Article ; Online: The Impact of Bedside Interdisciplinary Rounds on Length of Stay and Complications.
2017 Volume 12, Issue 3, Page(s) 137–142
Abstract: Background: Communication among team members within hospitals is typically fragmented. Bedside interdisciplinary rounds (IDR) have the potential to improve communication and outcomes through enhanced structure and patient engagement.: Objective: To ... ...
| Abstract | Background: Communication among team members within hospitals is typically fragmented. Bedside interdisciplinary rounds (IDR) have the potential to improve communication and outcomes through enhanced structure and patient engagement. Objective: To decrease length of stay (LOS) and complications through the transformation of daily IDR to a bedside model. Design: Controlled trial. Setting: 2 geographic areas of a medical unit using a clinical microsystem structure. Patients: 2005 hospitalizations over a 12-month period. Interventions: A bedside model (mobile interdisciplinary care rounds [MICRO]) was developed. MICRO featured a defined structure, scripting, patient engagement, and a patient safety checklist. Measurements: The primary outcomes were clinical deterioration (composite of death, transfer to a higher level of care, or development of a hospital-acquired complication) and length of stay (LOS). Patient safety culture and perceptions of bedside interdisciplinary rounding were assessed pre- and postimplementation.. Results: There was no difference in LOS (6.6 vs 7.0 days, P = 0.17, for the MICRO and control groups, respectively) or clinical deterioration (7.7% vs 9.3%, P = 0.46). LOS was reduced for patients transferred to the study unit (10.4 vs 14.0 days, P = 0.02, for the MICRO and control groups, respectively). Nurses and hospitalists gave significantly higher scores for patient safety climate and the efficiency of rounds after implementation of the MICRO model. Limitations: The trial was performed at a single hospital. Conclusions: Bedside IDR did not reduce overall LOS or clinical deterioration. Future studies should examine whether comprehensive transformation of medical units, including co-leadership, geographic cohorting of teams, and bedside interdisciplinary rounding, improves clinical outcomes compared to units without these features. Journal of Hospital Medicine 2017;12:137-142. |
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| MeSH term(s) | Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Interprofessional Relations ; Length of Stay/trends ; Male ; Middle Aged ; Patient Care Team/standards ; Patient Care Team/trends ; Teaching Rounds/methods ; Teaching Rounds/standards ; Teaching Rounds/trends ; Tertiary Care Centers/standards ; Tertiary Care Centers/trends | ||||||||||
| Language | English | ||||||||||
| Publishing date | 2017-03-09 | ||||||||||
| Publishing country | United States | ||||||||||
| Document type | Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't | ||||||||||
| ZDB-ID | 2233783-0 | ||||||||||
| ISSN | 1553-5606 ; 1553-5592 | ||||||||||
| ISSN (online) | 1553-5606 | ||||||||||
| ISSN | 1553-5592 | ||||||||||
| DOI | 10.12788/jhm.2695 | ||||||||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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