Date of Award

4-2019

Degree Name

Nursing (D.N.P.)

Department

College of Nursing

First Advisor

Sandra L. Spoelstra

Second Advisor

Sylvia Simons

Third Advisor

Mary Dougherty

Abstract

Introduction: Interprofessional collaboration (IPC) improves the quality of healthcare delivery. IPC enhances communication during discharge planning, through use of structured daily rounds to reduce readmissions, length of stay (LOS), cost, and mortality. A $240 billion reduction in cost could be achieved with IPC. The Joint Commission, Institute of Medicine, and World Health Organization emphasize use of IPC to reduce errors, improve patient outcomes, and refine transitions of care for patients.

Objectives: The goal of this project was to determine how IPC within structured daily rounds during discharge planning impacts patient LOS and staff satisfaction.

Methods: This quality improvement project was conducted at a large Midwestern hospital on two medical-surgical units. Implementation of structured daily rounds using a toolkit were evaluated. Data were collected via observations of discharge planning, daily rounds, and surveys; while LOS data was provided by the site.

Results: LOS was positively impacted by structured daily rounds. Unit A LOS was reduced by 0.09 days while unit B reduced by 0.14 days following implementation. Staff satisfaction and understanding of IPC during rounds improved by 11.3% (62.2% to 73.5%) following implementation.

Conclusions: LOS was positively impacted by structured daily rounds. LOS was successfully reduced following implementation. Staff understanding of IPC during daily rounds with the use of a toolkit had a small improvement. The toolkit, along with key stakeholder involvement, were beneficial to enhancing staff satisfaction through improved communication and education.

Implications: Practice improvements included structured daily rounds that would include IPC to ensure effective discharge planning and patient needs were met. Utilizing a toolkit enhanced daily rounds and improved uptake for practice change by developing necessary tools for education, audits, and expectations to warrant success and sustainability of structured daily rounds. Patient LOS is expected to further decline after continued use of the toolkit enhances daily rounds and the change in practice becomes the new culture for discharge planning.

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