6. MEET THE TEAM: PAIRING VERBAL INTRODUCTIONS AND VISUAL HANDOUTS TO IMPROVE FAMILY KNOWLEDGE OF THEIR CARE TEAM

Abstract

Background Hospitalized families often have poor knowledge of care team members which can negatively impact communication. Our institution lacked a standard process to introduce the multilevel learner team to families. Baseline data showed few families had knowledge of team members. We sought to create a standardized approach to introductions during patient and family centered rounds (PFCR) to improve family knowledge of their team. Aim Statement Increase the percent of families interviewed through our rounds coach program with knowledge of their team members to 75% over one year Interventions We conducted a quality improvement (QI) project with multiple plan-do-study-act cycles. We created a “Meet the Team” form (MTTF) outlining team member names, photos, and role explanations for the team (nurses, students, residents, fellows, faculty), b) process mapped and refined the steps of MTTF distribution, c) assessed family preferences for frequency and type of introductions via structured interviews by a trained rounds coach d) implemented a series of interventions to sustain the process including fostering introduction use culture change and data tracking/sharing. Measures The outcome measure was the percent of families interviewed by a rounds coach successfully identifying a team member. The process measure was the percent of PFCR that included introductions. The balancing measure was rounds length. We used statistical process control charts to track the impact of interventions. Results Focused interviews of 141 parents revealed 73% preferred verbal introductions on the first day of PRCR and if new members joined the team; 100% preferred paper over electronic MTTF. For the outcome measure, there was an increase in the percent of families who could identify team members from 10% to 78%. The process measure of the rate of PFCR that included introductions showed special cause variation, increasing from 40% to 80% of PFCR events (Figure 1). The balancing measure of rounds length held steady at ∼11 minutes/patient. Conclusions and Next Steps We performed a successful QI project that substantially increased the frequency of team introductions and increased family knowledge of team members with no change in rounds length. Next steps include evaluating the impact of increased team member knowledge on areas of family experience and understanding of care plans.