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Implementing Patient-Centered Multidisciplinary Bedside Rounds

St. Bernard Parish Hospital (Chalmette, Louisiana)

CSI Summary

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CSI Presentation

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CSI Toolkit

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Added to Collection

Project Topic

Multi-disciplinary bedside rounds

Hospital Unit

Intensive Care Unit (ICU)

CSI Participants

Katie Baye, MSN, RN-BC, CRNI
Stacey Esque, ADN, RN
Darcy McCaskell, ADN, RN
Domonique Price, MSN, RN
Tiffany White, ADN, RN

Project Goals/Objectives

  1. Educate 100% of the nursing team on rounding roles
  2. Complete rounds on 100% of patients three days a week
  3. Implement daily goals rounding checklist
  4. Document daily goals in electronic health record
  5. Monitor adherence to the daily goals rounding checklist, process and outcomes measures
  6. Improve Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores in areas of communication and patient experience 5%

Project Outcomes

  1. Reduced ICU length of stay 0.6 days
  2. Reduced ventilator days 19 days
  3. Reduced adverse events – C. diff occurrence decreased from three events to one
  4. Improved the patient experience as demonstrated by HCAHPS scores
  5. These outcomes resulted in an estimated annual fiscal impact of $65,538.

Project Overview

Our eight-bed ICU is housed within a small, 40-bed community hospital. Hospitalists provide medical service to patients in the ICU, with an intensivist on site three times a week and available teleICU capabilities.

Prior to participating in the CSI Academy program, the unit had no structured multidisciplinary rounds. This resulted in missed opportunities for nursing collaboration, advocacy and patient and family involvement in care delivery. Recognizing that studies show adverse events are often due to lack of communication, our CSI team wanted to make a change in our unit.

We surveyed staff about communication related to the plan of care and rounding. Based on the survey results, the team decided to implement a structured and collaborative rounding process. We launched our multidisciplinary rounds project using a standardized daily goals rounding checklist for rounds with the intensivist on Mondays, Wednesdays and Fridays.

Our CSI team received positive feedback from patients and families, and we believed that communication did indeed improve. However, because we are such a small unit, we didn’t know if we would be able to show a real change in our unit data. When we compared year-over-year data, we that found that patient outcomes in several areas had improved as a result of our activities and process changes on daily inter-professional rounds. These improved outcomes include reduced length of stay, decreased ventilator days and decreased adverse events such as C. diff infections.

Permission to Reuse Materials
The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.

Disclaimer
The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.