1561: Breaking Silos in the Icu: A Team-Based Approach to Rounding and Communication in the Neuro-Icu

Introduction: Neurocritical care is inherently interdisciplinary, involving neurointensivists, APPs, nurses, pharmacists, therapists, and consulting services. Effective collaboration is essential, especially during structured activities like rounds. Despite teamwork being a recognized core competency, few formal opportunities exist to build these skills across disciplines. To address this gap, the neuroICU at Cleveland Clinic Main Campus partnered with the Office of Interprofessional Learning to participate in the RAYS Program (Relational Alignment to Yield Solutions)—a working retreat designed to evaluate and improve rounding through better communication, relationship-building, and team cohesion. Methods: This quality improvement initiative involved two multidisciplinary, four-hour discussion-based sessions with neuroICU staff, including physicians, nurses, pharmacists, and trainees. Sessions used relational mapping and collaborative problem-solving to identify team strengths, communication barriers, and strategies to improve rounding practices. Portions of this abstract were developed with assistance from ChatGPT, a language model by OpenAI, used to support content creation. All content was reviewed and finalized by the author(s) for accuracy. Results: Participants noted strengths such as full team presence during rounds, effective nurse-led rounding, strong pharmacist integration, and educational value. Challenges included inconsistent structure (especially in afternoons/nights), unclear roles, room constraints, and limited closed-loop communication. Relational mapping revealed gaps in nurse–resident and resident–APP relationships due to turnover, separation, and role ambiguity. Proposed solutions included pre-round huddles, reinforcing closed-loop communication, clarifying roles, improving onboarding, and introducing team-building. Visual tools and informatics were also recommended to streamline rounding. Conclusions: This initiative deepened understanding of team dynamics and interdependence, offering actionable strategies to improve communication, reduce inefficiencies, and strengthen interprofessional relationships. Ongoing implementation and collaboration with interprofessional educators will support sustained, relationship-centered improvements in neurocritical care.