Individualized Care Planning Process

Background:  At an NCI-designated Cancer Institution with 76 inpatient stem cell transplant (SCT) patients and a burgeoning staff, addressing continuity of care and patient satisfaction is an on-going opportunity for growth and innovation.  Press-Ganey patient satisfaction data revealed that patients wanted more consistency in care, improved communication, and increased involvement in their treatment plan. In response, a nurse-driven, patient-centered initiative examined the efficacy of creating individualized care plans, customized to each patient's unique needs, in collaboration with the patient and caregivers.

Purpose: To increase consistency of care, improve communication among nurses and patients, and raise patient satisfaction, a nurse-developed and driven Individualized Care Planning Process (ICPP) was developed.

Intervention: The ICPP engages nurse volunteers to be responsible for the development and tracking of individualized care plans in collaboration with patients who either self-identified or were identified by their clinical nurse as potentially benefitting from the ICPP.  Once identified, care plans are developed to address patient concerns, psychosocial factors, physical needs, daily routine, activity, nutrition, abnormal assessment findings, nursing interventions, discharge planning, short and long term goals. Copies of the care plan are given to the patient and placed with the nursing documentation to improve communication. Concurrently, monthly ICPP meetings are conducted with nurse ICPs to identify patients who need care plans, address challenges faced, and discuss literature that supports the need for providing patient-centered care.

Evaluation:  The ICPP initiative is evaluated through two sources, the first a five question quality improvement questionnaire utilizing Likert Scale responses to determine patient satisfaction with nurse communication, responsiveness, shared decision-making, and the individualized care plan.  In addition, Quarterly analysis includes comparing Press Ganey Patient Satisfaction scores pre and post ICP implementation and comparing ICP survey scores to Press Ganey scores.  Quality improvement data collected from June 1^st, 2012- December 31^st, 2012 will be presented to examine the efficacy of the ICPP on patient satisfaction scores.

Discussion:  The ICPP initiative is a creative, nurse-driven initiative to address patient satisfaction during prolonged admissions for SCT treatment and complications.  Preliminary quality improvement data demonstrates improvement in overall patient satisfaction scores across a 76-bed inpatient SCT service at an NCI-designated cancer center.  The ICPP process may prove beneficial and adoptable across SCT care settings in addressing and improving patient satisfaction.