Pilot to Practice: Evolution of Implementing Bedside Report

Abstract

Background:

Bedside report (BSR) is considered the accepted standard in shift report, aligning with evidence-based practice allowing clinicians to visualize patients, vital signs, work of breathing, ventilator waveforms, and other equipment and personnel related to the care of a patient. BSR leads to clinicians reporting increased satisfaction, increased adequate communication to prioritize workload, increased ability to communicate effectively with other providers directly after report, and improved overall awareness of patient needs. Previously, we reported the early phases of our quality improvement (QI) process of introducing BSR to UC Davis Medical Center’s respiratory care department. The current aim is to describe adherence and management of an ongoing QI process

Methods:

We performed analyses of BSR surveillance data collected between May of 2020 through October of 2021. Surveillance was conducted anonymously and reported via a Qualtrics Survey. Surveillance was isolated to 4 ICUs at the beginning of our QI project and expanded to all 9 of our ICUs and emergency department in July of 2021. A departmental goal of 75% adherence rate was established. Monthly adherence rates were calculated and highlighted in the respiratory staff lounge. We received exempt status through the UC Davis Medical Center Institutional Review Board.

Results:

There were a total of 1,177 surveillance surveys recorded. Data were analyzed in 3-month increments. Low adherence was noted in the first 3-month period of 38.8% to a high 3-month increment of 72%, with an overall adherence rate of 66.1%.

Conclusions:

Establishing BSR as a standard of practice at UC Davis Medical Center has been difficult. Our evolution has been well measured and we remain committed to continuous quality improvements. Our results underscore the difficulty in establishing culture change. Additionally, we recognize the difficulty of implementing practice change during the COVID-19 pandemic. There remains a need to heuristically study the implementation and ongoing management of BSR for respiratory care departments.