Pinpointing: one method of improving staff compliance with rehabilitation regimens

This project investigated the effects of a systematic pinpointing and feedback system upon staff follow-through with assignments on a rehabilitation inpatient service. The number and percentage of tasks were recorded over 8 weeks. An ABAB time series reversal design was used where the baseline phases occurred during weeks 1--2 and 5--6, and the intervention occurred during weeks 3--4 and 7--8. Intervention consisted of directing chart round interactions so that assignments were given to specific team members and a list of these tasks was distributed to the team. Results indicated that team performance was significantly affected during intervention weeks. Specifically, the percentage of pinpointing increased from 40% during baseline to an intervention average of 96%. Also, team compliance increased from baseline levels averaging 44% to a mean of 87% during the intervention. The effects of such inexpensive techniques on team effectiveness and the resultant cost benefits to patients in a rehabilitation setting are reviewed.