Development of a Patient and Family-centered orientation booklet for those placed within the Cardiac and Stroke unit, with the goal of reducing anxiety and confusion and of engaging patients and their family members as key partners in decision-making regarding their plan of care.

1. Kaiser Permanente, Northern California
Caritas in Action
How Caring Science informs and inspires KP caregivers and affirms our commitment to provide our
patients and their families exceptional care
Caritas Consortium 2014
Welcome To The 4E Team:
Developing Booklet for Patients and Families on a Cardiac/Stroke Unit
Honoring Health, Healing & Wholeness

2. 4E Patient Population
Designated Stroke Center
Telemetry Unit
Med/Surg Overflow
Page 2

3. Patient Characteristics
Patients tend to be older adults
Health event has sudden onset
Hospitalization unexpected
Patients arrive to 4E unprepared
Families stay at bedside
Page 3

4. Page 4
Typical bedside table
Important
papers and
business cards
damaged,
thrown away
or lost.

5. Santa Rosa implemented Family Centered Care
Offered staff training to deliver sensitive,
competent care to patients
Inconsistent family care provided without
formal training
Nursing Research Council received Barnes
Grant to study family needs on an oncology
unit
Page 5
2012 Events

6. Physical comfort
Resources and information
Better communication
Less challenging computer access for elderly
Names of professionals providing care
Where to obtain emotional and spiritual
support
Page 6
Identified Family Needs

7. How to find way around hospital
How to find amenities in local area
What to expect during hospital stay
Be informed about hospital routines
List of commonly used hospital phone numbers
Understand role of each therapist and
physician
Page 7
Identified Family Needs (Cont.)

8. Page 8
Created a Welcome Book

9. Page 9
Key Booklet Features
 Invites patients to be equal member of the team
 Introduces staff and explains roles
 Large print

10. Key Booklet Features (Cont.)
Page 10
 Provides schedule of
routines
 Outlines progression from
admission to day of
discharge
 Prepares patients for
discharge process

11. Key Booklet Features (Cont.)
Page 11
 List of important
internal phone
numbers
 Identifies chaplain
and other services
w/ contact
information

12. Key Booklet Features (Cont.)
Page 12
 Map of
general
area with
local
amenities
identified

13. Key Booklet Features (Cont.)
Page 13
 Map of Hospital

14. Page 14
 Lengthy projects take time (challenge for staff nurses to
volunteer this time outside of work)
 Finding mentor or manager who will support project
through fruition is crucial
 Important to engender “buy-in” from end users along
the way
 Follow up on everything and expect delays!
 Kaiser Permanente has many rules and multiple levels of
approval; know what these are before you start
 Important to build in flexibility for a constantly changing
environment
 Cost matters!!!
Things I’ve Learned:

15. Page 15
 Using evidence based research is valuable
 Plan product roll-out carefully
 Check in with end users (staff and patients) to make
sure product is being used appropriately
 Always do post roll-out evaluation (s/p first week, 1
month, 3 months) and make adjustments as needed
 Be sure to recognize and show gratitude to supportive
personnel for their help
Advice

16. Developing a Booklet for Patients & Families on
Cardiac/Stroke Unit
Intent to Contribute Statement:
Development of a Patient and Family-centered orientation booklet for those placed within the Cardiac and
Stroke unit, with the goal of reducing anxiety and confusion and of engaging patients and their family members
as key partners in decision-making regarding their plan of care.
As healthcare reform rolls out, many hospitals are being forced to reduce their operating costs. Staff is being
asked to work more efficiently than ever before. This efficient and often expedient way of working is for the
most part effective, but older patients and families sometimes complain that they are unable to absorb all the
information they are given during the admission process and are bewildered by the rapid pace of some of the
routines on our unit. This sometimes makes them feel uneasy and stressed which is not conducive to a peaceful
and healing environment. Our staff routinely provides printed discharge instructions and educational material
for clarification and patient reference, but we don’t usually offer instructions to patients and family members
about how each hospital unit works. This discrepancy was the genesis of our 4 East Cardiac/Stroke Center Book
entitled Join The Team. Our colorful, easy-to-read, large print book introduces new patients to our specialized
unit and explains what makes the care they receive on 4 East unique.
Page 16

17. Page 17
… Continued
After introducing photographs of the members of the various groups that make up our elite team, we identify
the most significant team member – our patient who is the center of all of our efforts and activity. Our patient
and family centered care philosophy as well as our commitment to keeping patients and their families informed
about, and included in, all decisions regarding their plan-of-care is reviewed. We also introduce our practice of
nurse knowledge exchange (NKE) and emphasize the importance of their participation in updating the plan-of-
care during each change-of-shift report. Photographs of the various groups that make up our team are
included, so that patients and families become familiar with the staff working on and around our unit, and we
outline the general daily activities that occur on our unit throughout their hospital stay. Patients can make
notations of special requests, questions, general information, and important personal phone numbers and then
refer back to these as needed. We also provide illustrated instructions on how to operate bedside phones, TVs
and call lights, and we include maps of the Medical Center and a quick area guide of downtown Santa Rosa
highlighting important necessities such as the location of the nearest gas stations, banks and Starbucks. Most
importantly, we manage patient and family
Developing a Booklet for Patients & Families on
Cardiac/Stroke Unit

18. Page 18
… Continued
expectations concerning room changes and our discharge process – two areas that frequently result in patient
and family distress. Finally, for our patient’s convenience, each book contains an attached, closable folder for
storing business cards and important documents accumulated throughout their hospital stay, and a back pocket
intended for storing educational material and discharge instructions. Our primary expectation is that our book
will alleviate some of the anxiety and anger that occasionally results from patient and family confusion about 4
East routines. Another expectation is that this book will organize the patient by providing a consistent place to
record information they want to remember. Many patients think of questions at night that they want to ask staff
in the morning, or can’t recall what their doctor said when families visit in the evenings. By providing patients a
section in the book to take notes, communication is facilitated and family satisfaction is improved. Finally, we
expect our book to nurture more patient control, independence and satisfaction and that is a very real and
authentic loving act of kindness and an example of caritas in action.
Developing a Booklet for Patients & Families on
Cardiac/Stroke Unit

19. Inspired Contributor(s) :
 Wendy Gaus
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Service Area: Marin/Sonoma
Medical Center: SRO
Affiliation: Adult Services
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Year Shared: 2014
Venue: Caritas Consortium
Format: Podium
ID #: N/A
Keyword TAGs:
Identifier
 Consortium2014-June, Marin
Sonoma, Santa Rosa, Podium,
Poster, Patient Care Services,
Adult Services
 Education & Staff Dev, Hospital
Initiatives, Patients/Families
Descriptor
 Authentic Relationship,
Mentoring/Empowering Others,
Stroke, NKE/Handoff
Page 19
Developing a Booklet for Patients & Families on
Cardiac/Stroke Unit

20. Page 20
Developing a Booklet for Patients & Families on
Cardiac/Stroke Unit