Hospital based medicine could be more effective when there is collaboration and open communication from sub specialties, nursing and discharge planning. To facilitate this effort the hospitalist group partnered with nursing leadership to establish a daily process in which the hospitalist, nursing and discharge planning migrated from a task orientated approach to a process that is an open discussion regarding the patient’s action plan for care.
To open communication between the hospitalist, nursing staff and discharge planning in order to make each patient’s plan of care a collaborative effort, and identify quick actions needed to keep established care plans moving forward.
“Quick Rounds” were developed as a result of a Kaizen event to assist with a geographical rounding pattern as a way to identify, discuss and plan the patients care. Our strategy was to expand the approach of patient care to make it consistent, concise and collaborative. We started June 5, 2011 with a pilot unit, Oncology. The process begins with the evening floor nursing staff updating the status of their patients to the day charge nurse. This sign out is expected to include, any changes in regard to status, results ordered and/or returned over night, current condition and where the patient is in their care plan from the previous day. At 7:15 AM each morning the charge nurse is joined on the unit by the hospitalist and discharge planning. The meeting’s goal is to discuss each patient on the hospitalist’s census. Each unit possesses a census of an average of 13 patients daily. At the beginning of each meeting, all real time patient concerns are problem solved in an SBAR (SituationBackgroundAssessmentRecommendation) format. After all real time concerns are addressed the remaining census is discussed. The following four items are prepared for this discussion: 1.Patient name, vital signs, and any issues of concern 2.The chart is on hand for review 3.There are order sheets and progress notes ready for use 4.When appropriate, the primary nurse is available for discussion of plan.
Our initiative has resulted in a decrease in length of stay, increase in nursing satisfaction and increase patient satisfaction. The below chart indicates specifics.
|Metric||Baseline (June, 2011)||Current Result (November, 2011)|
|Patient Satisfaction||9 formal grievances filed||1 formal grievance filed|
|Nursing Satisfaction; I agree that Physicians treat me with respect||75%||88%|
|ALOS on Oncology Unit||10.11||6.8|
To cite this abstract:Verhagen J, Cassidy R. Quick Rounds for Geographical Rounding. Abstract published at Hospital Medicine 2012, April 1-4, San Diego, Calif. Abstract 97737. Journal of Hospital Medicine. 2012; 7 (suppl 2). https://www.shmabstracts.com/abstract/quick-rounds-for-geographical-rounding/. Accessed September 17, 2019.