Developing collaborative practice models is emerging as a core strategy in creating an ideal patient safety climate, improving patient care outcomes, and increasing patient satisfaction. However structuring a workflow for team members that allows for open and timely patientcentered dialogue is often more an art than a science. Furthermore, although there are various means to measure the effectiveness of teamwork building initiatives in healthcare, few of these are formally validated. Within this background we decided to pursue the development of a multidisciplinary care rounding model for our institution.
To develop and pilot multidisciplinary care rounds on a general medical ward and measure the impact on the safety environment, work culture, and provider satisfaction. Also to measure impact on patient satisfaction, length of stay (LOS), and readmission rates.
We developed a clinical leadership team consisting of a senior leaders from from key hospital departments to reorganize our current infrastructure to allow the incorporation of a multidisciplinary patientcentered plan of care rounds (PPCR). A project timeline was developed which included the different phases of implementation. The pilot phase of the project was on a single general medicine unit which allowed a detailed evaluation and evolution of process, identifying successes and barriers. The multidisciplinary care team included: hospitalist, nurse, case manager, and pharmacist. Disciplinespecific responsibility checklists were created by consensus to ensure a structured mechanism for daily communications, and addressing relevant patient safety and care issues. Diagnosisbased geographic distribution of patients to specific units was ensured via coordination with our operations administrator. Electronic scheduling identified physicians leading PPCR daily and nurse rounding maps identified nurses’ patients to be reviewed chronologically. Various clinical rounding methods were trialed to determine a method that facilitated workflow. Preliminary outcomes were measured utilizing nationally recognized surveys, and unitspecific data was gathered on patient satisfaction, LOS, and readmit rates. Initial data revealed the following: (1) Significant improvement in nursing perception of working relationship with physicians. (2) Significant decrease in the amount of job stress felt by nursing. (3) Overall improvement in patient satisfaction scores. (4) Downward trend in LOS and readmission rates.
The implementation of a teambased care model that centers around multidisciplinary rounds can improve physiciannursing collaboration. The process can also impact patient satisfaction, LOS, and readmission rates. Interestingly, the implementation of a teambased process is itself a journey unto itself that can also give valuable insight into local organizational needs.
To cite this abstract:Manzon A, Boyte D, Verma L. Patient Plan of Care Rounds: Success of Teambased Inpatient Rounding. Abstract published at Hospital Medicine 2012, April 1-4, San Diego, Calif. Abstract 97738. Journal of Hospital Medicine. 2012; 7 (suppl 2). https://www.shmabstracts.com/abstract/patient-plan-of-care-rounds-success-of-teambased-inpatient-rounding/. Accessed March 28, 2020.