Presenter Status
Resident/Psychology Intern
Abstract Type
QI Project
Primary Mentor or Principal Investigator
Sarah Brunner
Presentation Type
Oral Presentation
Start Date
11-5-2026 12:45 PM
End Date
11-5-2026 1:00 PM
Abstract Text
Background: Effective communication during rounds is essential for safe, efficient, and high-quality care in the Pediatric Intensive Care Unit (PICU), where patient complexity requires timely interdisciplinary collaboration. Despite being standard practice, multidisciplinary rounds face barriers such as inconsistent structure, interruptions, absent team members, and variable attending physician preferences limiting full stakeholders' engagement. Baseline observations in our PICU highlighted a lack of shared mental models, with order read-back occurring only 13% of the time and respiratory therapist (RT) presence in just 31% of rounds. To address these gaps, our team initiated a project to standardize rounds for improved interdisciplinary communication of care goals.
Objectives/Goal: The project aims were to increase RT presence for rounds from 31% to 75% and improve order read-back from 13% to 90% by December 31, 2025.
Methods/Design: Using Lean methodology and Plan-Do-Study-Act (PDSA) cycles, a multidisciplinary team implemented targeted interventions. PDSA cycle 1 focused on increasing RT presence through direct phone notifications and a daily rounding order, enabling bedside nurses and RTs to anticipate timing and support consistent participation. PDSA cycle 2 introduced a multidisciplinary rounding script to standardize communication and promote order read-back, aimed at establishing a shared mental model for patient care. Pharmacists rounding with our PICU teams collected data. Outcome metrics included frequency of order read-back and RT participation. Process metrics included the percentage of time RT was called to rounds and the frequency of rounding script utilization. Balancing metric was rounding time per patient to assess impact on workflow.
Results: Following our interventions, RT presence increased from 34% to 83%. RTs were called to rounds 87% of the time. Order read-back compliance increased from 25% to 85%. Rounding duration remained stable, indicating workflow efficiency was maintained.
Conclusions: The rounding script has improved interdisciplinary communication and team engagement, receiving strong positive feedback from bedside nurses and RTs. Early engagement of frontline staff was key to building buy-in and fostering psychological safety. Future efforts will focus on reducing interruptions, streamlining RT participation via “doctor rounding” buttons, and enhancing sustainability with targeted script prompts with support from the Human Factors and Organizational Effectiveness teams, staff surveys, and audits.
Improving Rounding Communication in the Pediatric Intensive Care Unit
Background: Effective communication during rounds is essential for safe, efficient, and high-quality care in the Pediatric Intensive Care Unit (PICU), where patient complexity requires timely interdisciplinary collaboration. Despite being standard practice, multidisciplinary rounds face barriers such as inconsistent structure, interruptions, absent team members, and variable attending physician preferences limiting full stakeholders' engagement. Baseline observations in our PICU highlighted a lack of shared mental models, with order read-back occurring only 13% of the time and respiratory therapist (RT) presence in just 31% of rounds. To address these gaps, our team initiated a project to standardize rounds for improved interdisciplinary communication of care goals.
Objectives/Goal: The project aims were to increase RT presence for rounds from 31% to 75% and improve order read-back from 13% to 90% by December 31, 2025.
Methods/Design: Using Lean methodology and Plan-Do-Study-Act (PDSA) cycles, a multidisciplinary team implemented targeted interventions. PDSA cycle 1 focused on increasing RT presence through direct phone notifications and a daily rounding order, enabling bedside nurses and RTs to anticipate timing and support consistent participation. PDSA cycle 2 introduced a multidisciplinary rounding script to standardize communication and promote order read-back, aimed at establishing a shared mental model for patient care. Pharmacists rounding with our PICU teams collected data. Outcome metrics included frequency of order read-back and RT participation. Process metrics included the percentage of time RT was called to rounds and the frequency of rounding script utilization. Balancing metric was rounding time per patient to assess impact on workflow.
Results: Following our interventions, RT presence increased from 34% to 83%. RTs were called to rounds 87% of the time. Order read-back compliance increased from 25% to 85%. Rounding duration remained stable, indicating workflow efficiency was maintained.
Conclusions: The rounding script has improved interdisciplinary communication and team engagement, receiving strong positive feedback from bedside nurses and RTs. Early engagement of frontline staff was key to building buy-in and fostering psychological safety. Future efforts will focus on reducing interruptions, streamlining RT participation via “doctor rounding” buttons, and enhancing sustainability with targeted script prompts with support from the Human Factors and Organizational Effectiveness teams, staff surveys, and audits.
