OBJECTIVES Hospitalized families often have poor knowledge of care team members, which can negatively impact communication. Local baseline data revealed that few families had knowledge of team members. Our primary aim was to increase the percentage of families able to identify a member of their team to 75% over 1 year and sustain use of our improvement tools over 6 months. METHODS We conducted a quality improvement initiative at a tertiary pediatric academic center. Plan-do-study-act cycles were used to implement and test 3 main interventions: (1) a “Meet the Team” form (MTTF), a visual handout outlining care team members; (2) verbal introductions at the start of patient- and family-centered rounds (PFCR); and (3) data sharing regarding family feedback about tool use. The outcome measure was the percentage of families successfully identifying team members. Process measures were the percentage of families who received the MTTF and the percentage of PFCR that included verbal introductions. Balancing measures included rounds length. RESULTS We conducted structured interviews of 141 families and observed 11 597 PFCR events. There was an increase in the percentage of families who could identify a team member from 10% to 84%. The percentage of PFCR events that included verbal introductions revealed special cause variation, increasing from 40% to 80%. Rounds length held steady at ∼11 minutes per patient. CONCLUSIONS Implementing paired interventions of MTTF distribution and verbal team introductions was associated with increased family knowledge of team members and no change in rounds length.
Objectives: The objectives of this study were to: (1) identify local barriers to nursing presence on patient- and family-centered rounds (PFCR); and (2) increase nursing attendance during PFCR. Methods: An electronic survey needs assessment was administered to nursing staff on a single acute medical care unit to identify local barriers to nursing presence on PFCR. Daily tracking of nursing presence on rounds was then performed over a 7-month period. During this time period, 2 Plan-Do-Study Act cycles were conducted. The first intervention was a workshop for nurses about PFCR. The second intervention was the development of a strategy to contact nurses by using a hands-free communication device so that nurses were notified when rounds were starting on their patients. To evaluate the impact of our interventions, a p-chart was generated for the outcome of average daily nursing attendance (%) on PFCR per week over the 7-month period. Results: Two barriers identified on the survey were: (1) nurses were uncertain if physicians valued their input during PFCR; and (2) nurses were unsure when the physician team would be conducting rounds on their patients. On the p-chart, the average percentage of nursing attendance before interventions was 47%. After the nursing workshop, no change in the mean nursing attendance on PFCR was noted. After initiation of the hands-free contact strategy, nursing attendance on PFCR rose to 80%. Conclusions: A nursing contact strategy using a hands-free device led to a sustained increase in nursing attendance during PFCR.