Background: The drive for high-quality, efficient, and patient-centered care is paramount in contemporary hospital settings. At a large community hospital, a recognized need to reduce variability in clinical practice and optimize patient throughput led to a significant strategic undertaking. Led by the hospitalist team with substantial nursing input, new structured scripted Interdisciplinary rounds were developed. The core strategy involved the standardization of patient care plans, designed to systematically address critical areas: enhancing patient safety, reducing length of stay in the hospital, improving the quality of patient handoffs, decreasing avoidable readmissions, and elevating patient and family satisfaction as measured by HCAHPS scores, thereby improving LOS. Please noted Fig. 1 for benefits of IDRS
Purpose: The primary purpose of Interdisciplinary Rounds (IDRs) is to facilitate comprehensive, coordinated, and patient-centered care by bringing together the entire geographical team to discuss patient progress, address challenges, and plan for optimal outcomes. This will allow to decrease acute average LOS (ALOS) from 4.5 to below 4.5, and the total ALOS from 4.3 to 4.2 by the end of 2024 (Fig. 1).
Description: To enhance interdisciplinary communication and ensure consistent, comprehensive patient information exchange, a mandatory, standardized checklist has been developed and is being implemented for use by all care team members (e.g., nursing, medical, case management, social work, pharmacy, therapy) across all ACU units. This checklist must be completed for every patient and is central to presentations during IDRs (fig.1). Its primary purpose is to guarantee the consistent gathering, review, and presentation of critical, up-to-date patient data, including medical status, care plan specifics, discharge planning progress, identified barriers, and crucial next steps. This systematic approach aims to foster clarity, comprehensiveness, and efficiency in communication among the care team, ultimately improving patient care coordination. The development process was highly collaborative, incorporating direct team feedback, articulating the foundational importance of IDRs, and involving detailed discussions with an IDR committee to script and refine the checklist content. Following its development, the checklist has undergone successful piloting and auditing across multiple floors, demonstrating its practical application and effectiveness in diverse clinical settings.
Conclusions: Geographic scripting is a highly effective strategy, delivering comprehensive improvements across multiple critical fronts. It significantly: Decreases variability in patient care delivery. Reduces minutes spent in interdisciplinary rounds (IDRs). IDRs had also profound positive impact on patient care coordination and overall hospital efficiency. Crucially, the hospital has also realized substantial improvements in key performance indicators, including HCAHPS scores, reduced length of stay (LOS) (fig.2), and decreased re-admissions.
.png)
.png)