ÌÇÐÄ´«Ã½

Skip to main content
 
Notice: Users may be experiencing issues with displaying some pages on stanfordhealthcare.org. We are working closely with our technical teams to resolve the issue as quickly as possible. Thank you for your patience.
 

See our updated masking policy

ÌÇÐÄ´«Ã½

Implementing a Family-Centered Rounds Intervention Using Novel Mentor-Trios.

ÌÇÐÄ´«Ã½

Implementing a Family-Centered Rounds Intervention Using Novel Mentor-Trios. Pediatrics Khan, A., Patel, S. J., Anderson, M., Baird, J. D., Johnson, T. M., Liss, I., Graham, D. A., Calaman, S., Fegley, A. E., Goldstein, J., O'Toole, J. K., Rosenbluth, G., Alminde, C., Bass, E. J., Bismilla, Z., Caruth, M., Coghlan-McDonald, S., Cray, S., Destino, L. A., Dreyer, B. P., Everhart, J. L., Good, B. P., Guiot, A. B., Haskell, H., Hepps, J. H., Knighton, A. J., Kocolas, I., Kuzma, N. C., Lewis, K., Litterer, K. P., Kruvand, E., Markle, P., Micalizzi, D. A., Patel, A., Rogers, J. E., Subramony, A., Vara, T., Yin, H. S., Sectish, T. C., Srivastava, R., Starmer, A. J., West, D. C., Spector, N. D., Landrigan, C. P., Patient and Family Centered I-PASS SCORE Study Group 2024

Abstract

BACKGROUND AND OBJECTIVES: Patient and Family Centered I-PASS (PFC I-PASS) emphasizes family and nurse engagement, health literacy, and structured communication on family-centered rounds organized around the I-PASS framework (Illness severity-Patient summary-Action items-Situational awareness-Synthesis by receiver). We assessed adherence, safety, and experience after implementing PFC I-PASS using a novel "Mentor-Trio" implementation approach with multidisciplinary parent-nurse-physician teams coaching sites.METHODS: Hybrid Type II effectiveness-implementation study from 2/29/19-3/13/22 with =3 months of baseline and 12 months of postimplementation data collection/site across 21 US community and tertiary pediatric teaching hospitals. We conducted rounds observations and surveyed nurses, physicians, and Arabic/Chinese/English/Spanish-speaking patients/parents.RESULTS: We conducted 4557 rounds observations and received 2285 patient/family, 1240 resident, 819 nurse, and 378 attending surveys. Adherence to all I-PASS components, bedside rounding, written rounds summaries, family and nurse engagement, and plain language improved post-implementation (13.0%-60.8% absolute increase by item), all P < .05. Except for written summary, improvements sustained 12 months post-implementation. Resident-reported harms/1000-resident-days were unchanged overall but decreased in larger hospitals (116.9 to 86.3 to 72.3 pre versus early- versus late-implementation, P = .006), hospitals with greater nurse engagement on rounds (110.6 to 73.3 to 65.3, P < .001), and greater adherence to I-PASS structure (95.3 to 73.6 to 72.3, P < .05). Twelve of 12 measures of staff safety climate improved (eg, "excellent"/"very good" safety grade improved from 80.4% to 86.3% to 88.0%), all P < .05. Patient/family experience and teaching were unchanged.CONCLUSIONS: Hospitals successfully used Mentor-Trios to implement PFC I-PASS. Family/nurse engagement, safety climate, and harms improved in larger hospitals and hospitals with better nurse engagement and intervention adherence. Patient/family experience and teaching were not affected.

View details for

View details for