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Increasing Nurse-Physician Family-Centered Rounds Communication: A Quality Improvement Pilot Project
John T Kulesa1, Jordan N Tyris, Keira McQuiston-Lane
1Division of Hospital Medicine (Drs Kulesa Tyris, Herstek, and Rush) and Department of Pediatrics (Ms McQuiston-Lane), Children's National Hospital, Washington, District of Columbia.
Background:
High-quality nurse-physician communication during family-centered rounds (FCRs) can increase patient safety.
Local Problem:
In our hospital, interdisciplinary team members perceived that nurse-physician communication during FCRs declined during the COVID-19 pandemic.
Methods:
Using quality improvement methodology, we measured nurses' perceived awareness of components of the shared mental model, nurses' attendance during FCRs, compliance with completing FCR summaries, and average time spent per FCR encounter.
Interventions:
A structured resident huddle took place prior to an FCR. Residents used a tool to send individualized alerts to bedside nurses to prepare them for an FCR. Residents developed comprehensive summaries after each FCR encounter and sent a summary text to nurses who were unable to attend the FCR.
Results:
We assessed 40 FCRs over 16 weeks. Nurses' perceived awareness increased from 70% to 87%. Nurse attendance increased from 53% to 75%.
Conclusions:
We successfully piloted multiple interventions to improve nurse perceived awareness after an FCR.
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