Improving Patient Safety Through Daily Multidisciplinary Rounds

Abstract

To improve quality, satisfaction, safety, and communication by implementing multidisciplinary rounds (MDR) in a tertiary care NICU. Retrospective chart review. A 51 bed, open bay, level III NICU. Infants born from September 2014 to October 1, 2015 with an average daily census of 40. Electronic medical record abstraction, Professional Research Consultants, Inc. (PRC) family satisfaction scores, and Survey Monkey. Data suggest that our mean length of stay (LOS) for very low birthweight (VLBW) and all newborns born at less than 29 weeks gestation has decreased by as much as one day. Since beginning the MDR initiative, parent satisfaction scores have consistently trended upward in all areas: overall teamwork percentile rank increased from the 8th percentile to the 95th percentile; doctors involving parents in decision making percentile rank increased from the 37th percentile to the 100th percentile; overall quality of care percentile rank increased from the 69th percentile to the 85th percentile. Tactics utilized were staff meetings, staff and family newsletters, PRC data collection and dissemination, a staff kick-off party, and information in family areas. Barriers included staff resistance to shifting away from traditional bedside rounding and having many disciplines simultaneously present for a daily block of time. Pressure to instigate change came from senior leadership. Through the development and implementation of a comprehensive MDR quality initiative, parent and staff satisfaction scores are improving in the areas of communication, teamwork, efficiency, and quality. As a driver of LOS, discharge planning during MDR may be contributing to our decreasing LOS.