SHM Converge Scientific Abstract ePoster Gallery-Care Team Rounds: Development of Interdisciplinary Working Rounds

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The project aimed to reduce hospital length of stay (LOS) by improving communication and care coordination through Care Team Rounds (CTRs), using LEAN process improvement methods. An interdisciplinary team mapped inpatient workflow and identified delays in advancing care plans caused by late communication and delayed orders. CTRs were then introduced on a geographic medicine unit as interdisciplinary working rounds that brought together house staff, the attending, RN leadership, charge RN, case management, and social work. The primary goal was to decrease LOS by 10% over six months; a secondary goal was to improve communication. Data collected included LOS, HCAHPS scores, staff surveys, and a nursing focus group.<br /><br />CTRs were trialed from March to November 2023. Early results showed an improvement in LOS O/E from 1.97 to 1.35, but this benefit did not persist and LOS eventually returned to baseline. There was no significant change in HCAHPS scores. Qualitative feedback was mixed to negative: providers reported that teaching time suffered, and other staff felt the rounds interrupted workflow. Staff comments suggested that while communication improved, the process was less efficient and sometimes inconvenient.<br /><br />Overall, CTRs were not well received by staff. Although they helped speed communication, the downsides—especially reduced teaching quality, workflow disruption, and increased handoffs—outweighed the advantages of geographic rounding. The team therefore decided to move away from a geographic model and adopt a non-geographic approach.

Asset Subtitle

Faye E. Reiff-Pasarew

Meta Tag

Author List Emily J. Veldboom, Faye E. Reiff-Pasarew, Haley Waite, Julie M. Pearson, Kimberly Keller

Category Innovations

Concept Inpatient Flow

Concept Length of Stay

Concept Care Team Rounds

Concept Methodology

Concept Process Mapping

Distinguished Non-Finalist

Presenter Organization Mount Sinai Morningside Hospital, Icahn School of Medicine at Mount Sinai

Presenting Author Faye E. Reiff-Pasarew

Track Communication

Keywords

hospital length of stay

care team rounds

LEAN process improvement

interdisciplinary communication

care coordination

workflow delays

geographic medicine unit

HCAHPS scores

staff feedback

non-geographic approach

Inpatient Flow

Length of Stay

Care Team Rounds

Methodology

Process Mapping