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)