This month’s spotlight features Frances Reitz, CPHQ, performance improvement coordinator at this 292-bed, 1,100-employee community hospital in Columbus, GA.

o Problem

Patients requested advance directive counseling after hours when the advance directives team was gone and nurses were busy with other tasks. Reitz recalls why from personal inpatient experience: "During the day, I was going through the admitting and testing procedures. But in the evening and nighttime, it got quiet and I could lie there and think about my living will and medical power of attorney. That’s when I wanted to talk to somebody about my questions." Providers had trouble tracking status of patient discussions because stickers used to indicate completion got displaced.

o Solutions

For patients: (1) Closed-circuit television access to video, Your own path: Making and discussing health care choices [Care Source, Seattle, (800) 448-5213]. (2) Bedside consultation, any time, by one of 30 Right to Decide team members representing nursing and customer service (security personnel). Training: Two-hour session by pastoral services director. Content highlights: Ethical concerns, living will, and medical power of attorney explanations, Georgia’s advance directives laws.

For providers: (1) Immediate, accurate advance directive answers for patients and families. (2) One-sheet advance directive acknowledgment checklist per chart "makes the paper chase much easier," Reitz says.

o results

Early patient feedback indicates "they appreciate having somebody come and talk with them after regular office hours," Reitz notes. "Team members enjoy taking 20 minutes from their jobs to go that extra mile for patients."

o Keys to success

Employee enthusiasm. Reitz says, it’s another way to practice St. Francis’ motto, "patients first."

o Contact

Frances Reitz, St. Francis Hospital, P.O. Box 7000, Columbus, GA 31908. Telephone: (706) 596-4462. E-mail:

Share your QI project in a future QI/TQM issue: Contact Mary Kouri, editor. Telephone: (303) 771-8424. Fax: (303) 740-0520. E-mail: