Let’s Work Together: The Positive Impact of Implementing Multidisciplinary Rounds in a Hospitalist Program

1Rowan University School of Osteopathic Medicine, Stratford, NJ
2Our Lady of Lourdes Medical Center, Willingboro, NJ

Meeting: Hospital Medicine 2014, March 24-27, Las Vegas, Nev.

Abstract number: 116

Background:

There is a need for structured communication among hospital providers to improve efficiency and to provide patient‐centered care through collaboration in the hospital setting. A concise Multidisciplinary Rounds (MDR) model was designed and implemented with goals of improving efficiency, length of stay (LOS), collaboration, communication and teamwork.

Methods:

Interviews were conducted pre‐implementation to assess perceived barriers to teamwork and efficiency among providers in a 173‐bed community teaching hospital. Daily MDR participants included Hospitalists, Nurse Care Managers, Case Managers, Social Workers, Physical Therapists and Pharmacists. Each participant group was educated on their expected MDR role pre‐implementation. MDR was held daily. Guidance was provided by the Hospitalist and Nursing Directors for the first 4 weeks post implementation. Twelve weeks post, participants were surveyed on several MDR endpoints using a Likert‐type rating scale. Preliminary LOS data was also analyzed.

Results:

A total of 23 participants completed a post‐implementation survey. The mean rating for group perception of collaboration on a scale of 1‐4 was 3.70 (± 0.29) and for communication on a scale of 1‐3 was 2.60 (± 0.20). Aggregate subgroup analysis on these did not show significant perception differences between healthcare provider subgroups (Kruskal‐Wallis, χ2=0.68, P=0.89/χ2 =3.60, P=0.61). With MDR, 87% felt better empowered to care for patients, 82.6% felt it improved patient safety, 91.3% felt the information shared in MDR helped them provide better patient care and 87% felt an improvement in workday efficiency. All participants noted that information obtained in MDR helped them with discharge planning and wanted MDR to continue indefinitely. Analysis of physician vs. non‐physician providers showed a statistically significant difference in perceptions to delays in discharge planning between the two groups (χ2=16.70, P=0.01) with a trend toward physicians perceiving discharge delays as secondary to non‐physicians and vice‐versa. Eight week preliminary data suggests a LOS decrease by 0.495 days.

Conclusions:

MDR appeared to have a positive impact on provider perception of collaboration, communication and teamwork. Information obtained in MDR helped providers better care for their patients and effectively plan discharges. Physicians seem to perceive discharge planning delays as resultant to communication issues between non‐physicians. Non‐physician providers perceived similar deficiencies among inter‐physician interactions and their interactions with other healthcare team members. We believe that this represents decreased self‐perception of inefficiencies within individual provider subgroups. This can likely be improved with education, team building exercises and introspection. Further study is needed to determine this model’s efficacy and applicability to similar institutional settings.

To cite this abstract:

Kanikkannan S, Kravchak L, Antenucci D, Nessel M, Dombrowski H. Let’s Work Together: The Positive Impact of Implementing Multidisciplinary Rounds in a Hospitalist Program. Abstract published at Hospital Medicine 2014, March 24-27, Las Vegas, Nev. Abstract 116. Journal of Hospital Medicine. 2014; 9 (suppl 2). https://www.shmabstracts.com/abstract/lets-work-together-the-positive-impact-of-implementing-multidisciplinary-rounds-in-a-hospitalist-program/. Accessed May 26, 2019.

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