Improvingpatientsatisfactionandreducingreadmissionrateswith
interprofessionalroundsCindyAtkinsonRN,MSN,CNL,DNPstudent;LindaHulton,PhD.,RN;MargaretBagnardi,EdD,MSN,RN,CCRN,
CNLJamesMadisonUniversitySchoolofNursing
• Datawasgatheredpre-implementation(priortoJan2,2018),at3months,and6monthspostimplementationdatainprocess.
• Retrospectivechartreviewwasdone.• PostdatafromthepatientsatisfactionsurveyprovidedbyNationalResearchCorporation,willbecomparedandanalyzedwithpre-data.
• The30-dayreadmissionratedataforMedicarepatientsobtainedfromHealthQualityInnovators.
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Background Intervention
MethodConclusion
PreliminaryResults
• A255-bednonprofit,communityhospitalinamid-AtlanticState.
• TheCenterforMedicareandMedicaidServiceshasputastrongemphasisondecreasingreadmissionratesandsubsequentwithholdingofreimbursementforhospitals(Zakzesky,etal.,2015).
• Thecommunityhospitalhadconcernsregardinglackofreimbursementbasedonreadmissions,decreasedsafety,patientsatisfaction,andincreaseinhospitalcost(Burns,K.,2011).
• Lackofinterprofessionalcommunicationdelaysapatient’s
discharge,tiesupavailablebeds,reducesavailabilitytoacceptadmissionsandtransfers,promotesreadmissions,anddecreasedpatientsatisfaction(Burns,K.,2011).
• Implementinterprofessionalcollaborationroundsona55-bed
telemetryunitandevaluatetheoutcomesonpatientsatisfactionandreadmissionrate.
• Increasepatientsatisfactionscoresby2.5%andreducereadmissionratesby10%withimplementations.
Pre-dataDecember2017-ReadmissionratesonPCUwereat17%andat3months17.67%• December2017patientsatisfactionwithdischargefromPCUwas61.9%andat3months70%
• Awaitingfor6monthpostdata.
MeasuresFigure 1. Interprofessional Rounds Timeline
IHIqualityimprovementmodel–Plan-Do-Study-ActThreequestionswillbeaddressedintheintervention.• Whatarewetryingtoaccomplish?• Howwillweknowthatachangeisanimprovement?• Whatchangecanwemakethatwillresultinimprovement
(InstituteforHealthcareImprovement,2018?PDSAisarapid-cyclequalityimprovementmethodthatidentifies,implementsandmeasurechangestoimproveaprocessorsystem(InstituteforHealthcareImprovement,2018).
ProjectTimeline
• InterprofessionalRoundsareheldMonday-Fridayat11amattheNurses’StationonPCU.
• RoundsareCaseManagementled• RoundsareattendedbytheHospitalists,CaseManagers,Pharmacy,andtheChargeNurseofPCU
• Everypatientadmittedunderahospitalistcarearediscussedinrounds,dischargeplansandneedsarediscussed.
• GoallengthofInterprofessionalRoundsis20minutes
0102030405060708090
Jun-17
Aug-17
Oct-17
Dec-17
Feb-18
Apr-18
Jun-18
PatientSatisfactionScores
Readmissionrates
Purpose/Aim
Problem
PDSA1:Initialplanningstages.GoLivewith1DoctorMay-Oct2017
PDSA2:Redesignofdocumentationtemplate
Oct-Dec2017
PDSA3:ChangelocationofIRtoNurse'sstationDec
2017-Jan2018
PDSA4:Stoppedusingdocumentationtemplate,casemanagerdocumentsandflowstonursingstatus
boardJan-Feb2018
PDSA5:Setgoaltimelimitto30min.,stoppedgivingDoctors"headsup"pageFeb-April/May2018
PDSA6:removalofsettimesforDoctors,encouragenurseparticipation,doctorstogivequick2sentence
summaryApril/May2018-present
ImplicationsMethods
• Datacollectionstillinprocess.• Interprofessionalcommunicationand
collaborationbringstogetherseveraldisciplinestoroundoneachpatient.
• Promotesaclearplanofdischargefromthetimeofadmission.
• Furtherresearchandpilotstudiesareneededtoanalyzepromotionofpositivepatientoutcomesforfuturemodelsofcare.
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