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Arch Pediatr Adolesc Med. 2011 May;165(5):424-8. doi: 10.1001/archpediatrics.2011.54.

Unit-based care teams and the frequency and quality of physician-nurse communications.

Author information

  • 1Division of General Pediatrics, Department of Medicine, Children's Hospital Boston, 300 Longwood Ave., Boston, MA 02115, USA. mbgordon@post.harvard.edu

Abstract

OBJECTIVE:

To determine whether reorganizing physicians into unit-based teams in general pediatric wards is associated with greater ability to identify other care team members, increased face-to-face communication between physicians and nurses, greater perception that their patient care concerns were met, and decreased number of pages to residents.

DESIGN:

Prospective intervention study with data collected before and at 2 time points after implementation of unit-based teams.

SETTING:

General pediatric wards at an urban, tertiary care, freestanding children's hospital from April 1, 2008, through June 30, 2009.

PARTICIPANTS:

Pediatric residents rotating in the medical wards (n = 60) and ward-based pediatric nurses (n = 154).

INTERVENTION:

We reorganized resident-physician care teams to be based on specific inpatient units, with residents admitting and caring only for patients on their assigned unit.

MAIN OUTCOME MEASURES:

Anonymous physician and nurse self-reports of communication practices and number of pages residents received.

RESULTS:

In the unit-based team system, physicians were more likely to be able to identify the nurse for their patients with the most complex conditions (62.3% vs 82.8% vs 82.5%, P = .05), to report contacting (27.3% vs 64.9% vs 56.9%, P = .01) and being contacted by (7.7% vs 48.2% vs 55.2%, P = .002) that nurse in person, and to believe their patient care concerns were met (44.2% vs 82.1% vs 81.8%, P = .009). Nurses reported parallel improvements in communication patterns. The mean number of pages per day to residents decreased by 42.1% (19 vs 10 vs 11, P < .001).

CONCLUSION:

Unit-based teams improve the frequency and quality of multidisciplinary communication, which may create an improved climate for patient safety.

PMID:
21536957
[PubMed - indexed for MEDLINE]
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