Redesigning Intensive Care Unit Rounds to Improve Collaboration at a Military Hospital.

Area of Science:

• Healthcare communication
• Intensive care unit (ICU) protocols
• Interdisciplinary teamwork

Background:

• Effective team communication is vital for safe healthcare delivery in ICUs.
• Nurses in an adult ICU reported inconsistent presence during daily rounds and opportunities to improve communication.
• A clinical question was formulated to assess the impact of a standardized rounding script on interdisciplinary communication.

Purpose of the Study:

• To evaluate the effectiveness of a standardized daily rounding script in improving interdisciplinary communication among critical care staff.
• To compare the impact of a standardized script versus current practices on communication over a 36-week period.

Main Methods:

• A 36-week intervention introducing an interdisciplinary rounding script in two adult ICUs at a military hospital.
• The Collaboration and Satisfaction About Care Decisions survey assessed nurses' perceptions of collaboration pre- and post-intervention.
• Rounds were observed to evaluate key communication elements and adherence to the ABCDEF bundle.

Main Results:

• The mean survey score for collaboration increased by 1.5 units post-implementation.
• Nurse presence at rounds increased by 21.6% (P = .01) and contributions by 31.1% (P = .001).
• Review of ABCDEF bundle elements increased by 18.9% (P = .07), care summaries were given 53.6% more often (P < .001), and order read-backs increased by 69.8% (P < .001).

Conclusions:

• Implementing a standardized daily rounding script significantly enhances interdisciplinary communication in the ICU.
• The script improved nurse engagement, adherence to evidence-based practices (ABCDEF bundle), and critical communication steps like care summaries and order read-backs.
• Sustaining the script's use requires adaptation to practice changes and ongoing staff training.