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A Resident-driven Initiative to Increase Bedside Teaching on Interdisciplinary Rounds.
Becker, Andrew; Frosch, Olivia; Argraves, Melissa; Carroll, Bryn; Kamsheh, Alicia; Krass, Polina; Mehta, Sanjiv; Salazar, Elizabeth; Taylor, April; Hart, Jessica.
Afiliación
  • Becker A; Department of Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, Philadelphia, Pa.
  • Frosch O; Division of General Pediatrics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pa.
  • Argraves M; PGY4, Division of Rheumatology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pa.
  • Carroll B; Pediatric Residency Program, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pa.
  • Kamsheh A; PGY4, Division of Pediatric Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pa.
  • Krass P; Department of Pediatric Emergency Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pa.
  • Mehta S; PGY4, Department of Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, Philadelphia, Pa.
  • Salazar E; PGY4, Division of Neonatology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pa.
  • Taylor A; Improvement and Project Management, Department of Pediatrics Practice Innovation and Improvement Team, The Children's Hospital of Philadelphia, Philadelphia, Pa.
  • Hart J; Division of General Pediatrics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pa.
Pediatr Qual Saf ; 6(3): e408, 2021.
Article en En | MEDLINE | ID: mdl-34046537
Inpatient rounding serves numerous roles. The American Academy of Pediatrics recommends a family-centered bedside model. Residents identified physical examination teaching during and satisfaction with rounds as areas for improvement. A resident group developed a project utilizing quality improvement (QI) methodology to address these concerns. We aimed to increase the frequency of bedside physical examination teaching most or every day on a single inpatient unit by 20% over 1 year, with secondary goals to increase the percentage of interns spending one hour or more at bedside per day by 10% and intern satisfaction by 15%, without impacting rounding duration. METHODS: We developed an organizational structure to complete a long-term resident-led project. Interventions included daily bedside examination teaching on rounds, afternoon examinations, goal communication, topic recording, and a teaching "tip sheet." Using an institutional QI framework, we utilized iterative plan-do-study-act cycles to implement interventions and surveys to assess outcomes, with rounding efficiency as a balancing measure. RESULTS: The survey response rate was 57%. Bedside teaching frequency increased from a mean of 10% to 61%, perceived time at the bedside increased from 37% to 59%, and rounding satisfaction improved from a rating of 6.7/10 to 7.4/10. Efficiency was not impacted. CONCLUSIONS: We improved inpatient rounds bedside physical examination teaching and satisfaction without sacrificing efficiency. This project demonstrates the feasibility and success of a resident-driven education initiative to successfully motivate fellow residents and colleagues across disciplines to enact change. The organizational structure may serve as a model for resident-led QI projects across institutions.

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Pediatr Qual Saf Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Pediatr Qual Saf Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos