Increasing nursing participation in morning rounds for hospitalized patients at GWUH

Objective/Aim Improve communication of the plan of care to all team members, particularly the patient’s bedside nurse, by increasing nursing staff participation in bedside rounds to 75% by January 2017. Background Internal medicine patients hospitalized at George Washington University Hospital have multiple medical conditions that necessitate complex plans of care. The discussion of the plan of care occurs during morning rounds. In a previous study, we found that calling the nurse was effective at raising the number of nurses notified to greater than 50%. This study attempts to achieve a higher percentage of nurse participation in bedside rounds by leveraging a continuous quality improvement methodology. Quality Improvement Methods PDSA cycles were conducted on the Internal Medicine Green Team on non-call days. Day one was observational. The first PDSA cycle was to call the nurse from the number written on the white board in each patient’s room. The second PDSA cycle was to assign the medical students to collect the nurse’s number for each of their patients prior to rounds. The third PDSA cycle was to collect the distribution sheet listing the nurse’s numbers for the unit. Results During the day of observation prior to starting a PDSA cycle, only 36% of nurses aware of rounds with only 27% present at rounds. The first PDSA cycle using the phone number on the patient white board resulted in 100% of nurses notified of rounds on their patients with 66% present at rounds. The second PDSA cycle using medical students to collect phone numbers resulted in 75% of nurses aware and present at rounds. The third PDSA cycle using the nurse’s distribution paper resulted in 100% of nurses notified and 66% present at rounds. Discussion Our goal was to increase attendance to 75% through PDSA cycles that changed the way that nurse phone numbers were acquired by our team. We found that the most effective method of contacting nurses was whenever the phone numbers were available in advance, which gave the medical team more time to place the call and gave the nurses more time to plan to attend rounds. They are not currently available through the electronic medical record at George Washington University Hospital. Future PDSA cycles will focus on the time involved in each method of notification