Enhancing Nursing Practice and the Patient Experience in the BMT Program Using the Principles of Patient– and Family-Centered Care

Background: On the inpatient BMT unit, team members recognized a rise in dissatisfaction amongst patients, families, and staff, an increase in nursing burnout, and turnover rates. It was hypothesized that some of these stressors were related to a traditional hierarchical, hospital-focused model of care delivery and provided an opportunity to advance the practice of Patient-and Family Centered-Care (PFCC) utilizing its core concepts of dignity and respect, information sharing, participation, and collaboration.

Intervention: The BMT Patient Experience Committee, an interdisciplinary committee consisting of physicians, nurses, case managers, social workers, directors, pastoral care, and patient/ family advisors was formed.  The purpose of the committee was to further advance the practice of PFCC through enhanced collaboration among the interdisciplinary team members, patients and families, a more in-depth understanding of patient/family needs, and the opportunity to be innovative in the delivery of BMT care.  In addition, all nursing staff received education on the PFCC model of care.

A PFCC Hospital Self-Assessment Inventory was completed and data from multiple sources was assessed.  From the initial assessment, key areas were identified and the following subcommittees were formed; Caregiver, End of Life, and Nursing/Staff Enhancement.    

Outcomes: The subcommittees completed several projects.  To enhance participation in care, caregiver guidelines were developed and mounted in each inpatient room and a caregiver guide is in development.  To promote dignity and respect, a comfort care order set was developed and an Advanced Care Planning initiative is in process.  Nurses completed an educational needs assessment and are receiving training based on areas identified.  Interventions to provide stress management strategies for nurses are in development.  Measurable outcomes were realized since the organization of the BMT Patient Experience Committee including patient satisfaction and nurse turnover rates.  The committee and workgroups continue to meet on an ongoing basis to maintain efforts and begin new initiatives.