RAMPED-UP: The Development and Testing of an Interprofessional Collaboration Model

J Trauma Nurs. 2019 Nov/Dec;26(6):281-289. doi: 10.1097/JTN.0000000000000466.

Abstract

Interprofessional collaboration (IPC) is an essential component of care delivery needed to achieve optimal patient- and system-level outcomes. The purpose of this project was to measure the impact of a structured IPC model, RAMPED-UP, on hospital length of stay (LOS) in a surgical trauma population. The study design was a prospective cohort with a historical comparison group. The project was conducted at a Level 1 trauma center. The RAMPED-UP group constituted trauma patients admitted from October to December 2017 (n = 96). Trauma patients admitted from October to December 2016 constituted the pre-RAMPED-UP group (n = 98). The 2 groups were similar in demographics. Hospital LOS was not statistically significant between groups. Median RAMPED-UP LOS, defined as the number of days the patient received RAMPED-UP rounds, was 3 days. Patients in the RAMPED-UP group were more likely to be discharged home, with higher discharge-by-noon (DBN) rates of 18.2% (p = .005). A statistically significant correlation was found between incentive spirometry (I/S) values and hospital LOS and RAMPED-UP LOS in the RAMPED-UP group (95% CI: rs -0.301, p = .008; 95% CI: rs -0.270, p = .018, respectively). Although the RAMPED-UP model did not decrease hospital LOS, the model did significantly improve DBN and RAMPED-UP LOS. Further exploration of I/S values as a predictor of LOS is warranted. The use of a structured IPC model that includes essential members of the IPC team can aid in improving patient outcomes such as DBN.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Cohort Studies
  • Critical Care / psychology*
  • Critical Care Nursing / methods*
  • Female
  • Humans
  • Interprofessional Relations*
  • Intersectoral Collaboration*
  • Male
  • Middle Aged
  • Models, Nursing
  • Nursing Staff, Hospital / psychology*
  • Physicians / psychology*
  • Prospective Studies