Improving Patient Rounds (IPR): Medical College of Georgia/Georgia Health


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Principal investigator: Walter J. Moore, MD, Center for Patient- and Family-Centered Care

The IPR project will initiate patient- and family-centered- care rounds in adult medical and surgical rounds. Project will initially follow and measure improvement of one service team, practicing patient- and family-centered rounds, on the inpatient medicine unit, with attention to patient, family, staff and physician satisfaction; unit costs; resident and unit efficiency; and quality and safety. Educational effectiveness and team performance in PFCC rounds will also be evaluated through student/faculty culture survey (pre/post), written evaluations, student debriefing and videotaped session(s). Project results include identifying steps and strategies applicable to other adult-care units, and discovering and overcoming specific obstacles in PFCC rounds. Results will be developed into a blueprint for use in MCG units and other institutions.

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Improving Patient Rounds (IPR): Medical College of Georgia/Georgia Health

  1. 1. Improving Patient Rounds (IPR): Patient- and Family-Centered Care“Takes On” Academic Bedside Rounds at the Medical College of Georgia 4th International Conference PFCC Philadelphia, PA ~ August 18, 2009 MCG ~ MCGHealth Center for Patient- and Family-Centered Care Walter Moore, MD, Nettie Engels, Christine O’Meara, MA, MPH, Sol Guerrero, MD
  2. 2. Specific Aims: Quality Improvement Implement Bedside PFCC Rounds Adult care hospital - General Internal Medicine (5-W) Interdisciplinary Team - Red Team (attending, residents, interns, students), nurses, pharmacy, allied health staff Patient Advisor Observers Engage patients & families as partners In care, decision-making, discharge planning Disseminate PFCC Rounds Transform how we teach PFCC Impact graduate medical education • Professionalism, communication, interpersonal skills
  3. 3. Improving Patient RoundsOutcomes 16 Patients 67 PFCC Rounds encounters Timing and duration 2–30 minutes Upfront time investment More efficiency over time with same patient Benefits Patient/family Engaged; > Communication; > Satisfaction “Having PFCC Rounds is like taking a wall between the doctors and patient’s family away.” Benefits Nursing > Communication; > Exchange of information “Rounds with nurse helps with continuity of care.” “Keeps people informed, keeps nurse informed, make sure that we’re all on the same page as far as patient care.”
  4. 4. Improving Patient RoundsStrategic Elements & Infrastructure Contiguous Geographical Location Scheduled times (9:30 am – 11:30 am) Physicians onboard Nursing staff involved Leadership support Nursing Supervisor, Department Chair, Hospital Leadership Education & Training PFCC principles and practices
  5. 5. Improving Patient RoundsChallenges Patient Advisor Training Human Assurance Committee CITI; HIPAA Consent patients Coordinate nurses, doctors, allied health Dynamic group Make-up of team changes at Academic Medical Center (Attending, Residents, Interns, Students, Patient Advisors)
  6. 6. Improving Patient RoundsOvercoming Challenges Observer – Need more consistency with same patients PFCC Rounds standard of care – No consent Coordination – Set PFCC Rounds schedule to allow more interdisciplinary care team members to participate Dynamic group – Team building and development
  7. 7. Improving Patient RoundsObservation Checklist Patient Advisor Observer join care team Assess communications Debrief Care team self-assess Observer gives feedback to team Nurses Patient / Family Components: Demographics Domains – PFCC core concepts Behaviors – engage pt/family, listen actively, model
  8. 8. Improving Patient RoundsChecklistOBSERVATION ACTIVITY: Use Checklist while observing video Discussion View themed video segment Questions & Answers