10 Steps To Launch IBRs


Develop a project charter signed by CNO, CMO, Physician Group(s), and Departments of Pharmacy and Care Management


Standardize a nursing bedside handover process that systemizes nursing inputs to IBRs and verifies bedside compliance for 90% of nurses


Implement an interdisciplinary unit governance model, including a unit Medical Director with demonstrated passion for the unit and accountability for unit outcomes


Choose an evidence-based shared mental model for the structure of daily rounds, and use it to provide profession-specific job aids to all IBR participants, including daily prep sheets, advanced skills guides, and video examples


Train all IBR participants in advanced individual and team skills, and evaluate each against profession-specific, codified high-performance criteria


Develop a process for planning, managing, and evaluating rounds each day to optimize and protect quality and efficiency, and to flow daily IBR data into performance dashboards


Launch IBRs on a qualified alpha unit, prioritizing essentials before focusing on advanced competencies; report IBR performance to unit staff


Implement a profession-specific IBR skills certification program that provides real-lime coaching to all participants based on the codified high-performance criteria


Ensure long-term stability by responding appropriately and promptly to staff turnover and deviations in process fidelity, leveraging the IBR performance data and the unit’s leadership dyad


Learn from and replicate successes from the alpha unit to the next qualified unit, elevating standards for participant skills, process quality, and dyad accountability


Achieve high reliability clinical operations excellence across all participating units