NR 584 Week 4 Discussion: Client-Centered Care Initiatives

Grace J.
September 2, 2025September 2, 2025
CU MSN, NR-584

Student Name

Chamberlain University

NR-584: Quality and Safety for Advanced Nursing Practice

Prof. Name

Date

Client-Centered Care Initiative

Selected Initiative and Its Application

The client-centered care initiative chosen for this project is client and family engagement. In many emergency departments (EDs), patient satisfaction scores tend to be lower compared to other hospital units. A significant factor contributing to this issue is the limited time nurses can spend with patients, which often leads to poor communication and dissatisfaction with care.

To address this challenge, the department is adopting bedside shift reporting as a strategy to enhance client engagement. This process involves nurses conducting shift handovers at the patient’s bedside, directly involving patients and their families in discussions about care. By doing so, patients can share concerns, seek clarification, and actively participate in their treatment plan. This practice also improves transparency and fosters trust between healthcare providers and patients (O’Donnell et al., 2023).

According to Kaiser and Ashby (2024), bedside reporting allows for direct communication without distractions, reduces miscommunication, and ensures that both patients and families have a clear understanding of the care plan. In addition, it reassures patients about their safety, creates a sense of inclusion, and supports patient-centered outcomes.

Continuous Quality Improvement (CQI) Framework

Selected Framework: Plan-Do-Study-Act (PDSA)

The Plan-Do-Study-Act (PDSA) cycle is a well-recognized CQI framework that supports continuous testing and refinement of interventions. This model is particularly suitable for bedside shift reporting, as it allows the healthcare team to test the process on a small scale, evaluate results, and refine practices before hospital-wide adoption.

Application of PDSA Framework to Bedside Reporting

PDSA Step	Application to Bedside Reporting
Plan	Define the objective of improving patient satisfaction through bedside shift reports. Develop structured guidelines and create staff education sessions to support consistent implementation.
Do	Launch a pilot program across multiple shifts, ensuring both day and night staff participate. Provide real-time coaching and support during the trial period.
Study	Collect and review patient satisfaction data, staff feedback, and communication error rates. Compare these outcomes with baseline measures to determine effectiveness.
Act	If outcomes show improvement, standardize bedside reporting across the hospital. If gaps remain, refine strategies (e.g., more training, scripting, or family participation tools) and repeat the cycle.

Framework’s Impact on Client-Centered Care

The use of the PDSA framework enhances client-centered care by embedding an iterative evaluation process. It ensures that bedside reporting is not simply implemented but continuously improved based on measurable outcomes. This approach supports patient inclusion in decision-making, reinforces open communication, and strengthens family involvement in care.

Furthermore, it creates a culture of accountability and adaptability, as staff review patient experience data regularly and make necessary adjustments. Over time, this fosters a more transparent, safe, and empowering environment for patients in the emergency department.

Interprofessional Team Involvement in the CQI Process

Successful implementation of bedside shift reporting requires active participation from the entire interprofessional team. Nurses, physicians, patient care technicians, and administrative personnel each contribute to the initiative.

Strategies for Engaging Team Members

Education and Training: Staff should undergo training sessions, including role-play activities, to practice bedside reporting and effective communication techniques.
Use of Standardized Tools: Communication frameworks such as SBAR (Situation, Background, Assessment, Recommendation) help maintain clarity and consistency across staff.
Collaborative Feedback Mechanisms: Post-implementation debrief sessions encourage staff to share challenges and solutions, ensuring that all team members contribute to improvements.
Shared Accountability: Clear performance metrics and patient satisfaction goals hold all team members responsible for success, reinforcing the collective nature of quality care.

When interprofessional collaboration is prioritized, it integrates diverse perspectives, enhances problem-solving, and ensures that patient-centered strategies are effectively sustained.

Conclusion

The adoption of client/family engagement strategies, such as bedside shift reporting, represents a practical initiative for improving communication and patient satisfaction in emergency departments. By applying the PDSA cycle, healthcare teams can refine the process through continuous testing and feedback, ensuring interventions remain effective and sustainable.

The involvement of an interprofessional team further strengthens the initiative by combining skills, knowledge, and perspectives from multiple disciplines. Ultimately, CQI efforts such as this foster a culture of safety, transparency, and empowerment, aligning care delivery with the principles of client-centered care.

References

Kaiser, A., & Ashby, T. (2024). Bedside handoff and patient’s perception of the quality of their care. Oncology Nursing Forum, 51(2), 61C–61C.