Welcome to the first in a series of interviews conducted by the AMSN Digital Content Committee (DCC) with session presenters from the 2024 AMSN Annual Convention. Blaine Jumper, MSN, RN, CMSRN, chair of the DCC, talks with Megan Kirchen, MSN, RN, NPD-BC, CMSRN, CLC, about her convention session, “Taking a Walk in Their Shoes: A Patient Experience Simulation for Medical-Surgical Nursing Teams.” The patient experience simulation focused on utilizing tools and tactics to manage patient care; identifying techniques used to build trust between the patient, family, and medical-surgical nursing team; and demonstrating effective communication techniques. Simulation learners were able to step into the experience of the patient and family member while practicing the simulation objectives in a safe learning environment. 

Blaine Jumper: How did you feel about the stakeholder support when you decided to do the project in your facility? Do you feel it was easy to get buy-in from them? How important was that for you [and your co-presenter Amy Capasso, MSN, RN]?

Megan Kirchen: We were fortunate with the buy-in that we received from our stakeholders. It was something that we knew we needed to work on in our organization, and so we had executive leadership buy-in right away. The managers, assistant managers, everyone who would help teach and facilitate the simulation knew we wanted the medical-surgical nursing teammates to walk in the patient's shoes. The simulation facilitators walked the walk and talked the talk for our nurses to be able to understand the importance of doing the simulations and how it was going to impact that overall experience.

Jumper: Do you feel that the support of the stakeholders, as far as having them there and being involved in the simulation, improved staff buy-in to do the activity and to complete it?

Kirchen: I think so. I think sometimes, as the educator, we ask our teammates to come down and learn from us. And they know us, they see us, but they work with their managers and leaders every day. The nursing teammates want to make sure the leaders have that understanding, too; that they're also getting that information. I think having the leaders in the actual simulation really opened our teammates’ eyes to say, OK, it's not just the nurses at the bedside. It's that experience from the second that the patient and family come in. It’s truly a whole team effort so everyone can be a part of it.

Jumper: What other processes do you have in place in your organization to ensure that some of those key tools and tactics are consistently being utilized by staff?

Kirchen: We do informal rounding and speak to our teammates, and just kind of see what tools and tactics they are continually using. We try to incorporate patient experience into any education that we're doing, asking, ‘How is it going to reach the patient?’ For any clinical skill we are educating nurses on, we will include the patient and family education portion. We focus on how we validate the understanding and what resources are available to ensure the patient and family understand and can be successful with a new medication or skill they will need to do upon discharge.

I think a lot of it is just incorporating those tools and tactics, not into that specific patient experience/education simulation, but in everything that we do; that is in the forefront. One of the other things we've talked a lot about recently is how we're going to incorporate health literacy. That's important in everything we do, every interaction with the patient. We’re focused on bringing it to everything we’re doing, that we’re putting out as patient education, and making sure patients and their families understand in their own diverse needs.

Jumper: One thing that stood out to me is that you mentioned that after you did your first round of simulations, you saw that increase in your scores, both for Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and in your National Research Corporation (NRC), but after you finished your simulation sessions, the scores trended back down a little bit. Do you have any new processes within your organization where you are onboarding staff with that, and are you seeing some more consistent scores now that you’re including that in your onboarding for new hires?

Kirchen: Yes, we are. We have the simulations within the first three to six months of onboarding as an essential level of learning. We’re getting the nursing teammates to complete these simulations right away because we want them to build those good habits right from the start. With new grads, we can help mold their experiences, but for experienced nurses, we want to make sure we're starting them off on the right foot to be able to provide that excellent patient experience that we expect at our organization. So, we have seen a lot of consistency with our scores with our sustainability plan.

Jumper: Is there any one tool that you have implemented within your organization that you think has had the most significant impact on those key drivers for nurse listening and feeling heard?

Kirchen: I don't think a lot of people knew it was a tool or tactic, but that ‘commit to sit’ with the patient, in conjunction with that validation of understanding and teach back. So, actually taking the time and giving the perception that ‘I have time to teach you this, and I also really, really want to make sure that you understand so you're successful.’ It's a challenge, right? Because nurses are so busy, and we're thinking ahead to the next thing, like we talked about in the presentation, of giving that perception of time. So just talking to the nurses, following up. They might say, ‘I didn't have time to sit, or maybe there wasn't access to a chair, or how could we implement that?’ So that's always one tactic they take away. Why wasn't I doing this before? It's nice for me, too, because I get to sit.

Jumper: I get to take a break and actually sit down for just a second. It almost feels taboo, like I shouldn't be sitting down, but to know that you can and you should, that's great. With the success of the implementation that you've had with your key audience being nursing and direct care staff, has your organization considered branching out on training for other direct patient care units? At the beginning of your program, you said it's the entire patient experience from start to finish, and so patients come in and interact with a multitude of different healthcare providers during the hospital stay. So, are you considering potentially branching out to other specialties within the organization?

Kirchen: We’ve talked about doing a simulation for providers. I know throughout our local organization or enterprise organization, it's a goal to get the providers in there. They're face-to-face with that patient in a limited amount of time, but the majority of the time, those experiences from the provider can make or break the patient’s stay and impact how they feel about the nurses and CNAs, too. We would like to have some of the interdisciplinary departments, dietary, transport, etc., have some sort of abbreviated version of simulation because, again, they can make or break the patient experience. You often hear, ‘I had this wonderful environmental services staff member make conversation with me every single day for a week.’ That's part of the patient experience. While it wasn't clinical, we know how much of an impact they make, too. So, it’s important for them to have great tools and tactics as well. That's what I would love to see in the future.

Jumper: Could you also speak about the feedback you received at the AMSN Annual Convention on your presentation?

Kirchen: It was amazing to get feedback right after the presentation. There's one experience that really stood out to me. It was a woman who said she was not a healthcare provider. She was a guest of her daughter, who’s a nurse, and she came up and she cried. She said she had recently been a patient, and hearing all that healthcare providers are doing for the patient's perspective was really moving to her. It's just very moving to know this is something that's going to make a direct impact on the patient. I think that was the best feedback, and that the person wasn't a healthcare provider was awesome. I mean, that's what it's all about.

Jumper: Is there anything else you want our readers to know about your initiative?

Kirchen: I think it's important for our teammates, all medical-surgical nurses, to know that actions, big or small, can make a major impact on the experience of the patient and their families. Whether it's doing something clinical or just taking the time to sit and listen, that could make a huge difference in their stay, whether at the hospital or beyond. So, it's important to make sure patients are always at the center of what we're doing.