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Implementation of Standardized Rounds Using a Structured Rounding Tool to Improve Interdisciplinary Rounds

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Ha-Johnson, Tina M.
Date
2025-05
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DNP Project
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Problem: In 2023, a 36-bed intermediate care unit at a large community hospital in Baltimore, Maryland, recorded 47 avoidable hospital-acquired conditions (HACs). Ineffective communication, delays in patient care, and a lack of interdisciplinary collaboration between healthcare providers and nurses contributed to negative patient outcomes. Evidence suggests that implementing interdisciplinary rounds with a structured tool, such as the Daily Goals Checklist (DGC), can improve team communication, enhance collaboration, and ultimately reduce HACs while improving patient outcomes. Purpose: This quality improvement (QI) project aimed to implement standardized interdisciplinary rounds using the DGC to enhance communication and collaboration among the care team and reduce avoidable HACs. Methods: A workgroup was formed to adapt the DGC for the unit. Collaborative discussions were held with interdisciplinary team members to define the structure and logistics of the rounds. Education was provided to ensure all nursing staff were trained on the rounding process and the use of the DGC, achieving 100% staff participation (total number of staff who received education/total staff). Results: Compliance with conducting interdisciplinary rounds ranged from 63% (83/132) to 100% (140/140), which was number of patient rounds conducted in a week / total daily patient census in a week. Compliance with DGC utilization during rounds ranged from 11% (15/140) to 51% (46/90), which was total number of DGCs completed in a week/number of total patient rounds conducted in a week. Pre-implementation data showed 13 HACs over the 12 weeks prior to project initiation. During the 12-week implementation period, there was a 34% (8/13) reduction in HACs. Conclusion: The implementation of interdisciplinary rounds with the structured DGC tool led to improved communication and collaboration among the healthcare team, contributing to a reduction in negative patient outcomes and avoidable HACs.

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