducted focusing on each of the key drivers, with 1-10 cycles per ramp. A five-question in-person survey was conducted at the time of disposition by the research assistants. Process and outcome measures were tracked on the statistical process control charts.ResultsMean percentage of families who reported always receiving consistent communication increased from 52% to 70% over 12 months. Additionally, families reporting their visit as 'excellent' increased from 62.5% to 75%. Using in-person surveys, weekly responses increased from 3 to 22.ConclusionsIterative processes to improve interprovider communication and inform families about their care led to improvement in families' perceived communication consistency. Improved communication can lead to higher family satisfaction, most affecting those previously feeling neutral about their visit. In-person surveys can inform the real-time improvement efforts.© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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