Article Text
Abstract
The Nightingale Northwest (NNW) is a UK temporary field hospital set up to provide extra capacity during the COVID-19 pandemic. Policies and standard operating procedures were undeveloped. Visitors were permitted only in exceptional circumstances, resulting in heightened anxiety for patients, and their family/carers.
Recognising the crucial importance of effective communication at this time, we led a quality improvement project aiming to improve telephone communication between the medical team and next of kin (NOK).
NOK satisfaction with communication received from doctors (rating 1–5, plus qualitative feedback) was the primary outcome measure and was surveyed through standardised phone-calls.
We identified a wide, four point (1–5) variability in satisfaction. Less satisfied NOK predominantly reported reduced frequency of medical communication.
We used PDSA methodology and introduced three interventions: 1) ‘Gold standard’ for frequency of routine medical updates; 2) Record date of most recent NOK update on the doctors’ list; 3) Disseminate a light-hearted informative video of the ‘gold standard’ to increase awareness and motivation.
Early post-intervention data showed reduced variability in satisfaction, with levels consistently reported as 4 or 5 towards the end of data collection. Process measures demonstrated excellent uptake of interventions with 81.3% adherence to the ‘gold standard’ and 95.7% compliance to accurately updating the doctors’ list.
Early data indicates a promising tool for improving doctor-NOK communication primarily by prompting doctors to update NOK more regularly.
Our timeline was very limited but the excellent uptake of interventions suggests a potential for sustainable improvement. The lack of defined protocols and openness to rapid change at the NNW encouraged us as junior doctors to take the initiative and lead quality improvement work.