Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Date of Award

Fall 2018

Document Type

Dissertation

Degree Name

Doctor of Nursing Practice (DNP)

Department

School of Nursing

Advisor(s)

Linda J. Hulton

Margaret Bagnardi

Abstract

Abstract

Efficient throughput processes are a vital part of providing cost effective, safe, quality patient care. Research has shown interprofessional rounds can have success at improving throughput processes. A rural, not-for-profit, 255 bed hospital in a Mid-Atlantic State was experiencing issues with throughput/patient flow. The aims of this quality improvement project were 1). to implement Interprofessional Rounds on the Progressive Care Unit (PCU); 2). To design and build a working Interprofessional Rounds template into meditech to guide Interprofessional Rounds and streamline discharge documentation; 3). to increase the amount of discharge orders entered between 0700 and 1300 by ten percent; and 4). to decrease the average length of time between discharge order and actual discharge of the patient by ten percent.

The setting for this Quality Improvement project was the Progressive Care Unit (PCU). Using the Institution for Healthcare Improvement (IHI) Model of Improvement Framework, and Interprofessional Project Team completed six cycles of Rapid Cycle Quality Improvement (RCQI). Participants in the Interprofessional Rounds intervention were: Case Management, Scribe, Hospitalist, Pharmacy (on a limited schedule), Charge Nurse, and Unit Director.

A retrospective chart review was used to gather data from June 2017 to June 2018. The sample included patients under the hospitalist’s care, with an inpatient status, being discharged home. A total of 1643 charts were included in the project. Run charts were used. Results showed an increase in the amount of discharge orders entered between 0700 and 1300. The average length of time from discharge order entry to actual discharge showed some varying degrees of improvement but did not meet the ten percent goal set by the project team.

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