Multidisciplinary Transplant Rounds: A Step to Improved Team and Patient Satisfaction
1Transplant, Bariatric Surgery & Orthopedic Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA
2Penn Transplant Institute, Hospital of the University of Pennsylvania, Philadelphia, PA
3Quality, Hospital of the University of Pennsylvania, Philadelphia, PA.
Meeting: 2018 American Transplant Congress
Abstract number: A378
Keywords: Outcome, Psychosocial, Safety
Session Information
Session Name: Poster Session A: Quality Assurance Process Improvement
Session Type: Poster Session
Date: Saturday, June 2, 2018
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall 4EF
Background
Multidisciplinary communication (MDC) is critical for transplant patient (TXP) safety. We hypothesized that formal, scripted multidisciplinary rounds (MDR) would yield improved MDC HCAHPS scores (Hospital Consumer Assessment of Healthcare Providers and Systems) and provider self-assessment.
Methods
Formal transplant team MDR began at the start of FY18 (7/1/17) with charge RN, bedside RN, MDs, NPs, transplant coordinators, PharmD, social workers, dietician and discharge planners participating. Percent of “top box” (i.e. “Always”) HCAHPS scores before and after MDR were compared. An anonymous web survey to all team members asked about change after MDR on a scale of 0-10 (5 neutral, 10 “Much Better,” 0 “Much Worse,” etc.).
Results
HCAHPS Scores: % "Top Box"
| FY17 | FY18 YTD | P | |
| RN MDC | 87.5 | 92.5 | 0.13 |
| MD MDC | 91.2 | 93.3 | 0.46 |
| Medication MDC | 66.8 | 76.4 | 0.041 |
| Discharge Info | 95.1 | 98.7 | 0.092 |
| Care Transitions | 72.7 | 83.3 | 0.017 |
Change After MDR Survey:
22 RNs, 7 MDs and 13 multidisciplinary providers responded to the online survey (response rates 50%, 63.6% and 61.9% respectively). Respondents felt MDR had led to MDC improvements (shown as median survey Likert response, 0-10, > 5 improved):
| RNs | MDs | Other Provider | |
| Sense of TXP safety | 6.5 | 7 | 8 |
| Sense of belonging to multidisciplinary team | 5.5 | 5 | 9 |
| Comfort caring for TXP | 8 | NA | 9 |
| Comfort raising questions or concerns about TXP | 7 | NA | 6 |
| Multidisciplinary rounds are effective use of time | 8.5 | 7 | 10 |
| Job satisfaction | 5 | NA | 7 |
Conclusions
Formal, scripted multidisciplinary rounds improved caregiver engagement and sense of TXP safety. HCAHPS scores improved significantly in 2 MDC-related domains. Further data is needed to understand if MDR yield improvements in TXP safety, length of stay, readmission rates or overall cost of care.
CITATION INFORMATION: Sigafus K., LaMura E., Massimiani M., Chiang C., Nicoll K., Yoho M., Bleicher M., Nazarian S. Multidisciplinary Transplant Rounds: A Step to Improved Team and Patient Satisfaction Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Sigafus K, LaMura E, Massimiani M, Chiang C, Nicoll K, Yoho M, Bleicher M, Nazarian S. Multidisciplinary Transplant Rounds: A Step to Improved Team and Patient Satisfaction [abstract]. https://atcmeetingabstracts.com/abstract/multidisciplinary-transplant-rounds-a-step-to-improved-team-and-patient-satisfaction/. Accessed November 21, 2024.« Back to 2018 American Transplant Congress