Improving Transitions of Care with Bedside Report

IMPROVING TRANSITIONS OF CARE WITH BEDSIDE REPORT

Abstract

The goal of this project was to improve consistency of bedside reporting (BsR) at change-of-shift on a 34 bed Medical-Surgical unit of a

prestigious Northern California acute care hospital.  Through unit microsystem assessment and interviews with key stakeholders, it was

determined there were three root causes implicated in decreased BsR consistency; the first cause concerned an aspect of the

microsystem’s physical workflow that did not support BsR, the second cause concerned negative staff habits that impeded BsR as

perpetuated by certain negative RN perceptions of BsR, and the final cause concerned a lack of BsR accountability.  These foundational

weaknesses were respectively confronted with evidence-based interventions encompassing (a) a physical workflow modification

recommended to unit management; (b) using staff meetings to address certain negative RN perceptions of BsR using specific, positive

BsR knowledge already possessed by staff; (c) creation of a network-based BsR digital resource folder to reinforce these BsR specifics;

(d) establishment of an accountability system with motivations to foster development of all RNs into BsR champions.  Post-intervention

assessment showed an average BsR consistency improvement of 22.2 percent with largely positive RN perceptions of BsR.  Extended

success of the project would conceivably improve patient satisfaction ratings, decrease nursing overtime expense, and avoid potential

litigation, thereby positively impacting hospital financial yields for a period of at least six months.