• Lindsey B Justice, David S Cooper, Carla Henderson, James Brown, Katherine Simon, Lindsey Clark, Elizabeth Fleckenstein, Alexis Benscoter, and David P Nelson.
• 1Cardiac Intensive Care Unit, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 2College of Nursing, University of Cincinnati, Cincinnati, OH.
• Pediatr Crit Care Me. 2016 Jul 1; 17 (7): 677-83.

ObjectivesTo improve communication during daily cardiac ICU multidisciplinary rounds.DesignQuality improvement methodology.SettingTwenty-five-bed cardiac ICUs in an academic free-standing pediatric hospital.PatientsAll patients admitted to the cardiac ICU.InterventionsImplementation of visual display of patient daily goals through a write-down and read-back process.Measurements And Main ResultsThe Rounds Effectiveness Assessment and Communication Tool was developed based on the previously validated Patient Knowledge Assessment Tool to evaluate comprehension of patient daily goals. Rounds were assessed for each patient by the bedside nurse, nurse practitioner or fellow, and attending physician, and answers were compared to determine percent agreement per day. At baseline, percent agreement for patient goals was only 62%. After initial implementation of the daily goal write-down/read-back process, which was written on paper by the bedside nurse, the Rounds Effectiveness Assessment and Communication Tool survey revealed no improvement. With adaptation of the intervention so goals were written on whiteboards for visual display during rounds, the percent agreement improved to 85%. Families were also asked to complete a survey (1-6 Likert scale) of their satisfaction with rounds and understanding of daily goals before and after the intervention. Family survey results improved from a mean of 4.6-5.7. Parent selection of the best possible score for each question was 19% at baseline and 75% after the intervention.ConclusionsVisual display of patient daily goals via a write-down/read-back process improves comprehension of goals by all team members and improves parent satisfaction. The daily goal whiteboard facilitates consistent development of a comprehensive plan of care for each patient, fosters goal-directed care, and provides a checklist for providers and parents to review throughout the day.

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