By Robert L. Benz MD, Vice President of Medical Affairs, Lankenau Medical Center
Beginning last week, Main Line Health started a pilot on two units at both Lankenau and Riddle to standardize and improve our multidisciplinary rounds. Consistent with our efforts in alignment with the PE2020 objectives, the Care Progression Rounding Initiative will ensure consistent, patient-centered, dynamic throughput management.
The rounds are led twice a day by the Administrative Coordinator of the unit and will include Care Coordination and the bedside nurse. Where clinically appropriate, pharmacy, physical therapy, and clinical providers (residents, NPs, and PAs) also participate in the morning rounds. As the attending physician, your presence at Care Progression Rounds is not required but is encouraged and welcomed. If you are unable to attend rounds, we recommend a daily discussion with the patient’s bedside nurse addressing the care plan for the patient for that day as well as a reconfirmation of an estimated date of discharge. The nurse will then communicate the plan of care for the day at rounds. We also ask that you are available for any queries on the plan of care after rounds.
After the pilot, the new model will be implemented over a five-phase deployment schedule, with full implementation of all four sites by November 17, 2017. Below, please find a high-level overview of the participant composite, roles/responsibilities and rounding schedule.
| Rounding Lead | Administrative Coordinator or identified designee. |
| Rounding Participants | Clinical Providers (NP, PA, Residents), Administrative Coordinator, Clinical Nurses, Care Coordination (RN/SW)
Ad Hoc: Pharmacy, Physical Therapy, Occupational Therapy |
| Rounding Format | Each participant to provide clinical update relevant to reviewed patient clinical presentation, acute plan of care, barriers to throughput and transitions of care. |
| Scope of Discussion | Defined clinical and resource management focal areas to be discussed per discipline or service area. |
| Meeting Occurrence | Mon. – Fri.
Twice Daily: – Meeting A: Between 11:15 AM – Meeting B: Between 3:15 pm |
| Care Progression Rounding Deployment Schedule | ||||
| Deployment
Date |
Riddle | Lankenau | Bryn Mawr | Paoli |
| Phase I
9/12/2017 |
2 North, 4 Center | 1 Pavilion, 2 Southwest | N/A | N/A |
| Phase II
10/2/2017 |
2 East, 3 East, PCU, ICU | 1 South, 3 South, 1 southwest, 4 South, PEW Building (Trauma) | N/A | N/A |
| Phase III
10/9/2017 |
4 South, 4 East, 4 West | 2 South, 2P, 4P (CICU), 3 Southwest | N/A | N/A |
| Phase IV
10/16/2017 |
N/A | N/A | 6A, 6C, 5A, 4C | 3 Main, 3A, PCU |
| Phase V:
10/23/2017 |
N/A | N/A | 3B, 3C, NCICU, ICU | 4A, 4B, ICU |
| TBD | Mother/Baby | Mother/Baby | Mother/Baby; CDU/OBS | Mother/Baby;
CDU/OBS |
If you have any questions regarding the Care Progression Rounding Initiative, please feel free to reach out to your Care Coordination manager or VPMA.