Nobl provides all clients optional touchpoints with our support and services teams. Included are monthly phone calls, monthly or quarterly data review presentations, or “mini project” design conferences to build out new or customized features. As the CNO, I periodically join these meetings to learn from our team and client leaders. Earlier this month, I had the opportunity to join a monthly call with Lori McDougall, the Patient Experience Officer for Duke LifePoint’s Harris Regional and Swain County Hospitals in western North Carolina. As a follow-up to our conversation, Lori agreed to sit down with me to share more about her experience with the Nobl Rounding Platform.
Lori McDougall RN, BSN Patient Experience Officer Harris Regional Hospital/A Duke LifePoint Hospital Swain County Hospital/A Duke LifePoint Hospital
I guess you could call me an education “late Bloomer” since I explored several other careers before becoming a nurse in 2007. As a nurse in the step down unit of a busy trauma center at Loma Linda University Hospital I soon learned that I had a skill with challenging patients and de-escalating tough situations. Soon I was using my talent during leader rounding where I served as the Clinical Nurse Manager and ultimately on a total of four units. I use those rounds to “get ahead” of problems or issues before they escalated. I worked to find a “win-win” for our patients and for our staff. That skill has translated well into my role as the Patient Experience Officer. I was able to develop a relationship early on with my predecessor, telling people that I “wanted to be Janet when I grew up.” Her example and guidance were critical to my success and she left big shoes for me to fill when I assumed the role in October 2018.
We use Nobl to leader round, recently we started meeting our goal of rounding on 65% of all patients every day. We also perform patient experience rounds and at Swain Community we conduct pharmacy leader rounds. We also launched post-discharge phone calls about a month ago. Using Nobl eliminated the binders full of paper forms, while also enabling us to quickly communicate the issues to someone who can resolve concerns 24/7.
Being able to enter the compliments (praises) immediately to record and send compliments to staff easily right from the product has been a significant step in moving leaders along, and surprisingly, has had the added “side effect” of getting staff to read their email. They look forward to the verbatim comments from their patients.
Another great example of how we have utilized Nobl is for bedside shift report validation. I’m not here to audit that process at every shift change, but I can easily validate that process by asking the patient if bedside shift report was done. That is a key part of our “zero harm” goals. We frequently change our questions to match our current needs and that has never been a problem. Nobl staff never makes me feel like I am contacting them too much or asking for too much. That makes a big difference.
I was impressed with just how Nobl is comprehensive and “honestly, it is just so easy to use, it’s like playing a video game right on your phone.” The text is easy to read and works even better on the iPads we chose for use with the platform. I could see that we weren’t using it the fullest extent to help us not to work so hard.
Nobl exceeds my expectations! When I share a “what if” scenario, the Nobl team sets to work to make it happen. Any idea I have come up with, the Nobl team took it tens steps further than I thought. Honestly, there has never been a time when a go-live didn’t go as planned and often needed changes are completed in 24 – 48 hours. That is how we were able to get the discharge phone calls developed and launched.
Here’s one example, just last week I called back three patients with an easy resolution of their concerns before they even received their patient satisfaction survey to clear up misunderstandings. Because they see them in their rounds, the staff are asking about the questions and how they impact the CAHPS scores for patient safety and quality. It has really increased everyone’s knowledge about the whole process.
Nobl has been so helpful as we are trying to reach every corner of the hospital. For example, the ‘Dynamic Duo Award’ is presented every quarter to the clinical staff member and ancillary staff member who have received the most compliments. They get a t-shirt and big production. In the Emergency Department, we have the ‘hERo’ Program to recognize those who are complimented most for the work in that area. The ‘Blue Ribbon’ award goes to the team with the most praises and improvements in CAHP scores. Sometimes there is competition, which isn’t a bad thing since it drives excellence in patient safety and experience. Now because it is so meaningful when we read the statements from the patients. In fact, the surgery team received that award for the first time since they started using the post-discharge phone calls.
Absolutely! Staff can open a list of post-discharge questions that were customized to their process. That was a big deal in our Mommy-Baby units with the lactation consultants doing the calls. They are super stars, actually working to use the call backs to collect the statistics that the county wants. There was no way to collect it, and now this keeps a record and runs reports with patient identification. They have even figured out a way to create a concern category to notify the physicians when they see failure to thrive in an infant.
I provide a daily leadership email with all the rounding statistics from the previous day. I include screenshots of the users report and show the pie chart of users . This is shared with everyone so with that transparency all can see it all – who is completing rounds or not, and the comments next to the names. It builds goodwill. I also provide a weekly recap every Monday. Getting to the reports is such an easy download to Excel and then I can manage the data specifically for my needs. It really takes very little time.
Beyond the reports, I also use the trended data to develop process improvements too. For example, with the bedside shift report validations, I was also able to explain to the patients what is expected, even creating materials for patients to know our expectations around that process. From that report, we can accurately track our accountability and celebrate our staff when we reach 100%.
It has far exceeded my expectations. I feel supported and have the data I need to share with staff. Through that support our staff are all better able to understand what they are doing and why. When they can do that it improves patient care. Nobl provides that level of accountability to reach our “zero harm” expectations and it is in the best interest of our patients. Peers at other larger hospitals are doing rounds, but don’t have a way to pull it together like we do. Our CNO is onboard with that. We are excited to continue to work with Nobl to develop more ways to use the product to its fullest extent.