Being in a hospital can be scary. What will happen next? Who is looking after me? But good communication can turn the unknown into something manageable. At Mercy Hospital in Dunedin, New Zealand, communication has been designed into every step of the patient journey.

But good communication is more than how to talk to patients; it’s about how to listen. By paying attention to patient needs and feedback, Mercy has improved the patient experience and made life easier for its staff.

This commitment to listening has had a positive impact. In April 2024, Mercy Hospital’s Net Promoter Score (NPS) rose to 94, coinciding with a hospital-wide effort to streamline communication.

So how did they do it and how can you do the same? Niki Bujak (Associate Charge Nurse) and Angela Dewhirst (Quality Manager) from Mercy Hospital walked us through their patient journey to show us the changes they’ve made – from a smarter pre-admission to simple tools that reduce confusion and improve confidence, all the way to clearer, more effective medication communication at discharge.

For some patients, the nerves start long before they come through the hospital doors. Not knowing what to expect, who they’ll see, or how to prepare for surgery creates stress. That’s why Mercy Hospital focused on making its pre-admission process clearer and simpler.

Mercy improved their online pre-admission questionnaire to ensure incoming patients wouldn’t be overwhelmed by online notifications and phone calls.

“We wanted to make sure that our questions in pre-admission were logical and helped us get information relevant to their care,” says Niki. “We made the questions easy to understand and the back and forth of communication more natural.”

Listening to patient feedback has been valuable. “We’re tweaking things as we go and we’re still in the process,” says Niki, “in 2025, if there are any patients with missing information, we call them for feedback and say, ‘Hey, we see you didn't fill this out. Would anything have made that a bit different?’ just so we can get it as perfect as possible.”

Angela agrees, “The consumer is very much in the centre of all of this, and hearing their different stories and experiences has shaped this process.”

A refined online questionnaire has helped tailor the pre-admission process for patients. Before this change, every patient received a phone call before their procedure. A system that became overwhelming as new wards opened and patient numbers grew.

“We were calling every patient, which wasn’t sustainable. And some of the times you're going through all this stuff with somebody who’s wondering, ‘Why are you calling me?’” says Niki. “They've got no risk factors, so they don't want a call, it’s wasting their time.”

Now, thanks to a pre-admission process that identifies who needs additional support based on their medical background, only patients with specific risk factors or concerns are contacted before admission. “If risks are identified, we call. But if they have no risks and don’t want a call, we don’t call,” says Niki. “And if they have no risks and still want a call, we make sure they get it.”

This patient-driven approach ensures that those who want extra reassurance, get it, while those who prefer minimal contact aren’t burdened with unnecessary calls.

For patients, uncertainty can be one of the most stressful parts of preparing for surgery. Previously, Mercy Hospital staff only received patient details a few days before admission, meaning patients weren’t contacted until the last minute. With an improved system, the hospital gets patient information two weeks before surgery, giving staff the ability to reach out to help patients feel prepared and supported.

Patients receive the information they need earlier, reducing stress and confusion before their procedure. “They’re getting contacted earlier because we know about them earlier,” says Niki. “So, people aren't left in the dark until the last minute.”

Alongside improving the patient experience, this change has had unexpected benefits. “Having more time has meant that we've been able to make sure staffing is more accurate in advance.” With more time to plan and prepare, patients and staff benefit.

These new approaches shone through in Mercy Hospital’s Cemplicity scores. After implementation, their admission experience scores and Net Promoter Score (NPS) both improved, suggesting that a refined admission process has a positive effect on a patient’s overall experience and likelihood to recommend the hospital.

For Mercy Hospital, good communication doesn’t stop there, it carries on throughout a patient’s hospital stay. Once admitted to hospital, patients are met with a rush of new information while managing pain or anxiety.

To ensure patients and their families always have clear, accessible information at their fingertips, a simple but powerful tool is helping them keep track of their journey: a brightly coloured, laminated sheet that stays with them throughout. Patients get one upon arrival at the unit, where they have the option to go through it with a nurse or read it on their own and ask questions. It has clear information about what to expect on any given day of their admission, the day before surgery, the day of, and the days after.

“It’s a simple piece of paper, but it’s more than just a piece of paper,” says Angela. “It helps patients and families understand what’s going to happen on each day of their stay.”

For many, uncertainty about pain relief and monitoring can be a major source of anxiety. “Some patients are really anxious about being in pain or nauseous or wondering if someone will be checking on them,” says Niki. “So, the sheet includes information on when to expect pain relief and how regularly they’ll be checked on.”

The sheet acts as an anchor, giving patients and their families a reliable reference point.

“After surgery, we give the sheet back to the patient,” says Niki. “I tell them, ‘You remember this blue paper from downstairs.’ If they’re still groggy, I just let them hold onto it. Later, when they’re more alert, it becomes a discussion point. Family members who weren’t there during admission can also look at it and say, ‘Okay, this is what to expect for our loved one.’”

Patients don’t stop needing support once they leave the hospital. But Angela says that many patients understandably struggle to hold onto all the important details about medications, follow-up care, or what to expect after surgery.

“We did an experiment on the ward when nurses would chat to patients about their medication and they’d still remember crucial details a short time after, but a couple of days later when we checked again, they’d say ‘no, I’ve completely forgotten it all’ or ‘They didn’t tell me that’, even when the nurses had followed the protocol.”

To bridge this gap, Mercy Hospital focused on redesigning its discharge process to ensure patients leave the hospital feeling confident, informed, and supported in their recovery.

This focus has paid off and not just for patients. In their patient experience scores Mercy Hospital consistently ranks as a top performer for discharge experience across the Cemplicity community, showing that their efforts to improve discharge communication have had a measurable impact.

Rather than relying on patients to remember everything on their own, Mercy actively includes family members or support people in discharge conversations.

“So, we would say do you want us to wait for your wife, your partner, or if they’re already there, do you both want to be a part of this process?” explains Niki. “Even with kids, we involve them alongside their parents because it’s important that children can manage some things themselves.”

This shared approach makes sure key information is heard, understood, and remembered at home.

To make medication management easier for patients, Mercy Hospital introduced a structured, colour-coded medication guide, co-designed with non-clinical staff to make it easy to understand.

“It’s a four-sheet brochure, folded in half,” explains Niki, “Inside, there’s a sticker for each medication with the frequency clearly listed. So, for example, paracetamol every four to six hours, four times a day. There’s also a ‘last dose taken’ section, so if someone had Panadol at 6:00 AM, they mark ‘0600’ and can see when the next dose is due.”

Instead of overwhelming patients with fine-detail information, staff focus on key takeaways.

“We don’t go through everything with a fine-tooth comb, it’s too much to take in at once, so we highlight the most common side effects and the most important things to remember.”

To help their patients understand pain management at a glance, Mercy Hospital included an intuitive pain scale within the discharge booklet. By visually categorizing medications, patients can easily understand what they should take first and when to escalate to stronger pain relief.

“We used smiley faces to indicate levels of pain relief. Ibuprofen is at the top with a happy face, we want you to take that regularly. Midway down, we have medications like codeine and tramadol with slightly grumpy faces. And at the bottom, we’ve got the really sad face, which is where the strongest pain relief sits.”

Example of Mercy Hospital’s medication brochure template:

Mercy Hospital’s commitment to improvement is evident. The hospital is now turning its attention to supporting patients with disabilities by identifying potential barriers before they even step through the doors.

“What I'm aiming to do is a lot of work in the disability support space,” explains Angela “I want to identify before people arrive if they have a particular disability and see if I can walk alongside their journey to spot the barriers we’re unintentionally putting in their way.”

Sometimes, these barriers are small but significant, such as the size of the font on pamphlets and don’t require sweeping changes but simple alternatives that improve accessibility.

“It doesn’t necessarily mean we have to change everything for everyone,” says Angela “But having options for people, like someone with high support needs like autism, for example, can make a huge difference in how supported they feel throughout their care.”

To refine this process, the team is starting with clearer, more visible disabilities before expanding into more complex needs. “We don’t want to start with someone who has a challenging disability and get it wrong, we want to first master our process, then build from there.”

To ensure they are identifying and supporting these patients early, Mercy Hospital can lean into the hard work they have been putting into pre-admissions.

“Angela put out an email to several different people asking if they knew of patients who frequently come through,” says Niki “Then we realised pre-admissions already has this information. They know these patients and can help us reach them before their hospital stay even begins.”

By proactively identifying patients who need extra support, Mercy Hospital hopes to further personalise the patient journey, ensuring every patient feels seen and heard throughout their care.