Encouraging Communication and Actionable Recommendations from the Rounds

The fifth and final practice change for operationalizing Whole Community Palliative Rounds is taking action to improve care.

First, discussion of each case presented at rounds must end with agreed-upon actions, then the care team must implement the actions.

The key to any effective follow-up process is to keep it as simple as possible. Clarifying the roles and responsibilities of rounds participants will keep all providers informed. Easily accessible documentation will allow clinicians to quickly and efficiently follow up on the recommendations from the rounds.

After the rounds, communication is critical. Clinicians must communicate with other care providers to ensure recommendations are implemented. Outcomes from the recommendations are also communicated with the members of a patient’s circle of care. The WCPR process should include appropriate forms, channels or forums for this type of communication.

Establishing a Process for Actions and Accountability

For each case presented at WCPR:

• Clearly set a plan of action for the week, including all recommended care actions.
• Clearly identify who will do what, when and where.
• Clearly identify the communication responsibilities for presenting care providers and other attending clinicians.

After rounds:

• The referring clinician communicates the results of WCPR to all relevant members of the care team.
• The referring clinician sends medical suggestions from WCPR to the patient’s most responsible provider (nurse practitioner or physician) to request a new order (if the most responsible provider [MRP] is not able to attend the rounds).