Pilot Assesses Nurses’ Needs and Perceptions of Peer Feedback
By Rosemary O'Malley, MSN, MBA, RN
Executive Director, Strategic Practice Initiatives
Safety literature cites communication failures as the number one cause of sentinel events in health care. Evidence suggests that any opportunity to enhance respectful communication and collaboration among colleagues contributes to patient safety and healthy work environments. When staff nurses are asked to describe key features of a healthy work environment, the number one attribute identified is working with clinically-competent peers (source: AACN Standards for establishing and sustaining healthy work environments).
Peer feedback provides an opportunity to acknowledge the excellence in clinical care that happens every day and to enhance the professional development of colleagues for the purpose of improving quality and providing evidence-based care and optimal outcomes for patients and families.
To translate this evidence into practice at BWH, a pilot is underway on 10 patient care units to assess clinical nurses' needs and perceptions of peer feedback. There are three phases of the pilot:
- The first phase included a survey completed in April by clinical nurses on pilot units to assess their specific needs and perceptions of peer feedback.
- The second phase, currently underway, encompasses the educational component, which was developed and based on analysis of survey results. Education, which focuses both on providing and receiving feedback, includes didactic and simulation segments. The NICU and Tower 8CD and 12A participated in the educational program in June. In September and October, Shapiro 6 and 7 and Tower 8AB, 10BA and 16AB will participate. Peri-operative areas and Labor & Delivery are scheduled for January.
- The final phase is a survey three months after completion of the educational program to assess if there has been any change.
Clinical nurses who participated in the initial sessions noted that excellence happens every day in the clinical area and is often taken for granted. Excellence is expected, but perhaps not always acknowledged, and peer feedback is one way that nurses can acknowledge each other's contributions to providing extraordinary care and to a healthy care environment. Included in the ANA Code of Ethics for Nurses and in the AACN literature, peer feedback has been correlated with increased autonomy, accountability and a healthy work environment.
One BWH nurse's takeaway after the program was to try to offer one positive acknowledgement of a peer's clinical practice every day she works. Another commented that the value of peer feedback both individually and collectively as a team impacts the patient and family experience, and that this was seen more clearly after the program.
Look for additional updates in BWH Nurse as the pilot continues.