Enhancing Physician-Nurse Communication by Improving Attendance during Bedside Rounds

Objective/Aim: Enhance physician/nurse communication by improving nurse attendance to bedside rounds by 50% by the end of the academic year. Background: Communication between different health professionals is crucial to achieving high quality patient care. A review of literature revealed that effective communication led to: improved information flow, more effective interventions, improved patient safety, enhanced employee morale, increased patient and family satisfaction and decreased lengths of stay. As such, rounds are important to patient care, as different team members discuss and agree on a particular management plan, and it is the main venue to target for our project. Research has shown that Nurse-Physician rounding increased communication, and lessened the need to page doctors for questions. Which greatly improved workflow for both physician and nurses. Quality Improvement methods: We targeted patients on 5 south at The George Washington University, which is an Internal Medicine ward. First PDSA cycle was conducted between 1/27-2/5, excluding call days. Each day, the nurse distribution sheet was collected by a team member, which contained contact numbers for health care professionals for every patient on the floor. Every nurse was called before rounds and invited to join. In addition, if a nurse did not show up, a team member was left behind to provide updates, and this was called “Left behind briefing” which was used a balancing measure. Results: During the 10 day period, 5 day worth of data was collected, and the percentage of attendance (day) was 80 (1), 72 (2), 100 (6), 50 (7) and 100% (8). The rest of the 5 days, data were not collected. Number of “left behind briefing” (day) was 1 (1), 2 (2), 0 (6), 2 (7) and 0 (8). Conclusion: Calling nurses prior to rounds was an effective way to increase attendance for rounds, as all recording achieved target of 50%. Number of “left behind briefing” did not increase during that period. On half of the recorded days, no records were logged, as the process was not initiated by physician team. This was likely due to lack of reminders, which will be added to next PDSA cycle