In inpatient care, an exceptional family and patient experience are vital. The aim for an exceptional experience for both the family and patient is to provide care that is effective, safe, efficient, patient-centered, timely and equitable (Medicare.gov, 2019). In the provision of the care, there are two main drivers namely the primary drivers and the secondary drivers. There are five major primary drivers involved in exceptional patient and family inpatient experience that include, leadership that advocates for patient and family centred care, respectful partnerships and interactions with patients and their family, provision of reliable care, full engagement of the hearts and minds of the staff, and provision of evidence-based care by a competent, confident, and collaborative medical team.
The secondary drivers complement the primary drivers and include; those that complement leadership include words and actions that communicate and contribute to patient safety, decision making bodies (Stimpfel, Sloane, McHugh, & Aiken, 2016) . Other secondary drivers include improvement of care, sufficient staff, and resource mobilization. Staff and healthcare providers should be recruited according to values, merit as well as compassionate communication to complement the primary driver that is the full engagement of staff hearts and mind (Wick et al., 2015) . It is important to note that patients as well as the families are part of the care system and therefore and should be involved in what the patient chooses (Balik, Conway, Zipperer, & Watson, 2011). The care for the patient is customized according to their preferences and an interdisciplinary care plan instituted that focuses on patient education and effective communication.
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The physical environment is important in the healing of patients and therefore effective access to care without delays as well as the availability of staff to provide care is a vital secondary driver that supports respectful partnership (Wick et al., 2015) . Safe, coordinated care with open communication and apology as a secondary driver is helpful in achieving evidence-based care. Everyone in the patient care including the family and the patient should be provided with all the information they need (Balik, Conway, Zipperer, & Watson, 2011).
The IHI PFCC self-assessment tool is an improvement tool that was designed to help various organizations in assessing their improvement on the major aspects of improvement which include leadership for improvement, results, workforce, resources, data infrastructure and its management and improvement of competence and knowledge (Institute for Healthcare Improvement, 2019). Of interest is the improvement of competence of knowledge. To improve competence and knowledge, there ought to be comfort when working with all types of healthcare workers as well as family and the patient. Dealing with ambiguity is also a factor that improves competence. Innovation management, trust, integrity and motivation others works very effectively to improve staff knowledge and competence in the improvement of patient and family experience in the inpatient setup.
In a survey of patient experiences, the improvement of service aimed at increasing the feedback of the patients who report that the nurses sometimes communicated well is possible by several techniques (Wick et al., 2015) . Effective communication is by no doubt a vital component in good care. To improve nursing-patient communication, as a discharging RN, the patient ought to be put first. Patients should be made to understand why and how one is going to take care of them (Stimpfel, Sloane, McHugh, & Aiken, 2016) . They should be provided with comfort and respect. Apart from that, it is advisable to practice active listening from the patients to clearly get the content, intent and the general feeling of the one speaking. This also involves paying close attention to the non-verbal clues (Wick et al., 2015) . Lastly, frank and open communication helps show sincere intention as well as the acknowledgment of patients' attitudes and feelings. All of these are skills that a discharging RN, should be practiced by nurses to improve nurse-patient communication.
A comparison between the Massachusetts General Hospital and the New England General Hospital that are both acute care hospitals show that both have 5-star ratings (Medicare.gov, 2019). The New England General Hospital does not provide emergency services unlike the Massachusetts General Hospital but both are able to receive and track patient lab tests and results electronically as well as use inpatient and outpatient safe surgery checklists. Also, they both use the hospital survey on patient safety culture.
References
Balik, B., Conway, J., Zipperer, L., & Watson, J. (2011). Achieving an Exceptional Patient and Family Experience of Inpatient Hospital Care. IHI Innovation Series White Paper . Cambridge, Massachusetts: Institute for Healthcare Improvement. Retrieved from https://www.google.com/url?q=https://dyc.instructure.com/courses/19009/files/55228 3/download%3Fverifier%3DwIQKrJDg88nO7dXzPFk3AuaHH9XG3sw2d9RSBGpz %26amp%3Bwrap%3D1&ust=1554137040000000&usg=AFQjCNFNcdJXOfpHevV -ku3uOuzXiXQ74w&hl=en&source=gmail
Institute for Healthcare Improvement. (2019). Person- and Family-Centered Care . Retrieved from http://www.ihi.org/Topics/PFCC/Pages/Overview.aspx
Medicare.gov. (2019). Compare hospitals. Retrieved from https://www.medicare.gov/hospitalcompare/compare.html#cmprTab=0&cmprID=220 071%2C220088&cmprDist=2.9%2C3.9&dist=25&loc=BOSTON%2C%20MA&lat= 42.3584308&lng=-71.0597732
Medicare.gov. (2019). Measures and current data collection periods . Retrieved from https://www.medicare.gov/hospitalcompare/Data/Data-Updated.html#
Stimpfel, A. W., Sloane, D. M., McHugh, M. D., & Aiken, L. H. (2016). Hospitals known for nursing excellence associated with better hospital experience for patients. Health Services Research , 51 (3), 1120-1134.
Wick, E. C., Galante, D. J., Hobson, D. B., Benson, A. R., Lee, K. K., Berenholtz, S. M., ... & Wu, C. L. (2015). Organizational culture changes result in improvement in patient- centered outcomes: implementation of an integrated recovery pathway for surgical patients. Journal of the American College of Surgeons , 221 (3), 669-677.
