102 Virtual family-centered rounds: A collaborative necessity during COVID-19 and beyond
Notice bibliographique
Résumé
Abstract Primary Subject area Hospital Paediatrics Background Family-centered rounds (FCR) are the cornerstone of pediatric hospital care and have many proven benefits including improved patient outcomes, satisfaction, communication and safety. Traditionally, FCR take place in the patient’s room; however, due the COVID-19 pandemic, entering patient rooms was no longer advisable in order to maintain physical distancing and preserve personal protective equipment (PPE). Therefore, it became clear early in our pandemic response that a new process was required to ensure the benefits of FCR were maintained given their paramount importance to safe and quality patient care. Objectives The objective of this study was to virtualize the in-person FCR process used by our pediatric inpatient medicine teams to improve safety and reduce PPE costs during the COVID-19 pandemic. Design/Methods We quickly identified available hardware (laptops, tablets) and video conferencing software, assembled a multidisciplinary project team and secured administrative and quality improvement support. Quality improvement methodology and participatory design were used to develop and refine our virtual family-centered rounds (vFCR) standard work, and on April 6, 2020 we launched our first vFCR. Over the next 3 months we engaged in a series of plan-do-study-act (PDSA) cycles to iteratively improve our process: nurse auditors attended vFCR daily then met with our project team to review data and observations, and real-time feedback was sought from patients and caregivers. Results Data collected on 1792 vFCR between April 6 and July 31, 2020 revealed 74% of nurses, physicians and trainees were satisfied or very satisfied with vFCR and 88% felt they had a good understanding of the patient care plan after vFCR. 79% of patients and caregivers were satisfied or very satisfied with vFCR and 88% of caregivers felt like a valued member of their child’s care team. We met our target of 10 minutes per patient in 74% of vFCR with an average transition time of <3 minutes between patients. Patients and caregivers felt vFCR were collaborative, more private and less intimidating than in-person FCR, and some even preferred the virtual approach. Conclusion During this pilot, we achieved a standardized vFCR workflow that is safe, feasible, efficient and confidential, with high levels of stakeholder satisfaction and support. vFCR was highly valued by families and yielded unanticipated benefits. Based on current usage, vFCR are saving ~$36,000 monthly in PPE. The importance of this work during the COVID-19 pandemic is clear, but also has benefits in non-pandemic times, including allowing caregivers to participate in FCR when they cannot be at the bedside, enhancing FCR confidentiality, and improving communication and care for isolated patients. Furthermore, the vFCR process is easily adaptable to other inpatient workflows such as consults and multi-disciplinary meetings. We believe this virtual care model is both highly relevant and transferable to a variety of health care settings across Canada and beyond.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,029 | 0,034 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,009 | 0,005 |
| Communication savante | 0,004 | 0,003 |
| Science ouverte | 0,003 | 0,018 |
| Intégrité de la recherche | 0,002 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,008 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».