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Improving communication in a pediatric intensive care unit using daily patient goal sheets
Authors:Agarwal Swati  Frankel Lorry  Tourner Susan  McMillan Alex  Sharek Paul J
Institution:Division of Pediatric Critical Care, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA. swati.agarwal@inova.org
Abstract:PURPOSE: The aim of the study was to determine if a pediatric intensive care unit (PICU) daily patient goal sheet would improve communication between health care providers and decrease length of stay (LOS). MATERIALS AND METHODS: We evaluated a daily patient goal sheet's impact on questionnaire-based measures of effectiveness of communication, nurses' knowledge of physicians in charge, and on LOS in the PICU. RESULTS: Four hundred nineteen questionnaires were completed by nurses and physicians before goal sheet implementation and 387 after implementation. Nurses and physicians perceived an improved understanding of patient care goals (P < .001), reported increased comfort in explaining patient care goals to parents (P < .001), and listed a higher number of patient care goals after goal sheet implementation (P < .01). Nurses identified the patient's attending physician and fellow with increased accuracy after goal sheet implementation (P < .001). Median PICU LOS was unchanged; however, mean LOS trended toward a reduction after goal sheet implementation (4.1 vs 3.7 days, P = .36). Seventy-six percent of respondents found the goal sheets helpful. CONCLUSIONS: Using a PICU daily patient goal sheet can improve communication between health care providers, help nurses identify the in-charge physicians, and be helpful for patient care. By explicitly documenting patient care goals, there is enhanced clarity of patient care plans between health care providers.
Keywords:Communication  Patient goal sheet  Patient safety  Patient care  Pediatric intensive care units
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