The volunteer department at Sentara Norfolk General Hospital had been growing its program through greeters, walkers, and information desk, and with the ongoing focus of customer service and patient satisfaction, the Customer Service and Volunteer department teamed up to see how volunteers could directly impact the patient experience.
The Volunteer Coordinator met with leaders from the different nursing units to gather input as to what patient-centric activities a volunteer could do for them. After collecting the information and combining her own goals for the volunteers, a new Volunteer program called “PALS” or Patient Advocate Liaison Volunteers was formed.
The purpose of the “PAL” is to listen to patients/caregivers, families, and visitors in a caring, sensitive manor. The PAL should be responsive and understanding to any information shared. The PAL assists in resolving concerns by reporting and documenting appropriately. The “PAL” is given a unit or area of the hospital to round on and visit patients in their rooms. A script of questions or inquiries is provided so that they have some standardized guidelines.
First, the duties and description of what is expected in this special volunteer role needed to be outlined.
We decided that individuals need to be interviewed for a skill set different than the typical volunteer roles that already existed. Some of the requirements that an individual needed to be able to do were things such as maintain strict confidentiality, demonstrate excellent communication skills, ability to stay calm and focused, display compassion and interest in patients/caregivers and their families and have critical thinking skills. Once those individuals were identified, they attended a three hour workshop that reviewed all the requirements of the role, examples of how to round, questions to ask and how to document and report data and feedback. The volunteer is empowered to update the whiteboard with patient preferences and questions.
The PAL volunteers were taught the importance of proactive customer service and educated to make sure the patient has all their needs within reach (remote, water, etc.) as well as addressing the patients’ needs without the patient vocalizing them. The PAL volunteer was provided examples, such as recommending a pet therapy visit if the patient expressed missing their pet at home or informing the patient of the chaplaincy and patient advocacy services offered in the hospital. If the “PAL” uncovered a need that they could take care of, they noted on their rounding log and would handle it, such as obtaining an extra blanket, getting a magazine or turning on their TV. If the “PAL” uncovered something that wasn’t in their area of responsibility such as pain control, the “PAL” had a process of recording this on their rounding log and communicating to the staff on the unit and where appropriate, escalating to the hospital Patient Advocate for follow up.
PAL volunteers visited 920 patients between August-December 2014.
The four categories of concerns or areas that the PALS helped the patients with were divided into communication, facility, patient comfort, and attitudes.
Stats on the 920 patients rounded on were: 123 instances of help needed or 13% of total rounded on.
45 were patient comfort or 37% of the 123 instances
36 were communication or 29% of the 123 instances
23 were facility or 19% of the 123 instances
19 were attitudes or 15% of the 123 instances
The data shows that the PAL volunteers had an impact addressing a concern before it could possibly turn into a dissatisfier. The data has been very helpful for coaching of staff and sharing with unit managers. Patient comfort was the top need addressed by PAL volunteers in 2014. These needs included providing patients with items when they were bored, providing patients with blankets, ice, water, and addressing concerns about food.
The PAL volunteers receive a lot of satisfaction knowing that they are helping the patients while supporting the staff. The data showed that the PAL volunteers provide a crucial service to our patients and families. Additionally, it showed the importance of holistic care of the patient. The fact that 37% of patient needs addressed by PALs were regarding patient comfort reminds us that comfort is very important to our patients. Staff should be reminded to not only address the clinical needs of the patient, because our patients are telling us their comfort is important. Communication was not far behind patient comfort.
PAL volunteers escalated questions about updates of plan of care by informing the appropriate staff and updating the patients’ whiteboard. This information was not only shared with the unit leaders but also with the hospital leaders at the quarterly quality improvement meeting in first quarter of 2015. The next steps currently underway are the unit managers creating action plans to address these areas of concerns and how they can help their teams address these issues on the unit immediately.
How could this program be replicated?
Any hospital that has a current volunteer program could recruit, train and implement this program. It takes a dedicated Volunteer Coordinator who has the ability to meet with the unit leaders to get input from them as well as support for the program. The PALS need a contact to which they can give their information to and know who to contact in case they run into a concern they can’t handle themselves. We would happily share our PowerPoint training and presentation information with any hospital that is interested in this program
Sentara Norfolk General Hospital