Virtual Communication Embedded Bedside ICU Rounds: A Hybrid Rounds Practice Adapted to the Coronavirus Pandemic.
Identifieur interne : 000005 ( Main/Exploration ); précédent : 000004; suivant : 000006Virtual Communication Embedded Bedside ICU Rounds: A Hybrid Rounds Practice Adapted to the Coronavirus Pandemic.
Auteurs : Aarti C. Bavare [États-Unis] ; Jordana R. Goldman ; Matthew A. Musick ; Kerry A. Sembera ; Alex A. Sardual ; Anne K. Lam ; Sebastian C. Tume ; Satid X. Thammasitboon ; Eric A. WilliamsSource :
- Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies [ 1529-7535 ] ; 2021.
Abstract
OBJECTIVES
Coronavirus disease 2019 containment strategies created challenges with patient-centered ICU rounds. We examined how hybrid rounds with virtual communication added to in-person rounds could facilitate social distancing while maintaining patient-centered care.
DESIGN
Continuous quality improvement.
SETTING
Quaternary care referral pediatric hospital.
PATIENTS
Daytime rounds conducted on PICU patients.
INTERVENTIONS
Following a needs assessment survey and pilot trials, multiple technological solutions were implemented in a series of plan-do-study-act cycles. Hybrid rounds model was deployed where a videoconference platform was used to establish communication between the bedside personnel (nurse, patient/family, and partial ICU team) with remotely located remaining ICU team, ancillary, and consultant providers. Floor labels marking 6-feet distance were placed for rounders.
MEASUREMENTS AND MAIN RESULTS
Outcome metrics included compliance with social distancing, mixed methods analysis of surveys, direct interviews of providers and families, and reports of safety concerns. The clinicians adopted hybrid rounds readily. Compliance with social distancing and use of floor labels needed reminders. One-hundred fourteen providers completed the feedback survey. Twenty-five providers and 11 families were interviewed. Feedback about hybrid rounds included inability to teach effectively, suboptimal audio-video quality, loss of situational awareness of patient/unit acuity, alarm interference, and inability to socially distance during other ICU interactions. Benefits noted were improved ancillary input, fewer interruptions, improved efficiency, opportunity to integrate with data platforms, and engage remote consultants and families. Nurses and families appreciated the efforts to ensure safety but wanted the ICU attending/fellow supervising the team to participate at bedside, during rounds. Clinicians appreciated the multidisciplinary input but felt that teaching was difficult.
CONCLUSIONS
Hybrid rounds employed during pandemic facilitated social distancing while retaining patient-centered multidisciplinary ICU rounds but compromised teaching during rounds. A change to ingrained rounding habits needs team commitment and ongoing optimization. The hybrid rounds model has potential for generalizability to other settings.
DOI: 10.1097/PCC.0000000000002704
PubMed: 33653995
Affiliations:
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Goldman</name></author><author><name sortKey="Musick, Matthew A" sort="Musick, Matthew A" uniqKey="Musick M" first="Matthew A" last="Musick">Matthew A. Musick</name></author><author><name sortKey="Sembera, Kerry A" sort="Sembera, Kerry A" uniqKey="Sembera K" first="Kerry A" last="Sembera">Kerry A. Sembera</name></author><author><name sortKey="Sardual, Alex A" sort="Sardual, Alex A" uniqKey="Sardual A" first="Alex A" last="Sardual">Alex A. Sardual</name></author><author><name sortKey="Lam, Anne K" sort="Lam, Anne K" uniqKey="Lam A" first="Anne K" last="Lam">Anne K. Lam</name></author><author><name sortKey="Tume, Sebastian C" sort="Tume, Sebastian C" uniqKey="Tume S" first="Sebastian C" last="Tume">Sebastian C. Tume</name></author><author><name sortKey="Thammasitboon, Satid X" sort="Thammasitboon, Satid X" uniqKey="Thammasitboon S" first="Satid X" last="Thammasitboon">Satid X. 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Bavare</name><affiliation wicri:level="2"><nlm:affiliation>Section of Critical Care, Department of Pediatrics, Baylor College of Medicine, Houston, TX. Pediatric Critical Care Unit, Texas Children's Hospital, Houston, TX.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Section of Critical Care, Department of Pediatrics, Baylor College of Medicine, Houston, TX. Pediatric Critical Care Unit, Texas Children's Hospital, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Goldman, Jordana R" sort="Goldman, Jordana R" uniqKey="Goldman J" first="Jordana R" last="Goldman">Jordana R. Goldman</name></author><author><name sortKey="Musick, Matthew A" sort="Musick, Matthew A" uniqKey="Musick M" first="Matthew A" last="Musick">Matthew A. Musick</name></author><author><name sortKey="Sembera, Kerry A" sort="Sembera, Kerry A" uniqKey="Sembera K" first="Kerry A" last="Sembera">Kerry A. Sembera</name></author><author><name sortKey="Sardual, Alex A" sort="Sardual, Alex A" uniqKey="Sardual A" first="Alex A" last="Sardual">Alex A. Sardual</name></author><author><name sortKey="Lam, Anne K" sort="Lam, Anne K" uniqKey="Lam A" first="Anne K" last="Lam">Anne K. Lam</name></author><author><name sortKey="Tume, Sebastian C" sort="Tume, Sebastian C" uniqKey="Tume S" first="Sebastian C" last="Tume">Sebastian C. Tume</name></author><author><name sortKey="Thammasitboon, Satid X" sort="Thammasitboon, Satid X" uniqKey="Thammasitboon S" first="Satid X" last="Thammasitboon">Satid X. Thammasitboon</name></author><author><name sortKey="Williams, Eric A" sort="Williams, Eric A" uniqKey="Williams E" first="Eric A" last="Williams">Eric A. Williams</name></author></analytic><series><title level="j">Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies</title><idno type="ISSN">1529-7535</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVES</b></p><p>Coronavirus disease 2019 containment strategies created challenges with patient-centered ICU rounds. We examined how hybrid rounds with virtual communication added to in-person rounds could facilitate social distancing while maintaining patient-centered care.</p></div><div type="abstract" xml:lang="en"><p><b>DESIGN</b></p><p>Continuous quality improvement.</p></div><div type="abstract" xml:lang="en"><p><b>SETTING</b></p><p>Quaternary care referral pediatric hospital.</p></div><div type="abstract" xml:lang="en"><p><b>PATIENTS</b></p><p>Daytime rounds conducted on PICU patients.</p></div><div type="abstract" xml:lang="en"><p><b>INTERVENTIONS</b></p><p>Following a needs assessment survey and pilot trials, multiple technological solutions were implemented in a series of plan-do-study-act cycles. Hybrid rounds model was deployed where a videoconference platform was used to establish communication between the bedside personnel (nurse, patient/family, and partial ICU team) with remotely located remaining ICU team, ancillary, and consultant providers. Floor labels marking 6-feet distance were placed for rounders.</p></div><div type="abstract" xml:lang="en"><p><b>MEASUREMENTS AND MAIN RESULTS</b></p><p>Outcome metrics included compliance with social distancing, mixed methods analysis of surveys, direct interviews of providers and families, and reports of safety concerns. The clinicians adopted hybrid rounds readily. Compliance with social distancing and use of floor labels needed reminders. One-hundred fourteen providers completed the feedback survey. Twenty-five providers and 11 families were interviewed. Feedback about hybrid rounds included inability to teach effectively, suboptimal audio-video quality, loss of situational awareness of patient/unit acuity, alarm interference, and inability to socially distance during other ICU interactions. Benefits noted were improved ancillary input, fewer interruptions, improved efficiency, opportunity to integrate with data platforms, and engage remote consultants and families. Nurses and families appreciated the efforts to ensure safety but wanted the ICU attending/fellow supervising the team to participate at bedside, during rounds. Clinicians appreciated the multidisciplinary input but felt that teaching was difficult.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Hybrid rounds employed during pandemic facilitated social distancing while retaining patient-centered multidisciplinary ICU rounds but compromised teaching during rounds. A change to ingrained rounding habits needs team commitment and ongoing optimization. The hybrid rounds model has potential for generalizability to other settings.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">33653995</PMID><DateRevised><Year>2021</Year><Month>03</Month><Day>03</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">1529-7535</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>Mar</Month><Day>03</Day></PubDate></JournalIssue><Title>Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies</Title><ISOAbbreviation>Pediatr Crit Care Med</ISOAbbreviation></Journal><ArticleTitle>Virtual Communication Embedded Bedside ICU Rounds: A Hybrid Rounds Practice Adapted to the Coronavirus Pandemic.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.1097/PCC.0000000000002704</ELocationID><Abstract><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">Coronavirus disease 2019 containment strategies created challenges with patient-centered ICU rounds. We examined how hybrid rounds with virtual communication added to in-person rounds could facilitate social distancing while maintaining patient-centered care.</AbstractText><AbstractText Label="DESIGN" NlmCategory="METHODS">Continuous quality improvement.</AbstractText><AbstractText Label="SETTING" NlmCategory="METHODS">Quaternary care referral pediatric hospital.</AbstractText><AbstractText Label="PATIENTS" NlmCategory="METHODS">Daytime rounds conducted on PICU patients.</AbstractText><AbstractText Label="INTERVENTIONS" NlmCategory="METHODS">Following a needs assessment survey and pilot trials, multiple technological solutions were implemented in a series of plan-do-study-act cycles. Hybrid rounds model was deployed where a videoconference platform was used to establish communication between the bedside personnel (nurse, patient/family, and partial ICU team) with remotely located remaining ICU team, ancillary, and consultant providers. Floor labels marking 6-feet distance were placed for rounders.</AbstractText><AbstractText Label="MEASUREMENTS AND MAIN RESULTS" NlmCategory="RESULTS">Outcome metrics included compliance with social distancing, mixed methods analysis of surveys, direct interviews of providers and families, and reports of safety concerns. The clinicians adopted hybrid rounds readily. Compliance with social distancing and use of floor labels needed reminders. One-hundred fourteen providers completed the feedback survey. Twenty-five providers and 11 families were interviewed. Feedback about hybrid rounds included inability to teach effectively, suboptimal audio-video quality, loss of situational awareness of patient/unit acuity, alarm interference, and inability to socially distance during other ICU interactions. Benefits noted were improved ancillary input, fewer interruptions, improved efficiency, opportunity to integrate with data platforms, and engage remote consultants and families. Nurses and families appreciated the efforts to ensure safety but wanted the ICU attending/fellow supervising the team to participate at bedside, during rounds. Clinicians appreciated the multidisciplinary input but felt that teaching was difficult.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Hybrid rounds employed during pandemic facilitated social distancing while retaining patient-centered multidisciplinary ICU rounds but compromised teaching during rounds. A change to ingrained rounding habits needs team commitment and ongoing optimization. The hybrid rounds model has potential for generalizability to other settings.</AbstractText><CopyrightInformation>Copyright ©2021The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Bavare</LastName><ForeName>Aarti C</ForeName><Initials>AC</Initials><AffiliationInfo><Affiliation>Section of Critical Care, Department of Pediatrics, Baylor College of Medicine, Houston, TX. Pediatric Critical Care Unit, Texas Children's Hospital, Houston, TX.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Goldman</LastName><ForeName>Jordana R</ForeName><Initials>JR</Initials></Author><Author ValidYN="Y"><LastName>Musick</LastName><ForeName>Matthew A</ForeName><Initials>MA</Initials></Author><Author ValidYN="Y"><LastName>Sembera</LastName><ForeName>Kerry A</ForeName><Initials>KA</Initials></Author><Author ValidYN="Y"><LastName>Sardual</LastName><ForeName>Alex A</ForeName><Initials>AA</Initials></Author><Author ValidYN="Y"><LastName>Lam</LastName><ForeName>Anne K</ForeName><Initials>AK</Initials></Author><Author ValidYN="Y"><LastName>Tume</LastName><ForeName>Sebastian C</ForeName><Initials>SC</Initials></Author><Author ValidYN="Y"><LastName>Thammasitboon</LastName><ForeName>Satid X</ForeName><Initials>SX</Initials></Author><Author ValidYN="Y"><LastName>Williams</LastName><ForeName>Eric A</ForeName><Initials>EA</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>03</Month><Day>03</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Pediatr Crit Care Med</MedlineTA><NlmUniqueID>100954653</NlmUniqueID><ISSNLinking>1529-7535</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CoiStatement>Dr. Musick received grant funding from the National Institutes of Health. Dr. Sardual disclosed that he is employed by Texas Children’s Hospital. The remaining authors have disclosed that they do not have any potential conflicts of interest.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>3</Month><Day>3</Day><Hour>5</Hour><Minute>39</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>3</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>3</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33653995</ArticleId><ArticleId IdType="doi">10.1097/PCC.0000000000002704</ArticleId><ArticleId IdType="pii">00130478-900000000-97854</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>États-Unis</li></country><region><li>Texas</li></region></list><tree><noCountry><name sortKey="Goldman, Jordana R" sort="Goldman, Jordana R" uniqKey="Goldman J" first="Jordana R" last="Goldman">Jordana R. Goldman</name><name sortKey="Lam, Anne K" sort="Lam, Anne K" uniqKey="Lam A" first="Anne K" last="Lam">Anne K. Lam</name><name sortKey="Musick, Matthew A" sort="Musick, Matthew A" uniqKey="Musick M" first="Matthew A" last="Musick">Matthew A. Musick</name><name sortKey="Sardual, Alex A" sort="Sardual, Alex A" uniqKey="Sardual A" first="Alex A" last="Sardual">Alex A. Sardual</name><name sortKey="Sembera, Kerry A" sort="Sembera, Kerry A" uniqKey="Sembera K" first="Kerry A" last="Sembera">Kerry A. Sembera</name><name sortKey="Thammasitboon, Satid X" sort="Thammasitboon, Satid X" uniqKey="Thammasitboon S" first="Satid X" last="Thammasitboon">Satid X. Thammasitboon</name><name sortKey="Tume, Sebastian C" sort="Tume, Sebastian C" uniqKey="Tume S" first="Sebastian C" last="Tume">Sebastian C. Tume</name><name sortKey="Williams, Eric A" sort="Williams, Eric A" uniqKey="Williams E" first="Eric A" last="Williams">Eric A. Williams</name></noCountry><country name="États-Unis"><region name="Texas"><name sortKey="Bavare, Aarti C" sort="Bavare, Aarti C" uniqKey="Bavare A" first="Aarti C" last="Bavare">Aarti C. Bavare</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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