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A6857 - Quality Improvement Project Assessing Multidisciplinary Team Satisfaction Before and After Utilization of a Communication Tool
Author Block: M. K. Ellis1, A. B. Mathew2; 1Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States, 2Medical College of Wisconsin, Milwaukee, WI, United States.
Rationale: Ensuring accurate communication of patient care goals in the intensive care unit (ICU) is essential. This can be challenging as the patients in this setting are medically complex and require the coordination of large multidisciplinary teams which requires staff time and effort. The purpose of this pilot study was to determine whether the use of a 24-hour communication tool during daily interprofessional ICU rounds improved satisfaction regarding communication, understanding, and implementation of patient care goals.
Methods: This pilot study was done at our institution in a closed 18-bed combined medical and surgical ICU. The 24-hour communication tool included specific management plans regarding ventilator weaning, deep vein thrombosis prophylaxis, stress ulcer prophylaxis, nutrition, antibiotics, fluid status, line placement, pain management, physical and occupational therapy, swallow evaluation, lab results and requests, and nursing concerns. During the intervention period, the communication tool was completed by nursing staff and subsequently used by resident physicians during daily rounds for a two-week period. We created a 15-question survey that assessed the degree of satisfaction with communication, understanding, and achieving patient care goals with a 5-level Likert scale. This survey was completed by multidisciplinary ICU staff before and after implementation of the communication tool.
Results: We collected 16 surveys prior to implementation of the communication tool and 6 surveys after the implementation of the communication tool. Multidisciplinary team members that completed the survey included medical students, nurses, respiratory therapists, residents, fellows, and attending physicians. Prior to implementation of the communication tool, 27% of all survey responses reflected some level of dissatisfaction. Post implementation, we observed a 100% rate with some level of satisfaction across all survey domains. We observed the most significant positive change in survey domains gauging satisfaction with end of life communications and achieving patient care goals. For the domain in end of life communication, 75% of survey respondents expressed dissatisfaction prior to implementation, with post-implementation results indicating 100% satisfaction. For the domain of achieving patient care goals, 50% were dissatisfied prior to implementation, and 100% were satisfied post implementation of the communication tool.
Conclusions: Our data suggests that the use of a 24-hour communication tool to facilitate interprofessional ICU rounds improves staff satisfaction and achievement of patient care goals.