Abstract 10584: Transitioning a Pediatric Cardiac Intensive Care Unit Rounding Checklist from Paper to the Electronic Health Record to Improve Utilization - A Quality Improvement Project

Abstract

Background: Delivering excellent clinical care in a pediatric cardiac intensive care unit (PCICU) involves coordination of a multidisciplinary team and consistent implementation of best practices. A rounding checklist (RC) may mitigate failures in communication and reduce practice variability. Multiple barriers to successful RC utilization remain, including poor provider compliance. Aim: The primary aim of this quality improvement (QI) project is to implement and evaluate the utilization and effectiveness of an electronic health record (EHR)-based RC in the PCICU. Methods: In collaboration with key stakeholders, we used Plan-Do-Study-Act (PDSA) QI methodology to adapt our existing paper-based RC into an EHR-embedded tool (Fig 1). We conducted educational sessions prior to implementation of the RC to review its potential benefits. We evaluated project impact through pre- and post-implementation surveys of PCICU attendings, fellows and advanced practice providers. Our primary outcome metric was RC utilization. Results: Most pre-implementation survey respondents (n=33), agreed or strongly agreed that they would be interested in using a RC (78%), and it would be helpful (87%). During the first PDSA cycle, of 65 eligible patients, 74% (n=48) had the checklist completed at least once during their CVICU admission. Of 28 eligible providers during the same PDSA, 71% (n=20) completed a RC in the EHR at least once. Most survey respondents (n=25) after the first PDSA agreed or strongly agreed that using the RC is helpful (64%), easy (60%) and can be improved (60%). We continue to modify evaluate the RC and its utilization in subsequent PDSA cycles. Conclusion: Transitioning a RC from paper to the EHR is feasible and improves tracking of utilization. Engaging providers for feedback and making real-time modifications may improve future RC compliance. Continued data collection will improve our understanding of the RC’s impact on health care delivery and patient safety.