Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2024


Doctor of Nursing Practice (DNP)

Primary Advisor

Dr. Karen Kesten


Background: Communication failures within the healthcare team are the leading cause of inadvertent patient harm. Interdisciplinary Model of Care (IMOC) rounds have been found to increase positive patient outcomes through improved communication between healthcare team members.

Aims/Objectives: The purpose of this Quality Improvement (QI) project was to develop, implement, and evaluate IMOC rounds daily for non-critical care neurosurgical patient. This project has three aims: 1) decrease neurosurgical patient safety events, (PSEs) 2) increase utilization of IMOC rounds on the neurosurgery service, and 3) increase advance practice provider (APP) and registered nurse (RN) communication on patient plan of care by utilizing IMOC rounds.

Methods: This was a quality improvement (QI) project designed and implemented for neurosurgical IMC/Floor patients over 8-weeks. IMOC rounds were held daily, Monday-Friday, with the neurosurgery APP and RN utilizing an IMOC Checklist. To evaluate Aim 1, a report of PSEs three-months pre-intervention was compared to a three-month report of PSEs post-intervention using chi-square. For Aim 2, weekly reports were generated on IMOC Rounds and checklists were completed for each primary neurosurgical patient on the IMC/Floor. Percentages of IMOC usage over the implementation period was calculated using Excel. For Aim 3, Communication, Collaboration, and Critical Thinking surveys were conducted to obtain baseline data of APP/RN perceptions of communication/collaboration. Surveys were redistributed and analyzed for changes post-intervention using t-test.

Results: IMOC participation percentages were reported ranging from 35-77% over the implementation period. A t-test was conducted for APP/RN responses revealed two questions/statements as statistically significant for each survey. A chi-square test analysis revealed the difference between pre-post intervention PSEs on the neurosurgical floor, results were not significant.

Conclusions: Implementing IMOC Rounds was found to improve communication/collaboration between RN and APPs. A longer implementation period or continued unit practice is needed to further assess the changes in PSEs documented.

Open Access




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