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RAMPED-UP: The Development and Testing of an Interprofessional Collaboration Model
Kwame Asante Akuamoah-Boateng1, Clareen Wiencek, Jill H Esquivel
1Division of Acute Care Surgery, Department of Surgery, Virginia Commonwealth University, Richmond (Drs Akuamoah-Boateng, Torres, and Whelan); University of Virginia School of Nursing, Charlottesville (Drs Wiencek, Esquivel, and DeGennaro).
Abstract:
Interprofessional collaboration (IPC) is an essential component of care delivery needed to achieve optimal patient- and system-level outcomes. The purpose of this project was to measure the impact of a structured IPC model, RAMPED-UP, on hospital length of stay (LOS) in a surgical trauma population. The study design was a prospective cohort with a historical comparison group. The project was conducted at a Level 1 trauma center. The RAMPED-UP group constituted trauma patients admitted from October to December 2017 (n = 96). Trauma patients admitted from October to December 2016 constituted the pre-RAMPED-UP group (n = 98). The 2 groups were similar in demographics. Hospital LOS was not statistically significant between groups. Median RAMPED-UP LOS, defined as the number of days the patient received RAMPED-UP rounds, was 3 days. Patients in the RAMPED-UP group were more likely to be discharged home, with higher discharge-by-noon (DBN) rates of 18.2% (p = .005). A statistically significant correlation was found between incentive spirometry (I/S) values and hospital LOS and RAMPED-UP LOS in the RAMPED-UP group (95% CI: rs -0.301, p = .008; 95% CI: rs -0.270, p = .018, respectively). Although the RAMPED-UP model did not decrease hospital LOS, the model did significantly improve DBN and RAMPED-UP LOS. Further exploration of I/S values as a predictor of LOS is warranted. The use of a structured IPC model that includes essential members of the IPC team can aid in improving patient outcomes such as DBN.
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