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The index was calculated as the number of IDR notes completed per day (Monday through Friday) divided by the ward days of care calculated for that day.
Similarly, conventional quality measures of length of stay, excess bed days of care,and 30-day readmissions were unaffected by the intervention, consistent with prior studies that found these metrics insensitive to changes in interdisciplinary care processes [ 21].
Additional outcomes included IDR team member satisfaction and participation, discussion time, and standard quality metrics of length of stay, and 30-day readmission rate, and excess bed days of care.
The box-and-whisker plot illustrates this time variability, with no decrease in variability over the course of our study (Fig. 4).> -wrap-foot> * P-value for differences in means =0.0007 Hospital length of stay, 30-day readmission rates, and excess bed days of care did not indicate any special cause variation that could be attributed to the IDR QI process (Fig. 5a- c).
The primary outcome was note completion rates by charge nurses; IDR team member satisfaction and participation, discussion time and balancing metrics (i.e., excess bed days of care, length of stay, and 30-day readmissions) were also assessed.
The pre-invention IDR note completion rate, as measured by number of patients with a note per ward days of care, was 27%% over an 85-day observation period; post-intervention completion rate was 69%% over 119 days, with the post-intervention center line exceeding the pre-intervention upper confidence limit.
Set up for eight days of care, the group was already overwhelmed on the first day after allowing 1,500 people through the door, nearly 500 of whom had still not been served by day's end and had to return in the wee hours Wednesday morning.
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