We’re excited to announce that BC Women’s Neonatal Intensive Care Unit (NICU) team was named runner up for BCPQC’s 2018 Quality Award for Excellence in Quality: Getting Better. The award celebrates a project that improved care for acute illness or injury.
The team was nominated for the improvement of NICU rounds from an unchanged 25-year practice to a complete overhaul that significantly redesigned areas of teamwork and communication in preparation for the move into the Teck Acute Care Centre.
NICU patient rounds are an important way that care teams collaborate to review patients, share information relevant to specific roles and care tasks to create daily goals for patient care. The goals are to maintain clinical stability and patient safety, and chart a path towards discharge for each patient. With the restructure of the unit in Teck ACC, the team’s objectives were to reduce the total time of rounds, and improve family and staff satisfaction.
After a trial period to test changes and gather feedback, the team implemented the following changes:
- Introduce a new situational awareness huddle between neonatologists and clinical nurse leaders at the start of the day to identify the unstable babies that need an early round
- Introduce a rounds preparation period from 9:00-9:45 a.m. that details rounds preparation activities
- Introduce a definitive rounds time from 9:45-11:45 a.m.
- Introduce a model for structured patient reporting to highlight variances/concerns
- Reinforce contingency planning for unstable patients
By outlining clear start times and schedules for rounds activities, the team was able to reliably include parents and families who want to be present. Structured patient reporting was developed with parent feedback to help parents prepare to participate in rounds and articulate their concerns and goals for their babies, improving family satisfaction. Since implementation of changes, the median duration of rounds is 125 minutes, a decrease of 44 per cent.
The team’s efforts to adapting the rounds to a new environment and to actively involve patients in rounds and treatment plans clearly showcase the team's commitment to quality patient care.