Date of Completion
Fall 2026
Document Type
DNP Scholarly Project
Academic Department
School of Nursing
Degree Type
Doctoral
Degree Name
Doctor of Nursing Practice
First Advisor
Dr. Lorraine Hu
Abstract
Problem: Inconsistent nurse-physician bedside communication on a 28-bed hybrid intermediate stepdown unit contributed to gaps in care coordination, patient engagement, and discharge readiness. Baseline Centers for Medicare & Medicaid Services (CMS) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) (2026), Press Ganey (2022) communication scores were below the national 90th-percentile benchmark; nurse communication at 58% and doctor communication at 46%, indicating the need for a structured communication process.
Aim of the Project: The quality improvement project aimed to improve nurse-physician communication during daily bedside rounds by implementing a TeamSTEPPS-informed, structured bedside rounding process using the PATIENT tool over 12 weeks.
Review of the Evidence: Evidence supports structured interprofessional bedside rounding and standardized communication tools as strategies to improve communication reliability, collaboration, patient engagement, role clarity, and care coordination (AHRQ, 2023; Sturdivant et al., 2020). The literature also links bedside rounding to improved patient satisfaction, discharge planning, and operational outcomes (Gunnels et al., 2024; Natarajan et al., 2024).
Project Design (QI, PDSA, OHCM): The Institute for Healthcare Improvement Model guided the development of aims, measures, and change testing. Week 5 adherence of 81% prompted PDSA testing to reduce the documentation burden, resulting in 88% adherence in week 6. A second cycle addressed nurse availability, with adherence reaching 92%, 85%, 93%, 81%, and 90% in weeks 7-11. The OhioHealth Change Management supported the urgency, readiness, engagement, adoption, and sustainment.
Intervention: The intervention involved structured nurse-physician-patient bedside rounds using TeamSTEPPS and an adapted PATIENT tool checklist, originally developed by Johnson and Conner (2014, as cited in Sturdivant et al., 2020), to guide discussions regarding care plans, discharge, diagnostic results, concerns, education, nurse input, and next steps. Education, champion support, weekly audits, and feedback reinforced implementation.
Significant Findings/Outcomes: Following implementation, nurse communication scores improved from 58% to 86%, doctor communication scores increased from 46% to 83%, and checklist adherence reached 87%. Median discharge time improved by 13 minutes, from 15:59 to 15:46.
Implications for Nursing: Structured bedside rounding offers a low-cost, evidence-based nursing strategy to strengthen interprofessional communication, care coordination, patient-centered care, discharge planning, and workflow efficiency. DNP-prepared nurses can translate evidence into sustainable systems-level change that advances quality, safety, accountability, and patient experience.
Recommended Citation
Chinakwe, Harriet, "Enhancing Care Coordination: Nurse-Physician Bedside Communication to Improve Outcomes" (2026). All Doctor of Nursing Practice (DNP) Scholarly Projects. 80.
https://fuse.franklin.edu/dnp-project/80
Rights
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