Title : Improving patient outcomes and nurse burnout through a multidisciplinary nursing led pilot model in a progressive critical care unit
Abstract:
Background: Hospitalized patients in acute care settings frequently experience discharge delays and communication barriers that negatively affect transitions of care, patient experience, and readmission risk. Improving coordination among healthcare professionals, and standardizing discharge processes are recognized quality improvement priorities. Nurse burnout also plays a critical role in how optimal patient care is delivered. In response, a multidisciplinary collaboration model was implemented in a Progressive Critical Care Unit to improve communication between patients and members of the care team, enhance discharge efficiency, support better patient outcomes, and assess nurse burnout.
Purpose: Enhance communication between patients/ family and the clinical care team, reduce late discharges, 30 day readmissions, improve cost effectiveness. In addition, to evaluate nurse burnout post implementation.
Methods: A prospective 5 month quality improvement pilot (November 2025–March 2026) was conducted in a progressive care unit at a Level I trauma center in South Texas. The intervention adapted a previously successful intensive care multidisciplinary collaboration model to the progressive critical care setting using a structured, team based workflow focused on discharge readiness, care coordination, and evidence based decision making. The pilot incorporated a core interprofessional rounding team composed of hospitalists, charge and bedside nurses, case managers, pharmacists, respiratory therapists, physical therapists, and dietitians. Daily bedside rounds and focused discharge huddles were implemented to identify discharge barriers, coordinate discipline specific interventions, and establish shared patient goals. Nursing interventions included early identification of discharge needs at admission, discharge education, medication teaching reinforcement, patient and family engagement, and coordination of specialty follow up appointments. Pharmacists supported medication reconciliation and outpatient medication verification, while case managers facilitated transition planning and post acute placement needs. Evidence based discussions and shared multidisciplinary learning were reinforced through standardized communication tools and team based case review. We utilized the Maslach Burnout Inventory to evaluate nursing burnout before and after the implementation of the multidisciplinary collaboration team.
Results: The pilot demonstrated measurable improvements in multiple quality indicators. Thirty-day readmissions decreased from 14.59% to 13.10%, representing a 9.4% relative reduction. Late discharges, decreased from 41% to 35%, reflecting a 21.95% relative reduction. CMI improved from 2.08 to 2.17, supporting improved documentation accuracy and acuity capture. The pilot unit achieved benchmark level HCAHPS performance for the first time in over two years while maintaining patient safety, with no increase in mortality or hospital acquired conditions. Nursing driven discharge teaching, interdisciplinary bedside communication, and protected discharge planning time were identified as key contributors to improved outcomes. These improvements represent an estimated $300,000 Return on Investment (ROI) per year. Furthermore, we achieved a 30% relative risk reduction in nurse burnout.
Conclusions: Implementation of a structured multidisciplinary collaboration model in a progressive critical care unit was associated with measurable improvements in quality, operational, and patient experience outcomes while maintaining patient safety. These findings suggest that structured interdisciplinary workflows, coordinated discharge planning, and collaborative bedside communication may improve transitions of care and support broader quality improvement efforts across acute care settings.
