In an effort to improve the quality of care across all of our ICU pods, we have been performing a trial of multi-disciplinary “Quality Rounds” across all of our ICUs over the last two months. \u00a0The feedback has been uniformly positive. \u00a0Among other things, foleys are being removed, central lines are being addressed, and a spotlight is being put on mobility goals.<\/p>\n
The goal of Quality Rounds is to ensure that we are addressing key domains in the care of ALL of our ICU patients in a standardized fashion that involves all of the disciplines in the ICU. At the same time, the rounds are meant to be efficient, 10 minutes per pod, 15 minutes tops.<\/p>\n
At our ICU collaborative, we reviewed pros\/cons of the different versions and decided on the following scheme for Quality Rounds.<\/p>\n
– Multidisciplinary team, one rep from each discipline is present. At a minimum, fellow and nurse is present to proceed. – Follow through. \u00a0Fellow will refer to Rounding List on rounds so that deficiencies noted on Quality Rounds can be addressed in real time. \u00a0Lead nurse will also re-inforce appropriate action items with bed-side nurse.<\/p>\n -Rounding times. Schedule per pod: AFTERNOON As usual, this process is not set in stone. \u00a0We hope to continually reassess and improve. \u00a0Your feedback is important. Please let me know what works and what isn’t working so that we can refine. \u00a0I truly appreciate your collaboration and hope that you agree that this process will benefit all of our patients.<\/p>\n
\n-Walk rounds. \u00a0Team walks from bed to bed, visually ensuring items on the list are addressed.
\n– Quality Rounds List<\/a>. \u00a0This will be kept in a binder in each pod in the MDs office. \u00a0Items are quickly assessed with help of team members and\/or visually confirmed directly (eg lines). \u00a0\u00a0Remember, these are all yes\/no questions so there is no need to go into extensive detail on any item. It’s ok to collegially redirect a team member so that quality rounds move along quickly.<\/p>\n
\nMORNING: Make sure previous day’s list is available for reference.
\n– Pods 1-3: Starts in Pod 2 at 8am, proceed to pod 3, 815 in Pod 3 (pod 1 fellow takes over), finish in Pod 1.
\n– Pod 4: Start at 8am.
\n– Pod 5: Start at 830 AM<\/p>\n
\n-All pods start at 3pm. Fellow, nurse, and mobility. \u00a0Goal is to ensure that follow through has occurred on all items on the rounding tool.<\/p>\n