Communicating MD Plans Team

Problem

Both MDs and RNs value face-to-face communication during morning rounds as an excellent means of discussing the plan of care, resolving questions in real time, and promoting teamwork. However, both MDs an RNs are overwhelmed with individuals tasks and it is logistically difficult to be in the same place at the same time, especially during the morning.

Project Goals

  • Measure what percentage of AM rounds involve both an MD and RN at the bedside, and what the average length of co-location is
  • Pilot an intervention in which the event of an MD entering a patient room triggers overhead lights in the hallway, thereby giving RNs a visual cue of when the team is rounding
  • See if this intervention improves the percentage of AM rounds involving both an MD and RN at bedside

Results

Using wearable locators to study the MD-RN rounding habits has yielded a precise and quantitative tool that is valuable in both descriptive and intervention-assessment studies. We showed that the average MD rounding time was 7.3 minutes and, importantly, 42.1% of rounds occurred with an RN at bedside. When paired with automatic green lights to mark MD presence in patient room, the percentage of rounds with both MDs and RNs at bedside improved by 8% to 24% on the three wards that were studied.

Lisa Shieh, MD

Faculty Mentor & Team Coach
Internal Medicine Department

Adam Sang, MD

Team Leader
General Surgery Resident

Improving face-to-face communication between MDs and RNs is a holy grail of clinical medicine

Ian Chong, MD

Senior Member
Emergency Medicine Resident

Silvia Loica-Mersa

Senior Member
Internal Medicine Resident

Amelia Clark, MD

Core Member
Otolaryngology Resident

Blake Read, MD

Core Member
General Surgery Resident

Travis Miller, MD

Core Member
Plastic Surgery Resident

Julia Noel, MD

Core Member
Otolaryngology Resident

Deborah Unger, MD

Core Member
Hospice & Palliative Medicine Fellow