Journal article
Implementing a Family-Centered Rounds Intervention Using Novel Mentor-Trios
Pediatrics (Evanston), v 153(2), e2023062666
02 Jan 2024
PMID: 38164122
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
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.
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.
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.
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.
Metrics
Details
- Title
- Implementing a Family-Centered Rounds Intervention Using Novel Mentor-Trios
- Creators
- Alisa Khan - Harvard Medical SchoolShilpa J Patel - Kapi'olani Medical Center for Women and Children, Hawaii Pacific Health, Honolulu, HawaiiMichele Anderson - Score (Netherlands)Jennifer D Baird - Children's Hospital of Los AngelesTyler M Johnson - Boston Children's HospitalIsabella Liss - Boston Children's HospitalDionne A Graham - Boston Children's HospitalSharon CalamanApril E Fegley - Center for Quality Improvement, Society of Hospital Medicine, Philadelphia, PennsylvaniaJenna Goldstein - Center for Quality Improvement, Society of Hospital Medicine, Philadelphia, PennsylvaniaJennifer K O'Toole - Cincinnati Children's Hospital Medical CenterGlenn Rosenbluth - University of California, San FranciscoClaire Alminde - St. Christopher's Hospital for ChildrenEllen J Bass - Drexel UniversityZia Bismilla - University of TorontoMonique Caruth - Score (Netherlands)Sally Coghlan-McDonald - University of California, San FranciscoSharon Cray - St. Christopher's Hospital for ChildrenLauren A Destino - Lucile Packard Children's HospitalBenard P Dreyer - Department of Pediatrics, New York University Grossman School of Medicine, New York, New YorkJennifer L Everhart - Lucile Packard Children's HospitalBrian P Good - University of UtahAmy B Guiot - University of CincinnatiHelen Haskell - Mothers Against Medical Error, Columbia, South CarolinaJennifer H Hepps - Uniformed Services University of the Health SciencesAndrew J Knighton - Intermountain HealthcareIrene Kocolas - University of UtahNicholas C Kuzma - Drexel UniversityKheyandra Lewis - Drexel UniversityKatherine P Litterer - Boston Children's HospitalElizabeth Kruvand - Cardinal Glennon Children’s Medical CenterPeggy Markle - Walter Reed National Military Medical CenterDale A Micalizzi - Score (Netherlands)Aarti Patel - University of California San DiegoJayne E Rogers - Boston Children's HospitalAnupama Subramony - Cohen Children's Medical CenterTiffany Vara - Score (Netherlands)H Shonna Yin - Departments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, New YorkTheodore C Sectish - Harvard Medical SchoolRajendu Srivastava - Intermountain HealthcareAmy J Starmer - Harvard Medical SchoolDaniel C West - University of PennsylvaniaNancy D Spector - The Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) Program, Philadelphia, PennsylvaniaChristopher P Landrigan - Harvard Medical SchoolPatient and Family Centered I-PASS SCORE Study Group
- Publication Details
- Pediatrics (Evanston), v 153(2), e2023062666
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Information Science; Pediatrics
- Web of Science ID
- WOS:001265762200014
- Scopus ID
- 2-s2.0-85184139275
- Other Identifier
- 991021811624404721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Pediatrics