Implementation of Daily Goals Tool to Structured Multidisciplinary Rounds

Abstract

Problem: A Surgical Intermediate Care Unit (SIMC) within a large urban academic medical center is covered by multiple rotating Advanced Practice Providers (APP), leading to varied multidisciplinary rounding (MDR) formats. This lack of structure leads to communication breakdown, delayed communication, poor collaboration, and staff dissatisfaction. Five safety reports submitted from November 2021 to April 2022 were related to communication errors and inadequacy of communication. Purpose: This quality improvement (QI) project aims to implement a Daily Goals Tool (DGT) into the current MDR in the SIMC to evaluate the effectiveness of the structure rounding to improve staff collaboration, communication, and satisfaction. Methods: A unit-specific DGT was created with the input of SIMC staff. A DGT was utilized during MDR to discuss the plan of care for each SIMC patient over fourteen weeks following staff education. The use of the DGT was audited three times per week to measure compliance. Participants were asked to complete the Collaboration and Satisfaction about Care Decisions (CSACD) tool as a pre-and post-intervention survey. Results: Nine participants of MDT completed the pre-intervention survey and ten completed the post-intervention survey. Compliance audit found 60-100% weekly completion of the DGT. Post- CSACD result indicated that the structured rounding tool improved team members' satisfaction with decision-making, team communication, and team collaboration compared to the pre-CSACD result. Conclusion: Implementing a unit-specific structured rounding tool can organize the rounding process to improve staff collaboration, satisfaction, and communication among healthcare members.