The Impact of Standardized Interprofessional Rounds on Critically Ill Patients in the Emergency Department: A Quality Improvement Initiative

Abstract

Background & Local Problem

ED boarded ICU patients are generally not included in interprofessional ICU rounds. The project objective was to implement interprofessional rounds in the ED on boarded ICU patients.

Methods & Interventions

ICU patients in the ED were followed for two months from admission to transfer. The primary outcome was feasibility of ED ICU rounds, measured as the proportion of days on which rounds occurred.  Secondary outcomes included communication quality, time to oral intake, and DVT prophylaxis documentation.

Results

A total of 92 patients were included in this project. Rounds occurred on 33 of 36 possible days. Following rounds, nurses and physicians reported improved communication. New DVT prophylaxis orders were written for 42% of cases, and 61 near miss events were corrected. Time from patient ED presentation to first oral intake decreased from 28 to 17 hours.

Conclusions

Interprofessional rounds in the ED are feasible, improve patient care, and enhance communication among team members.