Bringing the Patient to the Center: Implementing an Interdisciplinary Rounding Approach in the Labor and Delivery Setting


Poster Presentation

Purpose for the Program

To create an interdisciplinary approach to care in a busy labor and delivery unit that keeps the patient at the center of the care provided.

Proposed Change

To create a standardized approach to care in which staff from obstetrics, nursing, neonatology, and anesthesia have the opportunity to meet and discuss the plan of care for each patient in the labor and delivery unit at designated times during the day. In addition, the patient has the opportunity to meet the team who will care for her and her infant in the upcoming shift.

Implementation, Outcomes, and Evaluation

By using performance improvement methodologies, an interdisciplinary team was assembled to identify why previous attempts at an interdisciplinary approach to care in this setting was unsuccessful, to work with their respective disciplines to bring the voice of the patient to the table, and to identify what elements of care were identified as the most important to share with the team and receive from the team during the actual interdisciplinary rounds. The team chose a huddle format where the interdisciplinary team would assemble at least twice a day in the labor and delivery unit, walk room-to-room to discuss each patient, and devise a plan of care that the entire team was aware of.

The outcomes identified an increased culture of safety in the labor and delivery unit. Two specific Agency for Healthcare Research and Quality (AHRQ) survey questions that highlight teamwork within the unit were distributed and transitions/handoffs are anticipated to be increased. The initial AHRQ survey was conducted approximately 1 year before the implementation of the interdisciplinary rounds. We will repeat the safety culture survey 6 months after implementation to see if there is an increase in the domains that have already been identified.

Implications for Nursing Practice

Successful implementation will allow the work of the nurse to be more streamlined, bring the voice of the patient to the discussion, and allow the nurse to fulfill her accountability of being the patient's primary advocate.