In addition to asking each day, “What went well and what could be improved?“Teams need to keep score. They require objective feedback, because without feedback improvement is not possible. When it comes to hospitalized patients two useful measures are length of hospital stay (shorter hospital stays reflect greater efficiency) and 30-day readmission rate (reduced readmission rates reflects higher quality of care). However these measures usually are not available for 2 to 3 months, long after team members have left the service.
In lieu of these measures teams can use performance measures rather than outcomes measures to assess how they are doing. The simplest performance measure is the duration of work rounds each day. When communication protocols are succinct and the resident has created a game plan for the day that allows the bedside nurses to know when the team will be arriving at each patients room we have found that teams can complete rounds on each patient within 10 minutes. On average teams are required to round on 12 active patients per day allowing the team to complete rounds in < 120 minutes (our goal to assure time for a didactic teaching session and completion of consultation and radiology orders by interns).
Below are our real time bar graphs of rounding duration that will allow each team to display their daily rounding duration times. Residents will enter their data each day by accessing google documents using this link Gatorounds Duration To enter new data you must sign in using your Google user name and password. Orange should enter duration of rounds in minutes on column G and their census for the day on column H. The other columns automatically populate and create the orange bar graph as well as the average time spent on each patient. Blue enter their data on columns J and K, and Gold enter their data on columns M and N.