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Patient Experience Case Study - VA Connecticut Healthcare System
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Using Patient Education Simulation to Improve the Veteran Patient and Family Experience

What was the challenge, opportunity or issue faced?

A challenge facing VA Connecticut Healthcare System (VACHS) involved improving the educational experience for Veterans undergoing Coronary Bypass Graft Surgery (CABG). Patients receiving CABG surgeries have expressed anxieties in the post-operative period over a lack of understanding of post-operative care and expectations. This lack of understanding and increased anxieties may affect the patient experience and satisfaction scores. This gap presented an opportunity for VACHS to create an intervention focusing on Veteran knowledge, anxiety and satisfaction to improve the overall stay.

What did you do to address it?

To address Veteran and family apprehensions over CABG surgery and post-operative expectations it was decided to utilize a high-fidelity simulation experience as an educational tool. Simulation has been recognized as a successful educational method with interprofessional teams including the aviation, medicine, military and nursing professions for decades. New research has emerged incorporating advanced technology into patient education sessions that provide an advantage over usual teaching methods.

Veterans scheduled to receive CABG surgeries at VACT were asked to join the educational experience. They were then randomized into control-usual education and intervention- simulation groups. The usual education took place with the Cardiothoracic APRN in a face to face session. The simulation intervention education involved meeting with the Nurse researcher in a simulated ICU environment with a mannequin, ICU equipment, alarms, etc.

A pre-CABG Knowledge and levels of State (current) and Trait (historical) anxiety (Spielberger, 1968, 1977) were measured before either educational intervention. After the interventions both the control and intervention groups knowledge, State anxiety and overall, satisfaction of the educational methods was evaluated.

What were the outcomes?

Significant outcomes were recorded by Veterans participating in the simulation experience over the usual educational group. Veteran anxiety was greatly reduced in the simulation experience over the usual education group. There was an increase in Veteran knowledge within the simulation education group compared to the usual control education group. The simulation group reported greater satisfaction with their educational experience.

Family members who were present during the simulation also commented:

"Excellent way to anticipate what is going to happen, it minimizes shock, this was terrific.” –Wife

"Taking part in the simulation was very helpful in preparing for what to expect when my father comes out of surgery during recovery. It was educational!” –Son

About VA Connecticut Healthcare System (VACHS)

VA Connecticut Healthcare System is a member of the VA New England Healthcare System. VAHSC serves Veterans in Connecticut and southern New England. Our West Haven campus is a 120 bed tertiary care facility classified as a Clinical Referral Level 1A Facility. Our Newington campus is an ambulatory care center that provides primary and specialty care. VACHS also has six Community Based Outpatient Clinics. This innovative experience explored simulation as an educational method with Veterans undergoing CABG surgery at VACHS. In hopes of improving both understanding and patient responses to a specific healthcare plan, the findings suggest there is great potential for use of high-fidelity simulation as an educational tool for meeting patients’ individual needs and improving the patient experience.

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