WIP 31 - Utilizing a Bedside Visual Aid to Improve the Safety of Inpatient Care for Patients with Specialized Cardiac Care Needs.

Poster Number: WIP 31
Publication Number: WIP 31.880

Background: Patients with cardiac disease often require specialized care due to their unique medical fragility and physiologies. When these patients are admitted to a general hospitalist service for non-cardiac conditions, ensuring these needs are met and identifying subtle signs of decompensation can be challenging due to a relative lack of comfort in management across the team. Establishing a shared mental model of cardiac care for these patients is essential to improve outcomes and prevent adverse events.

Objective: This quality improvement project aims to reduce the number of decompensation events in patients with a cardiac history admitted to the hospitalist service by 50% within 6 months. The objective is to achieve this reduction by implementing visual aids at the patients' bedsides, which convey crucial information on cardiac care parameters to all members of the care team.

Design/Methods: The patient population includes individuals with cardiac diseases significantly impacting their care when admitted to a medical/surgical ward for non-cardiac issues. The baseline rate for decompensation events was established via review of patient charts for 21 months prior to the start of the project. The visual aids include vital signs, oxygen parameters, recommended/contraindicated medical interventions, and potential cardiac complications specific to each patient. After deciding that a patient qualifies for the tool, the admitting senior physician completes a draft of the tool in real-time. A formal version is then completed with the cardiology team and is posted at the patient's bedside within 24 hours of admission or transfer to the hospitalist team. The tool is discussed during daily family-centered rounding. To assess for improvement in situational awareness, a pre- and post-intervention survey is conducted anonymously among all care team members to assess their knowledge, comfort, communication, and satisfaction with the visual tools. Qualifying patients will be monitored and tracked on our objective primary endpoints including PICU transfers, cardiac arrests, and mortality.