(1265) Using a Multidisciplinary Model to Integrate a Safety Checklist Into Pediatric Critical Care Rounds

Introduction: Pediatric Intensive Care Units (PICUs) face challenges in consistently implementing best practices to prevent harm, particularly in times of high patient census. Safety checklists are recognized for improving compliance with patient safety practices, but none are universally utilized. We aimed to develop and implement a multidisciplinary rounding script embedded into the provider and nursing presentations to increase discussion of patient safety practices.

Methods: For this quality improvement initiative, a multidisciplinary rounding script was created with input from key stakeholders including pediatric critical care fellows, faculty, residents, nursing, and pharmacy. Drivers and barriers to implementation were assessed via qualitative feedback and several iterative scripts were developed. Rounding team members were educated on the rounding script use and importance. Safety checklist compliance was observed directly during rounds, and rounding time per patient was tracked as a balancing measure. Data were collected as a convenience sample and trended using Statistical Process Control (SPC) charts.

Results: Prior to the rounding script implementation, safety checklist elements were discussed 23% of the time on morning rounds in the PICU. Since implementation of interventions in September 2023, including a standardized rounding script, education, badge cards, and process redundancy, compliance increased to 90%. Rounding time per patient increased from 11.8 minutes to 13.5 minutes.

Conclusions: Use of a standardized multidisciplinary rounding script with an embedded patient safety checklist increases the discussion of patient safety practices that may otherwise be overlooked in critically ill children. Rounding time increased by less than 2 minutes per patient. Further Plan-Do-Study-Act cycles are underway to sustain compliance and incorporate into the electronic medical record and other pediatric units.