Perceptions of rounding checklists in the intensive care unit: a qualitative study

Hallam, B; Kuza, Courtney C.; Rak, Kimberly; Fleck, Jessica C.; Heuston, Melanie M.; Saha, Debjit; Kahn, Jeremy M.

doi:10.1136/bmjqs-2017-007218

Cited by 20 publications

(26 citation statements)

References 17 publications

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“…These approaches to promoting the checklist to staff were employed strategically to encourage take-up. However, the emphasis on administrative discourses undermine the clinical status of checklists and make them less likely to be completed during busy times (Aveling et al, 2013;Hallam et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

The introduction of a safety checklist in two UK hospital emergency departments: A qualitative study of implementation and staff use

Stone

Banks

Brant

et al. 2020

Journal of Clinical Nursing

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Aims and objectives To explore the extent to which a checklist designed to support patient safety in hospital Emergency Departments was recognised and used by staff. Background Patient crowding in UK Emergency Departments makes it difficult for staff to monitor all patients for signs of clinical deterioration. An Emergency Department Safety Checklist was developed at a UK hospital to ensure patients are regularly monitored. It was subsequently implemented in six hospitals and recommended for use across the National Health Service in England. Methods This was a qualitative study in two UK hospital Emergency Departments. Data collection consisted of sixty‐six hours of nonparticipant observation and interviews with twenty‐six staff. Observations were sampled across different days and times. Interviews sampled a range of staff. Data were analysed thematically. The study was undertaken in accordance with COREQ guidelines. Results Staff described the Emergency Department Safety Checklist as a useful prompt and reminder for monitoring patients' vital signs and other aspects of care. It was also reported as effective in communicating patient care status to other staff. However, completing the checklist was also described as a task which could be overlooked during busy periods. During implementation, the checklist was promoted to staff in ways that obscured its core function of maintaining patient safety. Conclusions The Emergency Department Safety Checklist can support staff in maintaining patient safety. However, it was not fully recognised by staff as a core component of everyday clinical practice. Relevance to clinical practice The Emergency Department Safety Checklist is a response to an overcrowded environment. To realise the potential of the checklist, emergency departments should take the following steps during implementation: (a) focus on the core function of clinical safety, (b) fully integrate the checklist into the existing workflow and (c) employ a departmental team‐based approach to implementation and training.

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Section: Discussionmentioning

confidence: 99%

The introduction of a safety checklist in two UK hospital emergency departments: A qualitative study of implementation and staff use

Stone

Banks

Brant

et al. 2020

Journal of Clinical Nursing

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“…We postulated that by infiltrating the rounding process at various levels, we would increase reliability of discussion of key care goal topics, which was our outcome measure of interest. The integrated use of rounding checklists or templates has been previously suggested by Hallam et al 10 as being fundamental to success based on their qualitative study of the perception of ICU rounding checklists by providers. Other studies have found the integration of checklists into the EHR beneficial.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, this phenomenon was noted by Newkirk et al 14 in their study on prompted ICU rounding checklist use, in which they showed that discussion of checklist topics before prompting increased on rounds as the study period progressed. 10…”

Section: Discussionmentioning

confidence: 99%

Improving Reliability to a Care Goal Rounding Template in the Pediatric Intensive Care Unit

Efune

Morse

Sheehan

et al. 2018

Pediatric Quality &Amp; Safety

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Background: Effective pediatric intensive care requires addressing many important aspects of care delivery during morning rounds, often achieved using a rounding checklist. Our objective was to develop a care goal rounding template and then double the reliability of discussion of rounding topics during morning rounds without the use of a checklist. Methods: The Institute for Healthcare Improvement Model for Improvement was used for this initiative. A care goal rounding template was established through discussions and consensus with pediatric intensive care unit (PICU) faculty. Rounds were audited in a blinded fashion over a 3-month period to obtain baseline data on rounding topic discussion. Three interventions were then trialed (plan, do, study, act cycles) over a 12-month period. Weekly reliability in rounding topic discussion was tracked. Results: Baseline reliability with discussion of rounding topics was 36%. The first intervention included the use of a standardized progress note in the electronic health record, which contained topics and served to prompt the discussion on rounds. The second intervention was implementation of laminated cards provided to PICU fellows highlighting the elements of the care goal rounding template. The third intervention addressed a standardized handoff sheet often used during rounds. Mean reliability for discussion of rounding topics improved to 52% shortly following the second intervention. Reliability was sustained more than 1 year later. Conclusions: Following the establishment of a PICU care goal rounding template and various interventions, the reliability in discussing important care goal elements on patient rounds improved.

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“…It allows aligning and standardizing the activities performed by HMB, besides functioning as a reminder for the application of the best evidence (31) . Its application has been increasingly common in the health area, and has demonstrated potential to be used as a standardization and communication tool in the Intensive Care Unit, to increase safety and avoid errors (32) .…”

Section: Tools To Improvement Of Processesmentioning

confidence: 99%

Quality management in Human Milk Banks: a scope review

et al. 2020

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Objectives: to identify the main quality management interventions used by professionals working at Human Milk Banks. Methods: a scope review conducted at PubMed, VHL, Scopus, SciELO, CAPES thesis and Google Scholar databases. Primary studies were included that address quality improvement strategies to improve Milk Bank processes in Portuguese, English and Spanish. Results: search totaled 192 scientific studies, 17 of which met the objective of the study and inclusion criteria. The main quality management interventions used in the Human Milk Bank addressed tools for continuous improvement. Six were aimed at improving processes, one to prevent errors and failures and two to achieve continuous monitoring. Final Considerations: the tools used by professionals working in Human Milk Banks have demonstrated effectiveness in managing the quality of services.

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Perceptions of rounding checklists in the intensive care unit: a qualitative study

Abstract: Our results provide potential insights about why ICU rounding checklists frequently fail to improve outcomes and offer a framework for effective checklist implementation through greater feedback and accountability.

Cited by 20 publications

References 17 publications

The introduction of a safety checklist in two UK hospital emergency departments: A qualitative study of implementation and staff use

The introduction of a safety checklist in two UK hospital emergency departments: A qualitative study of implementation and staff use

Improving Reliability to a Care Goal Rounding Template in the Pediatric Intensive Care Unit

Quality management in Human Milk Banks: a scope review

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