Mindfulness Rounds Initiative - A Short Mindfulness-Based Program for A Busy Workplace

Study Overview
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Brief Summary
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An 8 week course of mindfulness education and practices will be presented to all staff, patients, and visitors voluntarily attending the thrice weekly presentations. The goal is to reduce staff stress, improve communication, enhance patient satisfaction, and improve quality of care.

Detailed Description
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Mindfulness Rounds Care-giver well-being is recognized as an important goal in decreasing burnout, increasing job satisfaction, and may have implications in improving quality of care and patient satisfaction. Mindfulness training is a well-studied tool used to enhance care-giver well-being. The impact of a Mindfulness training experience for caregivers, support staff, and patients and their families working together in a hospital unit on patient satisfaction has not been well studied, if at all. The researchers propose instituting a pilot program of Mindfulness Rounds on a given hospital unit and assessing the effect on employee well-being, patient satisfaction, and quality of care. Introduction: The physical and mental health of healthcare practitioners (HCPs) has become an area of attention and research in recent years as HCP burnout and suicide are now openly discussed concerns in medicine. Well-being education is now a required curricula component by the Accreditation Council for Graduate Medical Education (ACGME). Mindfulness is a technique and philosophical concept which has received significant attention in the medical literature as a tool for increasing HCP well-being. Mindfulness describes the idea of maintaining a conscious presence in the present, of avoiding obsessing about the past or the future, and of continuously being aware of, and grateful for, the things we have in life as opposed to the things we don't. Mindfulness-Based Stress Reduction (MBSR) is one particular system, developed by Jon Kabat-Zinn over 30 years ago, which has been built into a well-structured certified training program for teaching mindfulness. Numerous studies have used MBSR or similar techniques to advance HCP psychologic well-being, and while some have investigated a variety of HCP training techniques to improve the patient experience, few have sought to explore a relationship between the impact of mindfulness training for HCP on patient satisfaction, quality of care outcomes, and HCP overall health. To the investigators' knowledge, no one has sought to bring mindfulness education to an entire hospital unit - physicians, nurses, support staff, as well as patients and their families wherever possible - with the goal of improving both HCP and the overall patient experience. The researchers propose instituting a pilot program of Mindfulness Rounds on a given hospital unit and assessing the effect on employee well-being, patient satisfaction, and quality of care.

Official Title
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Mindfulness Rounds Initiative - An 8-Week, Short Session, Mindfulness Based Protocol for On-Site Delivery of Stress Reduction Practices

Conditions
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Healthcare Practitioner Stress, Patient Satisfaction

Intervention / Treatment
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* Behavioral: Mindfulness Rounds


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: - Employees on the Units Exclusion Criteria: - none

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The participants are staff on two hospital units tending to the same patient population with the same policies and protocols - postpartum patients. One unit will have the Mindfulness Rounds Initiative ass the intervention, the other will not. Both units will be evaluated against each other, and against themselves in a pre-/post- design.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Mindfulness Rounds<br>Participants will be exposed to thrice weekly Mindfulness Rounds education on the Unit; participation in the actual sessions is voluntary. | Behavioral: Mindfulness Rounds<br>* Throughout the 8-week study period, a different mindfulness practice will be introduced weekly in 3 separate 15-minute live sessions. Posters describing the particular practice of the week will be placed around the Unit as visual reminders to encourage actual practice.<br>|
| No Intervention: Control<br>No intervention will take place on this Unit | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Pain scores | Patient pain scores are routinely collected by Nursing and entered into the electronic medical record (EMR). Full pain scale from 0-10, higher score indicates more pain. | 1-3 months pre-intervention, 1-3 months post-intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Discharge time | Duration from discharge order to discharge time. | 1-3 months pre-intervention, 1-3 months post-intervention | 
| Change in Narcotic usage | Aggregate total narcotics administered/patient hours on unit. | 1-3 months pre-intervention, 1-3 months post-intervention | 
| Change in Patient Satisfaction survey | Pres-Ganey survey to assess patient satisfaction. Pres-Ganey Survey: 24 item instrument, each item scored: very poor (score = 0), poor (25), fair (50), good (75) and very good (100). Full scale from 0 - 100, higher score indicates more satisfaction. | 1-3 months pre-intervention, 1-3 months post-intervention | 
| Change in Perceived Stress Scale (PSS) survey | This is a validated survey tool to assess an individual's perceived stress. Full scale range from 0 to 40, higher score indicates higher perceived stress. | Within 1 month prior to intervention, within one month post the intervention. | 
| Change in number of Staff sick days | Number of total staff sick days. | 1-3 months pre-intervention, 1-3 months post-intervention | 
| Change in number of staff injuries | Number of total staff injuries | 1-3 months pre-intervention, 1-3 months post-intervention | 
| Change in number of workers compensation claims | Number of total workers compensation claims | 1-3 months pre-intervention, 1-3 months post-intervention | 
| Change in number of discharges before noon | Number of discharges before noon as a hospital metric tracked for efficiency. | 1-3 months pre-intervention, 1-3 months post-intervention | 
| Change in Staff handwashing rates | Routinely tracked by anonymous observers | 1-3 months pre-intervention, 1-3 months post-intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Stress, Mindfulness, pain scores, patient satisfaction, Perceived Stress Scale, MBSR