Improving Bedside Care Team Communication and Collaboration Between Nursing and Respiratory Therapists

Background:

Effective communication and collaboration between multidisciplinary teams are crucial for quality patient care. It is essential for registered nurses (RNs) and respiratory therapists (RTs) to be viewed as one bedside care team, seamlessly coordinating plans of care and medical management. Patient experience is impacted when respect among teams are demonstrated and perceived by the patient. A workgroup of staff RNs and RTs from a medical/pulmonary nursing floor (4SW) was assembled with RN/RT leadership serving as facilitators. The focus was to evaluate perception of communication among RNs and RTs, develop and implement a focused action plan to determine if perception of communication could be improved.

Methods:

The 4SW workgroup developed a survey of staff RNs and RTs from 4SW to understand current perceptions of communication and to identify areas of opportunity. Top focus areas for opportunity were phone interactions, RT understanding of patient condition when called and RN awareness of RT timeframe. The action plan included RN/RT call logs, RNs scripting for patient assessment and urgency level, and RTs providing expected time of arrival.

Results:

The post implementation surveys showed a 30% improvement in the perception of communication from RTs and no change of perceptions of RNs. Further analysis of the call logs shows accurate assessment of patient condition by RN 69% of time, appropriate urgency level assigned by RN 56% of the time, and arrival within 5 minutes of expected time frame given by RT 96% of the time.

Conclusions:

By creating an action plan by key stakeholders, this workgroup demonstrated improvement in perception of communication for RT staff. Additional work is needed to evaluate additional opportunities and barriers. Further research is needed to understand larger impacts, including patient satisfaction, employee satisfaction, and patient outcomes.

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