INTERCONNECT

Project By-line: INTERdisCiplinary rOunding iN iNpatiEnt Care seTtings

Introduction Paragraph: Multidisciplinary rounding, or the purposeful rounding of a group of clinicians from different clinical disciplines, focused on organizing and optimizing communication and care delivery across provider groups to improve overall patient safety, health, and satisfaction. Interdisciplinary rounding enables the team to make collaborative decisions regarding patient care as a unified whole. The goal of the interdisciplinary team and rounds is to create comprehensive and coordinated treatment plans that focus on each patient’s needs and goals of care. This is particularly important in elderly patients who often have multiple discharge needs.

Primary Aim: To evaluate the efficacy of a multidisciplinary team rounding protocol on pre-discharge measures of safety and quality (length of stay, patient-reported hospital satisfaction (HCAHPS), and readmission rate and mortality at 90 days), and post-discharge measures of safety and quality (follow-up phone call contact at 48 hours, follow-up appointment attendance, cardiac rehab attendance, and medication adherence) in patients with ACS over the age of 80.

 Design: This study is a quality improvement initiative using 2 cycles of observation. In a population of patients of age >80 admitted with acute coronary syndrome (ACS) we aimed to assess the effect of the implementation of a standardized, evidence-based approach to interdisciplinary rounds on communication during care transitions, length of stay, and readmission rates. We will observe care delivery and communication processes 12 months prior to and 12 months following implementation of an evidence-based practice intervention to improve care transition communication for patients being discharged from cardiology progressive care units in the Duke Heart Center at DUH (units 7100 and 7300). 

 Metrics: Care transition outcomes of interest include: follow-up phone call contact at 48 hours, follow-up appointment attendance, cardiac rehab attendance, and medication adherence.  In addition, inpatient outcomes of interest include: length of stay, patient-reported hospital satisfaction (HCAHPS), and readmission rate and mortality at 90 days.

 Timeline: 12 months pre-implementation and 12 months post-implementation.

Project Team Leads: Chelsey Moore (Chelsey.moore@duke.edu), Kelsey Ignat (Kelsey.ignat@duke.edu), Fran Cosgrove (francis.cosgrove@duke.edu)