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Abstract Details

BBRAINS: Reducing Unnecessary Overnight Pages in the Neurology Unit via Improved Resident/Nurse Communication
Practice, Policy, and Ethics
P9 - Poster Session 9 (12:00 PM-1:00 PM)
7-013

To reduce unnecessary overnight pages in a neurology unit by implementing an afternoon huddle between residents and nurses.

On-call neurology residents face high overnight workloads due to a myraid of reasons, including nurse paging for patient care issues that could have been addressed earlier when the day team was present.  To reduce overnight paging, we created resident-nurse afternoon huddles to discuss relevant neurological issues for inpatients.
As part of the ongoing IGNITE (Improving GME-Nursing Interprofessional Team Experiences) program funded by ACGME, neurology residents and nurses co-created a huddle for the senior resident with bedside nurses using the acronym BBRAINS (Blood pressure, head of Bed, Restraints/sitter, Analgesic, Imaging/anticipated procedures, Nutrition, Sugar). The nursing team monitored huddle occurence using a Managing Daily Improvement board, and we interrogated pagers to correlate average weekly on-call overnight resident pages with the occurrence of BBRAINS huddles. Residents completed before and after surveys about overnight workflow and pages.  Length of stay was obtained from the hospital scorecard.
From month 3 to month 11, BBRAINS was implemented successfully. Weekly huddle rates for 3 months ranged from 0% to 100%. When BBRAINS huddles occurred, average overnight paging volume to the on-call pager was up to 40% less per night than when they did not occur (30 vs 18).  Residents reported improved satisfaction with MD/RN communication (3.2 pre vs 3.6 post, p=0.027). Two thirds of residents reported B-BRAINS improved patient care. In the 3 months before and after BBRAINS, mean length of stay for the neurology unit reduced by 0.51 days (6.76 days to 6.25 days), corresponding to quarterly cost savings of $315,000.
Improving resident and nursing communication with brief afternoon huddles can improve overnight paging burden, resident and nurse satisfaction, and length of stay.
Authors/Disclosures
Jumana T. Alshaikh, MD (University of Utah)
PRESENTER 		Dr. Alshaikh has nothing to disclose.
No disclosure on file
No disclosure on file
Changrui Xiao, MD (UC Irvine) Dr. Xiao has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for WIley. The institution of Dr. Xiao has received research support from NIH.
Zachary B. Bulwa, MD (University of Chicago) Dr. Bulwa has nothing to disclose.
Faten El Ammar, MD (University of IL, Chicago) Dr. El Ammar has nothing to disclose.
Julia Bodnya, MD (University of Chicago) Dr. Bodnya has nothing to disclose.
Helene Rubeiz, MD (University of Chicago Medicine) Dr. Rubeiz has nothing to disclose.
No disclosure on file