Enhancing Patient Experience in the Emergency Department Through Nurse Bundling Strategies and Servant Leadership Principles: A Quality Improvement Project.

Background: U.S. federal regulations have shifted health care systems to focus more on providing quality of care than quantity of care. Patient experiences that include nursing communication are important quality measures that have a positive impact on satisfaction ratings. Objective: This quality improvement project aimed to demonstrate that using nurse bundling strategies and employing servant leadership principles to influence nurses' caring behaviors toward patient care may improve patients' ratings on treatment with courtesy and respect. Methods: Registered nurses (RNs) in the emergency department (ED) were observed for 8 weeks in January 2020 using validated measurement tools and completed an electronic, 23-item Servant Leadership Questionnaire (SLQ) survey. Results: Bedside shift reporting observations were the lowest reported strategy. The Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) survey results did not improve from the previous quarter's data but increased and sustained in the three following quarters. The SLQ survey demonstrated statistically significant increases (p = .0191) from preintervention to postintervention. Conclusion: Though RNs were aware of servant leadership principles, further exploration is warranted to strengthen structures and processes related to nurse bundling strategies and the development of other ED-specific measurement tools and the patients' perception of courtesy and respect, an HCAHPS measure. Implications for Nursing: Expanding RN sample size, including other ED staff members, performing random leadership rounding, and using ED-specific measurement tool are nursing implications.