Bedside interprofessional rounds: Perceptions of benefits and barriers by internal medicine nursing staff, attending physicians, and housestaff physicians. Issue 10 (6th August 2014)

• Record Type: Journal Article
• Authors: Gonzalo, Jed D.; Kuperman, Ethan; Lehman, Erik; Haidet, Paul
• Is Part Of: Journal of hospital medicine. Volume 9:Issue 10(2014)
• Page Start: 646
• Page End: 651
• Publication Date: 2014-08-06
• Subjects: Hospital care -- Periodicals; Clinical medicine -- Periodicals; 610
• DOI: 10.1002/jhm.2245
• Languages: English
• ISSNs: 1553-5592

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jhm2245-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>Interprofessional collaboration improves the quality of care, but integration into workflow is challenging. Although a shared conceptualization regarding bedside interprofessional rounds may enhance implementation, little work has investigated providers' perceptions of this activity.</p> </sec> <sec id="jhm2245-sec-0002" sec-type="section"> <title>OBJECTIVE</title> <p>To evaluate the perceptions of nurses, attending physicians, and housestaff physicians regarding the benefits/barriers to bedside interprofessional rounds.</p> </sec> <sec id="jhm2245-sec-0003" sec-type="section"> <title>DESIGN AND PARTICIPANTS</title> <p>Observational, cross‐sectional survey of hospital‐based medicine nurses, attending physicians, and housestaff physicians. Descriptive, nonparametric Wilcoxon rank sum and nonparametric correlation were used.</p> </sec> <sec id="jhm2245-sec-0004" sec-type="section"> <title>MAIN MEASURES</title> <p>Bedside interprofessional rounds were defined as "encounters including 2 physicians plus a nurse or other care provider discussing the case at the patient's bedside." Eighteen items related to "benefits" and 21 items related to "barriers" associated with bedside interprofessional rounds.</p> </sec> <sec id="jhm2245-sec-0005" sec-type="section"> <title>RESULTS</title> <p>Of 171 surveys sent, 149 were completed (87%). Highest‐ranked benefits were related to communication/coordination, including "improves communication between nurses‐physicians;" lowest‐ranked benefits were related to efficiency, process, and outcomes, including "decreases length‐of‐stay" and "improves timeliness of consultations." Nurses reported most favorable ratings for all items (<italic>P</italic> < 0.05). Rank order for 3 provider groups showed high correlation (<italic>r</italic> = 0.92, <italic>P</italic> < 0.001). Highest‐ranked barriers were related to time, including "nursing staff have limited time;" lowest‐ranked barriers were related to provider‐ and patient‐related factors, including "patient lack of comfort." Rank order of barriers among all groups showed moderate correlation (<italic>r</italic> = 0.62–0.82).</p> </sec> <sec id="jhm2245-sec-0006" sec-type="section"> <title>CONCLUSIONS</title> <p>Although nurses perceived greater benefit for bedside interprofessional rounds than physicians, all providers perceived coordination/teamwork benefits higher than outcomes. To the extent the results are generalizable, these findings lay the foundation for facilitating meaningful patient‐centered interprofessional collaboration. <italic>Journal of Hospital Medicine</italic> 2014;9:646–651. © 2014 Society of Hospital Medicine</p> </sec> </abstract>