Standardized Work Rounds Enhance Teaming, Comprehensiveness, Shared Mental Model Development, and Achievement Rate of End-of-Shift Goals*

Objectives: To determine the impact of standardized PICU work rounds on the frequency of ideal teaming behaviors, rounds comprehensiveness, shared mental model index development, and rate of completed end-of-shift goals. Design: A single-center, pre-post, prospective cohort study. Setting: A 259-bed, quaternary, pediatric referral center. Patients: Children 0–18 years old from November 2018 to January 2020. Interventions: Standardized, bedside, nurse-led PICU work rounds, emphasizing ideal teaming behaviors using a collaboratively developed rounding script and quality/safety checklist. Measurements and Main Results: Study data were collected by direct observation and immediate postrounds participant questionnaire data. Primary outcomes were frequency of observed ideal teaming behaviors, rounds comprehensiveness, efficiency (rounds content divided by duration), shared mental model index (congruence among rounds participants regarding key healthcare data and planning), rounds face validity, and achievement rate of rounds-established, end-of-shift goals. During study, 154 encounters were observed (50 preintervention, 52 after Plan-Do-Study-Act cycle 1, and 52 after Plan-Do-Study-Act cycle 2). We observed improvements in overall shared mental model index (24–87%), rounds comprehensiveness (72–98%), and ideal teaming behaviors (including closed-loop communication: 82–100%; responsibility delegation: 74–100%; interdependence behavior...
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Feature Articles Source Type: research