With pressures to improve hospital efficiency, reduce length of stay and decrease readmissions, effective communication among care teams is more important than ever. Improved physician-nurse communication is associated with improved patient experience, outcomes, and staff engagement. Communication on surgical units poses unique challenges due to early rounding by the resident team and difficulty communicating with them while in the OR.
To combat these challenges, we implemented an “MD/APP-in-room” button in patient rooms in May 2019 to send real-time notifications to nursing. Surgical residents press the button in each room, alerting the nurse to come to the bedside if able, and promoting daily face-to-face communication. This also promoted involvement of patients in team communication, as it allowed for patients to directly hear their care plan, ask questions of both their physician and nurse, and feel assured that their team was working together to care for them.
Button utilization was electronically tracked and we assessed the impact on resident experience and clinical efficiency using a post-implementation survey, changes in paging volume, length of stay (LOS), and bed turnover rate (BTR). Our outcomes demonstrated a trend toward decreasing paging volumes throughout the day, suggesting more communication was occurring face to face. We also saw a decrease in average length of stay and an increase in bed turnover rate, suggesting greater efficiency of care and resource utilization on the units that implemented the MD-in-Room button.
This intervention required minimal change in workflow and led to improved communication. Despite challenges of early rounding and competing clinical obligations, interdisciplinary communication can be improved by implementing a mechanism to notify nursing staff when the resident team is rounding at the bedside. In the era of COVID-19, this button may also be a powerful tool to provide effective care, allow for social distancing, and minimize PPE usage.
In accordance with the Accreditation Council for Continuing Medical Education’s Standards for Commercial Support, adopted by the Joint Accreditors for Interprofessional Continuing Education, the National Center for Interprofessional Practice and Education has a conflict of interest policy that requires that all individuals involved in the development of activity content disclose their relevant financial relationships with commercial interests. All potential conflicts of interest that arise based upon these financial relationships are resolved prior to the educational activity.
Fernando Ona, Samuel Lowe, Steven Bingaman, Bethany Robertson, Amisha Metha, Jessica Star, Meredith Lora, Shirly Kooran, Beth Quatrara, Beth Turrentine, Danny Harris, Lisa Daniels, Kathy Lee Bishop, Jennifer Sharp, Caroline Coleman, Douglas Ander, Chase Corvin, Anastasia Pozdnyakova, Kelli Yukon, Allison Norenberg, Kimisha Cassidy, Kevin Roggin, Ross Milner, Vineet Arora
declare no vested interest in or affiliation with any commercial interest offering financial support for this interprofessional continuing education activity, or any affiliation with a commercial interest whose philosophy could potentially bias their presentation.
In support of improving patient care, this activity is planned and implemented by The National Center for Interprofessional Practice and Education. The National Center for Interprofessional Practice and Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.
As a Jointly Accredited Provider, the National Center is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. The National Center maintains responsibility for this course. Social workers completing this course receive continuing education credits.
This activity was planned by and for the healthcare team, and learners will receive Interprofessional Continuing Education (IPCE) credit for learning and change.
- Physicians: This activity will be designated for CME AMA PRA Category 1 Credit(s)TM through ACCME.
- Physician Assistants: NCCPA accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by ACCME or a recognized state medical society.
- Nurses: This activity will be designated for CNE nursing contact hours through ANCC.
- Pharmacists and Pharmacy Technicians: This activity will be designated for CPE contact hours (CEUs) through ACPE.
- Social Workers: This activity will be designated for social work continuing education credits through ASWB.
- All health professionals: This activity was planned by and for the healthcare team, and learners will receive Interprofessional Continuing Education (IPCE) credit for learning and change.