title: Clinical Workflow Observations to Identify Opportunities for Nurse, Physicians and Patients to Share a Patient-centered Plan of Care.
abstract: Patient- and Family-Centered Care (PFCC) is essential for high quality care in the critical and acute-specialty care hospital setting. Effective PFCC requires clinicians to form an integrated interprofessional team to collaboratively engage with the patient/family and contribute to a shared patient-centered plan of care. We conducted observations on a critical care and specialty unit to understand the plan of care activities and workflow documentation requirements for nurses and physicians to inform the development of a shared patient-centered plan of care to support patient engagement. We identified siloed plan of care documentation, with workflow opportunities to converge the nurses plan of care with the physician planned To-do lists and quality and safety checklists. Integration of nurses and physicians plan of care activities into a shared plan of care is a feasible and valuable step toward interprofessional teams that effectively engage patients in plan of care activities.
authors.affiliation: Partners Healthcare Systems, Wellesley, MA ; Brigham and Women's Hospital, Boston, MA ; Harvard Medical School, Boston, MA.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Collins
authors.affiliation: Brigham and Women's Hospital, Boston, MA.
authors.forename: Priscilla
authors.initials: P
authors.lastname: Gazarian
authors.affiliation: Brigham and Women's Hospital, Boston, MA.
authors.forename: Diana
authors.initials: D
authors.lastname: Stade
authors.affiliation: Brigham and Women's Hospital, Boston, MA.
authors.forename: Kelly
authors.initials: K
authors.lastname: McNally
authors.affiliation: Brigham and Women's Hospital, Boston, MA.
authors.forename: Conny
authors.initials: C
authors.lastname: Morrison
authors.affiliation: Brigham and Women's Hospital, Boston, MA.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Ohashi
authors.affiliation: Brigham and Women's Hospital, Boston, MA ; Harvard Medical School, Boston, MA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Lehmann
authors.affiliation: Brigham and Women's Hospital, Boston, MA ; Harvard Medical School, Boston, MA.
authors.forename: Anuj
authors.initials: A
authors.lastname: Dalal
authors.affiliation: Partners Healthcare Systems, Wellesley, MA ; Brigham and Women's Hospital, Boston, MA ; Harvard Medical School, Boston, MA.
authors.forename: David W
authors.initials: DW
authors.lastname: Bates
authors.affiliation: Brigham and Women's Hospital, Boston, MA ; Harvard Medical School, Boston, MA.
authors.forename: Patricia C
authors.initials: PC
authors.lastname: Dykes
mesh_terms: D000046:Academic Medical Centers; D005190:Family; D006801:Humans; D007297:Inpatients; D008404:Massachusetts; D009726:Nurses; D010347:Patient Care Planning / Q000458:organization & administration*; D010348:Patient Care Team; D010358:Patient Participation; D018802:Patient-Centered Care / Q000458:organization & administration*; D010820:Physicians; D011368:Professional-Family Relations; D057188:Workflow