A scoping review of new implementations of interprofessional bedside rounding models to improve teamwork, care, and outcomes in hospitals

ABSTRACT

Poor communication within healthcare teams occurs commonly, contributing to inefficiency, medical errors, conflict, and other adverse outcomes. Interprofessional bedside rounds (IBR) are a promising model that brings two or more health professions together with patients and families as part of a consistent, team-based routine to share information and collaboratively arrive at a daily plan of care. The purpose of this systematic scoping review was to investigate the breadth and quality of IBR literature to identify and describe gaps and opportunities for future research. We followed an adapted Arksey and O’Malley Framework and PRISMA scoping review guidelines. PubMed, CINAHL, PsycINFO, and Embase were systematically searched for key IBR words and concepts through June 2020. Seventy-nine articles met inclusion criteria and underwent data abstraction. Study quality was assessed using the Mixed Methods Assessment Tool. Publications in this field have increased since 2014, and the majority of studies reported positive impacts of IBR implementation across an array of team, patient, and care quality/delivery outcomes. Despite the preponderance of positive findings, great heterogeneity, and a reliance on quantitative non-randomized study designs remain in the extant research. A growing number of interventions to improve safety, quality, and care experiences in hospital settings focus on redesigning daily inpatient rounds. Limited information on IBR characteristics and implementation strategies coupled with widespread variation in terminology, study quality, and design create challenges in assessing the effectiveness of models of rounds and optimal implementation strategies. This scoping review highlights the need for additional studies of rounding models, implementation strategies, and outcomes that facilitate comparative research.

KEYWORDS:

• interprofessional bedside rounds
• structured interprofessional bedside rounds
• interprofessional collaborative practice
• patient-centered rounds
• rounding models and best practices
• patient-centered care
• hospital communication
• patient safety

Acknowledgments

The lead author received funding to support her time during the conceptualization, data collection, analysis and manuscript writing for this project from the NIH National Heart, Lung, and Blood Institute K12 (#5K12HL137940) as part of the UW Implementation Science Training Program and her time during manuscript revisions from a National Heart, Lung, and Blood Institute K23 (1K23HL144910-01A1). BK and NS received support from NCATS (UL1 TR002319). RS received support from the Macy Foundation.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the writing and content of this article.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

This work was supported by the NHLBI [1K23HL144910-01A1,5K12HL137940]; National Center for Advancing Translational Sciences [UL1 TR002319]; Macy Foundation.

Notes on contributors

Erin Abu-Rish Blakeney

Erin Abu-Rish Blakeney, PhD, MA, RN is a Research Assistant Professor at the University of Washington (UW) School of Nursing. She is also a co-lead of the Institute of Translational Health Sciences Team Science Core and affiliate faculty with the UW Center for Inteprofessional Education, Research and Practice. 

Frances Chu

Frances Chu has a Masters in Library and Information Science and works as an Adjunct Medical Librarian at Gonzaga University. She is also a PhD candidate at the University of Washington School of Nursing.

Andrew A. White

Andrew White, MD is a Professor of Medicine at the University of Washington.  He is board certified in Internal Medicine and Clinical Informatics.

G. Randy Smith

Randy Smith is an assistant professor of hospital medicine at Northwestern University Feinberg School of Medicine, and a unit medical director at Northwestern Memorial Hospital.

Kyla Woodward

Kyla Woodward is a PhD candidate at the University of Washington School of Nursing

Danielle C. Lavallee

Danielle Lavallee, PharmD, PhD is the Scientific Director for theBritish Columbia Academic Health Science Network and Affiliate Associate Professor in the Departments Health Services at theUniversity of Washington.

Rachel Marie E. Salas

Rachel Salas, MD, MEd, FAAN, FANA is a board-certified Sleep Neurologist at Johns Hopkins Medicine, Department of Neurology.

Mayumi A. Willgerodt

Mayumi Willgerodt, PhD, MPH, RN, FAAN, FNASN is Associate Professor and Vice-Chair for of Education in the Department of Child, Family, and Population Health Nursing at the University of Washington and affiliate core faculty in the Center for Health Sciences Interprofessional Education Research and Practice (CHSIE) and Leadership and Education in Adolescent Health Training Program (LEAH).

Deborah Dang

Deborah Dang recently retired from the Johns Hopkins Hospital and Health System as Director of Nursing. John Dent, MD, MS is a Professor Emeritus of Medicine at the University of Virginia Health System and a Clinical Professor of Nursing at the University of Virginia School of Nursing.

Elizabeth Ibby Tanner

Elizabeth K. Tanner, Ph.D, R.N., is a registered nurse and Professor Emeritus at Johns Hopkins School of Nursing with a joint appointment in the School of Medicine, Division of Geriatric Medicine and Gerontology. She was core faculty in the Center on Aging and Health;  principal faculty in the Center for Innovative Care in Aging and inaugural Director of the Collaborative for Interprofessional Education and Practice.

Nicole Summerside

Nicole Summerside, MHA is an affiliate instructor in the department of Biobehavorial Nursing and Health Informatics at the University of Washington School of Nursing and the Manager of Program Operations for the UW Center for Health Sciences Interprofessional Education, Research and Practice.

Brenda K. Zierler

Brenda Zierler PhD, RN, FAAN is a professor in the Department of Biobehavioral Nursing and Health Informatics at the University of Washington School of Nursing and is adjunct professor in the Department of Health Services at the University of Washington School of Public Health, and in the Departments of Surgery (Vascular Division) and Department of Biomedical Informatics and Medical Education at the University of Washington School of Medicine. She is Co-Lead of the Team Science Core for the UW Institute for Translational Health Sciences and Director of Research and Training for the Center for Health Sciences Interprofessional Education, Research and Practice.

Kevin D. O’Brien

Kevin O’Brien, MD is a Professor of Medicine at the University of Washington and Service Director for Inpatient Cardiology at the University of Washington Medical Center. 

Bryan J. Weiner

Bryan Weiner PhD, is Professor, Department of Global Health and Department of Health Systems and Population Health, at the University of Washington.