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.

Sustaining improvements in relational coordination following team training and practice change: A longitudinal analysis

“…We see a number of important next steps in our work around SIBR as well as for the field of team-based practice transformation (also known as interprofessional collaborative practice). For example, there are numerous SIBR-type models being described in the literature, some with purposeful team training and some without (Blakeney et al, 2019). Understanding the similarities and differences among these models (i.e., approach, purpose, and implementation strategies) will clarify the mechanism of action of SIBR, identify essential program components, and inform effective implementation strategies for different environments.…”

“…In addition, it is important to come to a greater understanding of the patient outcomes that might be affected (either positively or negatively) by SIBR implementation. Multiple studies have examined patient-centered outcome measures, but few have also reported on the impact on the team following SIBR implementation (Blakeney et al, 2019; Ratelle et al, 2019). Our working hypothesis of SIBR’s mechanism of action is that it helps to improve team communication and relationships, thereby enhancing a team’s ability to provide highly reliable care.…”

“…In this study, our academic-practice partnership collaboratively adapted and implemented interprofessional team training, leadership workshops, and SIBR processes (our intervention) in an inpatient advanced heart failure setting, with the goal of improving the quality and reliability of communication, relationships, and efficiencies (Abu-Rish Blakeney et al, 2019;Martelli et al, 2018;Willgerodt et al, 2019). Prior to SIBR implementation, coordination of care occurred through multiple steps each day, including team rounds in a designated office space and/or outside the patient's room (in the hallway) followed by patient assessment at the bedside.…”

“…Findings of a recent systematic scoping review have identified a sharp rise in publications about SIBR implementation and outcomes—with 16 new publications in 2018 alone (Blakeney et al, 2019). This growing body of literature associates SIBR-type models with improvements in team communication, relationships, work process efficiencies, and patient outcomes (Bhamidipati et al, 2016; Blakeney et al, 2019; O’Leary et al, 2016; Ratelle et al, 2019). However, most prior studies of SIBR implementation have been cross-sectional and short term (within 1–2 years of the intervention).…”

Influence of Mutual Support on Burnout among Intensive Care Unit Healthcare Professionals

“…It has also been reported that the TeamSTEPPS program improves teamwork and clinical outcomes (Salas et al, 2008; Schmutz & Manser, 2013). In addition, bedside rounding has been reported to enhance communication among ICU professionals, which may enhance mutual support in the ICU (Blakeney et al, 2021). Using such a program to enhance ICU healthcare professionals’ mutual support system may prevent burnout.…”