Improving MD to Nurse Communication Systems Based Project Vertical - - PowerPoint PPT Presentation

Improving MD to Nurse Communication

Systems Based Project

Vertical Team: Janelle Fauci MD, Lindsay Frederick MD, Michael Polin MD, Jovana Martin MD Faculty Mentor: Joseph Biggio MD

Why is this important?

 Essential part of providing excellent care  Increasing number of shift changes and

patient checkout

 EMR and electronic orders

Impact Orders

 PROBLEM: Some orders are not being

recognized or are “missed”

 SOLUTION:

– Unit secretary should notify RN of stat orders – MD will notify RN of stat orders when possible – RN should check orders for changes q 2 hrs – Consider using a flowsheet for orders

Discharge Planning

 PROBLEM: RN is not aware of plan of care  SOLUTION:

– Charge nurse and social worker to attend rounds or run list with residents – MD to make plan of care clear in progress notes – RN to notify MD of any issues with discharge

MD Response Time

 PROBLEM: Nurses complain that the residents

are too slow to respond to requests.

 SOLUTION: – Use paging for routine prn medication orders – Repage in 30 minutes if not completed – Avoid paging between 5 and 6 pm unless an emergency – RN to ask the other nurses if they need to talk to the night float resident prior to paging – Night float PGY2 to notify GYNX charge nurse if going to BW or in an OR case

RN Availability

 PROBLEM: RN not prepared to speak with MD

regarding patient problem at time of page

 SOLUTION: – Must have a full set of current vital signs and UOP if calling regarding an abnormal vital sign – Attempt to stay at phone for 5 minutes after page is sent – Put first and last name in page and request return call via vocera

RN and MD Assignments

 PROBLEM: RN and MD unsure who to contact  SOLUTION: – Charge nurse or unit secretary should update tracking board on L&D, MBU, HRO. A GYNX tracking board would be helpful. – Class lieutenants will post the call schedule, rotation schedule, and monthly “on-service” schedule in each nursing pod – RN should contact the primary resident unless it is an emergency or that resident has not responded in > 30 minutes

MEU Communication

 PROBLEM: RNs do not check orders on

Impact

 SOLUTION:

– MD places lab and medication orders on the tracking board – RN should update tracking board when labs drawn and meds given

Questions?