The Science Journal of the American Association for Respiratory Care

2006 OPEN FORUM Abstracts

CHANGING ROUNDS TO IMPROVE COMMUNICATION AMONG CAREGIVERS WHILE ON PHYSICIAN ROUNDS IN A NEONATAL INTENSIVE CARE UNIT (NICU)

Betty L. Blake B.S., RRT, NPS, Stacey Mann B.S., RRT, Anne-Lise Yohay, MD,  Susan Aucott, MD.  The Johns Hopkins Hospital, Baltimore, Maryland.

Introduction:  The Joint Commission of Accreditation of Hospitals has released the Critical Access Hospital and Hospital National Patient Safety Goals for 2006. Goal two is to improve the effectiveness of communication among caregivers.  The new approach to physician rounds in the NICU was developed and evaluated as the QuEST (Quality, Efficient, and Safe Teamwork) Study. The rounding system had specific goals; enhance communication among team members,   improve accuracy in the transfer of information, expand nursing, respiratory therapist (RT), and resident educational experience, increase collaboration among team members, and improve efficiency of rounds.  The goal of the study is to enhance communication and satisfaction of health care providers.

Results:  The new rounding system went into effect the first week of February 2006.  The team consisted of the bedside nurse, RT, pediatric resident, neonatal fellow, attending physician, and nutritionist.  Each team member had a specific part of the patient's care plan to present during rounds.  The RT presented the patient's respiratory status, mode of therapy, blood gases and any concerns about their patients.  The RT's were given a survey during the first weeks of the study and at the end of the study to obtain their perception of the new rounding system.  Seventy one percent of the RT's felt that they had a better perception of the patient's care plan during the study than prior to the study.  Fifty seven percent of the RT felt that the role of the RT had improved since the inception of the new rounding system (see chart below).

2 weeks into the QuEST Study                                         Week ending the QuEST Study

Do you have a (___)sense of your patient's care plan Better Worse Same 100% Do you have a (___)sense of your patient's care plan Better 71% Worse Same 29%
Has the role of the Respiratory Therapist in the patient care plan Improved 17% Stayed the same 83% Declined Has the role of the Respiratory Therapist in the patient care plan Improved 57% Stayed the same 43% Declined

Discussion:  Introduction of an explicit approach to clinical and educational responsibilities and to reporting assessments and plans during bedside rounds in a tertiary care intensive care unit improves communication and satisfaction of health care providers. The RT's felt that having nurses and RT's on rounds together allowed the team to have a better concept of the patient's care plan.  The RT's also felt that the time spent rounding did improve the role of RT in the NICU setting. 

Conclusion:  Developing a specific role for the participation of the RT on rounds resulted in an improvement in the RT's perception of communication, and improved role satisfaction despite the increased time commitment required for participation on rounds.


The only thing I would suggest is looking for some replacement word for "improve" (i.e. advance, increase, better)

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