Implementing a Family-Centered Rounds Intervention Using Novel Mentor-Trios

Author:

Khan Alisa12,Patel Shilpa J.34,Anderson Michele56,Baird Jennifer D.7,Johnson Tyler M.1,Liss Isabella1,Graham Dionne A.28,Calaman Sharon9,Fegley April E.10,Goldstein Jenna10,O’Toole Jennifer K.11,Rosenbluth Glenn1213,Alminde Claire14,Bass Ellen J.15,Bismilla Zia16,Caruth Monique6,Coghlan-McDonald Sally613,Cray Sharon617,Destino Lauren A.1819,Dreyer Benard P.20,Everhart Jennifer L.1819,Good Brian P.21,Guiot Amy B.22,Haskell Helen623,Hepps Jennifer H.24,Knighton Andrew J.25,Kocolas Irene21,Kuzma Nicholas C.2627,Lewis Kheyandra2627,Litterer Katherine P.628,Kruvand Elizabeth629,Markle Peggy630,Micalizzi Dale A.6,Patel Aarti31,Rogers Jayne E.32,Subramony Anupama33,Vara Tiffany46,Yin H. Shonna34,Sectish Theodore C.12,Srivastava Rajendu2125,Starmer Amy J.12,West Daniel C.3536,Spector Nancy D.262737,Landrigan Christopher P.123839,

Affiliation:

1. aDivision of General Pediatrics, Department of Pediatrics, Boston Children’s Hospital, Boston, Massachusetts

2. bDepartment of Pediatrics, Harvard Medical School, Boston, Massachusetts

3. cDepartment of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii

4. dKapi‘olani Medical Center for Women and Children, Hawaii Pacific Health, Honolulu, Hawaii

5. eFamily Centered Care Department, Lucile Packard Children’s Hospital Stanford, Palo Alto, California

6. fPatient and Family Centered I-PASS SCORE Family Advisory Council, Boston, Massachusetts

7. gInstitute for Nursing and Interprofessional Research, Children’s Hospital Los Angeles, Los Angeles, California

8. hProgram for Patient Safety and Quality, Boston Children’s Hospital, Boston, Massachusetts

9. iDivision of Pediatric Critical Care, NYU Langone Health/Hassenfeld Children’s Hospital, NYU Grossman School of Medicine; New York City, New York

10. jCenter for Quality Improvement, Society of Hospital Medicine, Philadelphia, Pennsylvania

11. kDepartments of Pediatrics and Internal Medicine, Cincinnati Children’s Hospital Medical Center/University of Cincinnati College of Medicine, Cincinnati, Ohio

12. lDepartment of Pediatrics, University of California San Francisco School of Medicine, San Francisco, California

13. mBenioff Children’s Hospital, San Francisco, University of California San Francisco School of Medicine, San Francisco, California

14. nDepartment of Nursing, St Christopher’s Hospital for Children, Philadelphia, Pennsylvania

15. oDepartment of Information Science in the College of Computing and Informatics, Drexel University, Philadelphia, Pennsylvania

16. pDepartments of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada

17. qPatient Safety and Quality Improvement Committee, St Christopher’s Hospital for Children, Philadelphia, Pennsylvania

18. rDepartment of Pediatrics, Stanford University School of Medicine, Palo Alto, California

19. sLucile Packard Children’s Hospital Stanford, Palo Alto, California

20. tDepartment of Pediatrics, New York University Grossman School of Medicine, New York, New York

21. uDepartment of Pediatrics, Primary Children’s Hospital, University of Utah School of Medicine, Salt Lake City, Utah

22. vCincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio

23. wMothers Against Medical Error, Columbia, South Carolina

24. xDepartment of Pediatrics, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Bethesda, Maryland

25. yHealthcare Delivery Institute, Intermountain Health, Murray, Utah

26. zDepartment of Pediatrics, St Christopher’s Hospital for Children, Philadelphia, Pennsylvania

27. aaDepartment of Pediatrics, Drexel University College of Medicine, Philadelphia, Pennsylvania

28. bbOffice of Experience, Boston Children’s Hospital, Boston, Massachusetts

29. ccSSM Health Cardinal Glennon Children’s Hospital, St Louis, Missouri

30. ddWalter Reed National Military Medical Center, Bethesda, Maryland

31. eeDepartment of Pediatrics, University of California San Diego, Rady Children’s Hospital, San Diego, California

32. ffDepartment of Nursing, Boston Children’s Hospital, Boston, Massachusetts

33. ggDepartment of Pediatrics, Cohen Children’s Medical Center, Hofstra Northwell School of Medicine, New Hyde Park, New York

34. hhDepartments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, New York

35. iiDepartment of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania

36. jjPerelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania

37. kkThe Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) Program, Philadelphia, Pennsylvania

38. llDivision of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, Massachusetts

39. mmDivision of Sleep Medicine, Harvard Medical School, Boston, Massachusetts

Abstract

BACKGROUND AND OBJECTIVES Patient and Family Centered I-PASS (PFC I-PASS) emphasizes family and nurse engagement, health literacy, and structured communication on family-centered rounds organized around the I-PASS framework (Illness severity-Patient summary-Action items-Situational awareness-Synthesis by receiver). We assessed adherence, safety, and experience after implementing PFC I-PASS using a novel “Mentor-Trio” implementation approach with multidisciplinary parent-nurse-physician teams coaching sites. METHODS Hybrid Type II effectiveness-implementation study from 2/29/19-3/13/22 with ≥3 months of baseline and 12 months of postimplementation data collection/site across 21 US community and tertiary pediatric teaching hospitals. We conducted rounds observations and surveyed nurses, physicians, and Arabic/Chinese/English/Spanish-speaking patients/parents. RESULTS We conducted 4557 rounds observations and received 2285 patient/family, 1240 resident, 819 nurse, and 378 attending surveys. Adherence to all I-PASS components, bedside rounding, written rounds summaries, family and nurse engagement, and plain language improved post-implementation (13.0%–60.8% absolute increase by item), all P < .05. Except for written summary, improvements sustained 12 months post-implementation. Resident-reported harms/1000-resident-days were unchanged overall but decreased in larger hospitals (116.9 to 86.3 to 72.3 pre versus early- versus late-implementation, P = .006), hospitals with greater nurse engagement on rounds (110.6 to 73.3 to 65.3, P < .001), and greater adherence to I-PASS structure (95.3 to 73.6 to 72.3, P < .05). Twelve of 12 measures of staff safety climate improved (eg, “excellent”/“very good” safety grade improved from 80.4% to 86.3% to 88.0%), all P < .05. Patient/family experience and teaching were unchanged. CONCLUSIONS Hospitals successfully used Mentor-Trios to implement PFC I-PASS. Family/nurse engagement, safety climate, and harms improved in larger hospitals and hospitals with better nurse engagement and intervention adherence. Patient/family experience and teaching were not affected.

Publisher

American Academy of Pediatrics (AAP)

Reference55 articles.

1. Changes in medical errors after implementation of a handoff program;Starmer;N Engl J Med,2014

2. Patient- and family-centered care and the pediatrician’s role;Committee on Hospital Care and Institute For Patient- And Family-Centered Care;Pediatrics,2012

3. Family-centered rounds;Mittal;Pediatr Clin North Am,2014

4. Family-centered rounds: past, present, and future;Destino;Pediatr Clin North Am,2019

Cited by 2 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3