Structured interdisciplinary bedside rounds improve interprofessional communication and workplace efficiency among residents and nurses on an inpatient internal medicine unit

ABSTRACT

Structured Interdisciplinary Bedside Rounds (SIBR) is a standardized, team-based intervention for hospitals to deliver high quality interprofessional care. Despite its potential for improving IPC and the workplace environment, relatively little is known about SIBR’s effect on these outcomes. Our study aimed to assess the fidelity of SIBR implementation on an inpatient medicine teaching unit and its effects on perceived IPC and workplace efficiency. We conducted a quasi-experimental study with 88 residents and 44 nurses at a large academic medical center and observed 1308 SIBR encounters over 24 weeks. Of these 1308 encounters, the bedside nurse was present for 96.7%, physician for 97.6%, and care manager for 94.7, and 64.7% occurred at the bedside. Following SIBR implementation, perceived IPC improved significantly among residents (93.3% versus 67.9%, p < .024) and nurses (73.7% versus 36.0%, p < .008) compared to before implementation. Moreover, residents perceived greater workplace efficiency operationalized as being paged less frequently with questions by nurses (20.0% versus 49.1%, p = .01). No statistically significant improvements were reported regarding burnout, meaning at work, and workplace satisfaction. Our implementation of SIBR significantly improved perceived IPC and workplace efficiency, which are two important domains of healthcare quality. Future work should examine the impact of SIBR on patient-centered outcomes such as patient experience.

KEYWORDS:

• Interprofessional collaboration
• bedside rounds
• SIBR
• interprofessional communication
• workplace efficiency

Acknowledgments

Contributors: Naadu Adjoka-Nartey, Project Assistant

Disclosure statement

The authors declare no conflicts of interest.

Additional information

Funding

This work was supported by the Yale School of Medicine Department of Internal Medicine Clinical Incentive and Innovation Award.

Notes on contributors

Jeremy I Schwartz

Jeremy I Schwartz is an Associate Professor of Medicine (General Medicine) and Epidemiology (Chronic Disease) at Yale School of Medicine and Yale School of Public Health. He is a Firm Chief/Medical Director of an inpatient general medicine teaching unit at Yale New Haven Hospital

Rosana Gonzalez-Colaso

Rosana Gonzalez-Colaso, PharmD, MPH is an Assistant Professor and Director of Research Education at Yale Physician Associate Program and Faculty Director of Workforce Diversity and Research at Equity Research and Innovation Center

Geliang Gan

Geliang Gan, PhD is a biostatistician at Yale Center for Analytic Sciences based at Yale School of Public Health.

Yanhong Deng

Yanhong Deng, MPH is a biostatistician at Yale Center for Analytic Sciences based at Yale School of Public Health.

Michael H Kaplan

Michael H Kaplan, MD is a clinical fellow in the Division of Rheumatology, Department of Medicine at Icahn School of Medicine.Patricia-Ann Vakos, RN is a Patient Service Manager at Yale New Haven Hospital.

Kathleen Kenyon

Kathleen Kenyon, RN is the former Director of Medicine Nursing at Yale New Haven Hospital.

Amy Ashman

Amy Ashman, RN is a Patient Service Manager on an inpatient gene

Andre N Sofair

Andre N Sofair, MD, MPH is Professor of Medicine (General Medicine) and Epidemiology (Microbial Diseases) at Yale School of Medicine and Yale School of Public Health. Along with Dr. Schwartz, he is a Firm Chief/Medical Director of an inpatient general medicine teaching unit at Yale New Haven Hospital.

Sarwat I Chaudhry

Sarwat I Chaudhry, MD is an Associate Professor Medicine (General Medicine), Associate Dean for Student Research, and co-Director of the National Clinician Scholars Program at Yale School of Medicine.