Purpose: The goal of the performance improvement project was to improve the patient experience and communication during bedside handoff report in a medical-surgical unit at a Magnet hospital in the Southeast United States.

Relevance: Addressing patient’s questions and concerns is fundamental for patient-centered approach. Moreover, patients need time to voice their concerns and needs. Nurses in the Unit Practice Council (UPC) noticed a decrease in patient satisfaction scores that correlated with communication with nurses.

Implementation: Starting September 2018 the UPC implemented the C.A.R.E. (Courtesy, Attitude, Respect, and Enthusiasm) Initiative by performing “face-to-face first impression”, which is completed when the patient arrives to the unit. The patient’s nurse and clinical partner introduce themselves and spend five minutes with the patient and their love ones without any equipment in the room. The next step is to complete the “wish list” on the white board as discussed by everyone. The goal is to have three attainable wishes (ex: pain control, promptness in responding to the call light, basic comfort measures). The “wish list” is revised daily by any person on the care team or rounding on the patient.

Evaluation: The necessity to improve patient satisfaction scores by focusing on courtesy, respect, promptness and keeping the patient informed was recognized in both the unit Press-Ganey and HCAHPS scores relating to communication. Since implementation of the CARE Initiative, our Press Ganey scores have increased to 92.7% - 96% from 89%-92%.

Implications for Practice: The focus on the patients and their families is “we listen to your concerns or complaints; we want to help you, and provide excellent care.” Finding innovative ways to improve communication with patients and their families is key to providing a successful patient and family experience. The CARE Initiative has continued to bridge communication between nurses, patients, and family members and has proven to be an innovative strategy that has improved patient satisfaction scores.

Publication Date


Presented At:

14th Annual BHSF Research Conference

Content Type


Open Access

Available to all.