School of Medicine and Health Sciences Poster Presentations
Utility of Trio Rounds and Barriers to Their Implementation
Document Type
Poster
Abstract Category
Quality Improvement
Keywords
QI, Trio Rounds
Publication Date
Spring 5-1-2019
Abstract
Background: "Trio" rounding between physicians, nurses, and patients, has been shown to improve communication among healthcare team members, improve patient safety, decrease costs, improve length of stay, and improve patient satisfaction. These factors combined have the potential for a dramatic improvement on the quality of patient care. In this study, the efficacy of trio rounding was measured and barriers to trio rounding were elicited. Methods: Afternoon trio rounds – separate from morning rounds – were completed in seven sessions during three PDSA cycles between November 2018 and February 2019 on the medicine wards of George Washington University Hospital (GWUH). A “rounding checklist” was developed and distributed to facilitate trio rounding. This checklist highlighted several areas for potential interventions to improve patient care – including functional status, pain control, skin care, nutritional status, glycemic control, mental status, and respiratory status. The rounding provider was then asked to evaluate if there were any new or changed orders, or any near misses. Provider, nurse, and patient satisfaction with the rounding process was also measured. In each PDSA cycle, barriers to trio rounding were identified. Results: Afternoon trio rounds generated on average 2.43 new orders. In all instances, providers, nurses, and patients rated their satisfaction with trio rounds highly (>8/10) and all providers and nurses felt that these rounds improved physician-nurse communication. Several barriers to trio rounding were identified. These included competing nursing duties, patient location, lack of physician initiative, provider availability, nurse availability, and time constraints. Conclusions: Our findings correlate with previous studies that have shown improvement in communication between healthcare team members from trio rounding as well as satisfaction among all participants in the trio rounding process. Despite the strong benefits associated with trio rounding, its adoption on the medicine wards of GWUH remains a challenge due to several factors. Further quality improvement projects could be aimed at reducing these barriers which could result in a significant improvement in patient care.
Open Access
1
Utility of Trio Rounds and Barriers to Their Implementation
Background: "Trio" rounding between physicians, nurses, and patients, has been shown to improve communication among healthcare team members, improve patient safety, decrease costs, improve length of stay, and improve patient satisfaction. These factors combined have the potential for a dramatic improvement on the quality of patient care. In this study, the efficacy of trio rounding was measured and barriers to trio rounding were elicited. Methods: Afternoon trio rounds – separate from morning rounds – were completed in seven sessions during three PDSA cycles between November 2018 and February 2019 on the medicine wards of George Washington University Hospital (GWUH). A “rounding checklist” was developed and distributed to facilitate trio rounding. This checklist highlighted several areas for potential interventions to improve patient care – including functional status, pain control, skin care, nutritional status, glycemic control, mental status, and respiratory status. The rounding provider was then asked to evaluate if there were any new or changed orders, or any near misses. Provider, nurse, and patient satisfaction with the rounding process was also measured. In each PDSA cycle, barriers to trio rounding were identified. Results: Afternoon trio rounds generated on average 2.43 new orders. In all instances, providers, nurses, and patients rated their satisfaction with trio rounds highly (>8/10) and all providers and nurses felt that these rounds improved physician-nurse communication. Several barriers to trio rounding were identified. These included competing nursing duties, patient location, lack of physician initiative, provider availability, nurse availability, and time constraints. Conclusions: Our findings correlate with previous studies that have shown improvement in communication between healthcare team members from trio rounding as well as satisfaction among all participants in the trio rounding process. Despite the strong benefits associated with trio rounding, its adoption on the medicine wards of GWUH remains a challenge due to several factors. Further quality improvement projects could be aimed at reducing these barriers which could result in a significant improvement in patient care.
Comments
Presented at Research Days 2019.