External Service Providers (ESP) Reach-Out Project: How Can Nurses Assist With Improving Patients’ Social, Economic, and Physical Environments?

Abstract

This project aimed to improve Capital, Coast and Hutt Valley’s cardiology outpatient “nurses” confidence in connecting patients to community support services (Exercise, Food and Nutrition, Medications, Healthy Homes including Power and Gas, Mobility, Social Isolation and Transport) from 46% to 80% by October 2022. The plan-do-study-act (PDSA) cycle is a methodology for rapidly testing change. A baseline of the “nurses” confidence and identification of the types of services needed by patients was established. Follow-up focus group sessions were held with nurses at two hospitals, covering four geographical locations, within the district. The development of a driver diagram translated the high-level improvement goal and identified various causes to help organise the Change Ideas. Not all ideas could be undertaken in the 3-month timeframe. However, Change Idea One—“Help Directory”—was researched and created by the project manager, which is currently a 37-page resource, with seven categories of services, formatted by region (four) that includes links to service providers, referral forms, and printable handouts for patients. The resource was shared with the “nurses” and an incentivised quiz developed to encourage its review. A second anonymous survey was constructed, allowing for a PDSA cycle, to compare confidence levels after having access to the resource. Cardiology outpatient nurses’ level of confidence (quite confident to extremely confident) connecting patients to community support services increased from 46% to 100%. Since completion, the ESP Reach-Out Resource has proven useful to select nurses and, in turn, their patients. The next steps are to escalate to executives within the hospital to seek budget for the development of the resource, including a more environmentally friendly and dynamic resource that is preferably electronic. Once established, it will be promoted within Capital, Coast and Hutt Valley for internal users.