Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2023


Doctor of Nursing Practice (DNP)

Primary Advisor

Richard Ricciardi, PhD, CRNP; Althea L. Mighten, EdD, DNP, APRN, BC


TeamSTEPPS®; Post-Surgical Discharge; Communication


Background: Communication breakdowns contribute to discharge delays in the acute care settings. TeamSTEPPS® is and evidence-based program that seeks to optimize patient outcomes by improving communication and teamwork.

Objectives: The primary aim of this Quality Improvement (QI) project was to increase by 5% the number of patients discharged by noon. The secondary aims of this project were to improve the interdisciplinary team's communication and to improve workforce efficiencies and use of staff time.

Methods: A pre and post intervention design was used to collect and analyse the rate of successful discharges by noon, in addition to evaluating the interdisciplinary team’s perception of teamwork. Staff time was measured as a calculated cost of patient care.

Results: The pre-implementation rate of successful discharges by noon was 27% as compared to 29% post-intervention. In utilizing a z-score calculator, the p-value was .8181, resulting in no statistical significance. The second objective of increasing the interdisciplinary team's perception of communication using TeamSTEPPS® principles, a Wilcoxon signed-rank test was performed. There was statistical significance noted in team function (p = 0.37), leadership (p = 0.15), situation monitoring (p = .006), and mutual support (p = .001), yet no statistical significance was noted in the team's perception of communication. Lastly, the goal of decreasing staff time associated with post-surgical discharge inefficiencies; a t-test comparison was used, in which the results indicated non-significance with a p-value 0.232, however three months post- implementation there was a cost savings of $6,616.89.

Conclusions: This QI project improved discharge rates and improved workflow, leading to reduced costs and increased knowledge in 4 of the 5 TeamSTEPPS® concepts.

Open Access




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