Bringing the Patient to the Center: Implementing an Interdisciplinary Rounding Approach in the Labor and Delivery Setting
Title: Bringing the Patient to the Center: Implementing an Interdisciplinary Rounding Approach in the Labor and Delivery Setting
- Identify 2 performance improvement principles that can be utilized to create a new process or alter an existing process.
- Understand the importance of interdisciplinary care on the Labor and Delivery Unit.
- Identify 2 potential barriers encountered when implementing a new initiative.
Proposed change: To create a standardized approach to care where Obstetrics, Nursing, Neonatology, and Anesthesia have the opportunity to meet and discuss the plan of care for each patient present on the Labor and Delivery unit at designated times during the day. In addition, the patient has the opportunity to meet the team who will have a hand in caring for herself and her baby for the upcoming shift.
Implementation, outcomes and evaluation:
Implementation:Using performance improvement methodologies, an interdisciplinary team was assembled to identify why previous attempts at an interdisciplinary apprach to care in this setting was unsuccessful, work with their respective disciplines to bring the "voice of the stakeholder" to the table, and identify what elements of care were identified as the most important to both share with the team and receive from the team during the actual rounding itself. The team chose a huddle format where the interdisciplinary team would assemble at a minimum of twice a day on the Labor and Delivery unit, then walk room to room to discuss each patient and devise a plan of care the entire team was aware of.
Outcomes identified: Increased "culture of safety" on the Labor and Delviery unit. Two specific AHRQ survey questions highlighting teamwork within the unit and transitions/hand-off are anticipated to be increased. The initial AHRQ survey was conducted approximately one year prior to the implementation of the Interdisciplinary Rounds.
Evaluatuion: Repeating the safety culture survey six months after implementation, to ideally see an increase in the domains already identified.
Implications for nursing practice: Successful implemetation will allow the work of the nurse to be more streamlined and bring the vioce of the patient to the discussion and allow the nurse to fulfill her accountability of being the patient's primary advocate.
Keywords: Interdisciplinary Rounds, Performance Improvement Methodologies, teamwork,