Effects of Interdisciplinary Rounds on Length of Stay in a Telemetry Unit

Wild, Dorothea; Nawaz, Haq; Chan, WC; Katz, David L.

doi:10.1097/00124784-200401000-00011

Cited by 40 publications

(32 citation statements)

References 8 publications

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“…11 A third, smaller study showed no effect on LOS and cost with the use of IDR. 14 In light of the final sample size for the intervention unit being slightly less than our intended target, it is possible that our study was underpowered to detect a difference in LOS or cost. Our study has several limitations.…”

Section: Discussionmentioning

confidence: 95%

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Improving Teamwork: Impact of Structured Interdisciplinary Rounds on a Medical Teaching Unit

et al. 2010

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Section: Discussionmentioning

confidence: 95%

“…Although two studies documented a reduction in LOS and cost with the use of IDR, 11,13 another study showed no effect. 14 This study had three aims. The first was to assess the impact of an intervention, structured inter-disciplinary rounds (SIDR), on both physicians' and nurses' ratings of collaboration and teamwork and safety climate.…”

Section: Introductionmentioning

confidence: 99%

Improving Teamwork: Impact of Structured Interdisciplinary Rounds on a Medical Teaching Unit

et al. 2010

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“…13 A third, smaller study found no effect on LOS and cost with the use of IDR. 15 No prior study has evaluated the effect of IDR on LOS and cost in a nonteaching hospitalist service setting.…”

Section: Discussionmentioning

confidence: 99%

“…12,14 Previous studies also indicate variable effects of IDR on length of stay (LOS) and cost with 2 studies finding a reduction in LOS and cost with the use of IDR, 12,13 while another did not. 15 Furthermore, all these prior studies evaluated the use of IDR on resident-covered teaching services. The effect IDR has on collaboration, LOS, and cost in a nonteaching hospitalist service setting is not known.…”

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confidence: 99%

Improving teamwork: Impact of structured interdisciplinary rounds on a hospitalist unit

O’Leary

Haviley

Slade

et al. 2011

Journal of Hospital Medicine

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BACKGROUND:Effective collaboration and teamwork is essential in providing safe and effective care. Research reveals deficiencies in teamwork on medical units involving hospitalists.OBJECTIVE:The aim of this study was to assess the impact of an intervention, Structured Inter‐Disciplinary Rounds (SIDR), on nurses' ratings of collaboration and teamwork.METHODS:The study was a controlled trial involving an intervention and control hospitalist unit. The intervention, SIDR, combined a structured format for communication with a forum for regular interdisciplinary meetings. We asked nurses to rate the quality of communication and collaboration with hospitalists using a 5‐point ordinal scale. We also assessed teamwork and safety climate using a validated instrument. Multivariable regression analyses were used to assess the impact on length of stay (LOS) and cost using both a concurrent and historic control.RESULTS:A total of 49 of 58 (84%) nurses completed surveys. A larger percentage of nurses rated the quality of communication and collaboration with hospitalists as high or very high on the intervention unit compared to the control unit (80% vs. 54%; P = 0.05). Nurses also rated the teamwork and safety climate significantly higher on the intervention unit (P = 0.008 and P = 0.03 for teamwork and safety climate, respectively). Multivariable analyses demonstrated no difference in the adjusted LOS and an inconsistent effect on cost.CONCLUSIONS:SIDR had a positive effect on nurses' ratings of collaboration and teamwork on a hospitalist unit, yet no impact on LOS and cost. Further study is required to assess the impact of SIDR on patient safety measures. Journal of Hospital Medicine 2010. © 2010 Society of Hospital Medicine.

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“…7,8 Interdisciplinary rounds (IDR), also known as multidisciplinary rounds, provide a means to assemble hospital care team members and improve collaboration. [9][10][11][12][13] Prior research on the use of IDR has demonstrated improved ratings of collaboration, 11,12 but inconsistent effects on length of stay and cost. 10,12,13 Notably, the format, frequency, and duration of IDR in prior studies has been variable and no studies, to our knowledge, have evaluated teamwork performance during IDR.…”

Section: Discussionmentioning

confidence: 99%

Assessment of teamwork during structured interdisciplinary rounds on medical units

O’Leary

Boudreau

Creden

et al. 2012

Journal of Hospital Medicine

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BACKGROUND:Interdisciplinary rounds (IDR) provide a means to assemble hospital team members and improve collaboration. Little is known about teamwork during IDR.OBJECTIVE:To evaluate and characterize teamwork during IDR.DESIGN:Cross‐sectional observational study.SETTING:Six medical units which had implemented structured interdisciplinary rounds (SIDR).MEASUREMENTS:We adapted the Observational Teamwork Assessment for Surgery (OTAS) tool, a behaviorally anchored rating scale shown to be reliable and valid in surgical settings. OTAS provides scores ranging from 0 to 6 (0 = problematic behavior; 6 = exemplary behavior) across 5 domains (communication, coordination, cooperation/backup behavior, leadership, and monitoring/situational awareness) and for prespecified subteams. Two researchers conducted direct observations using the adapted OTAS tool.RESULTS:We conducted 7–8 independent observations for each unit (total = 44) and 20 joint observations. Inter‐rater reliability was excellent at the unit level (Spearman's rho = 0.75), and good across domains (rho = 0.53–0.68) and subteams (rho = 0.53–0.76) with the exception of the physician subteam, for which it was poor (rho = 0.35). Though teamwork scores were generally high, we found differences across units, with a median (interquartile range [IQR]) 4.5 (3.9–4.9) for the lowest and 5.4 (5.3–5.5) for the highest performing unit (P < 0.01). Domain scores differed, with leadership receiving the lowest (median [IQR] = 5.0 [4.6–5.3]), and cooperation/backup behavior and monitoring/situational awareness receiving highest scores (median [IQR] = 5.4 [5.0–5.5] and 5.4 [5.0–5.7]). Differences across subteams were of borderline significance (P = 0.05).CONCLUSIONS:The adapted OTAS instrument demonstrated acceptable reliability for assessing teamwork during SIDR across units, domains, and most subteams. Variation in performance suggests a need to improve consistency of teamwork and emphasizes the importance of leadership. Journal of Hospital Medicine 2012. © 2012 Society of Hospital Medicine

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Effects of Interdisciplinary Rounds on Length of Stay in a Telemetry Unit

Abstract: IRs did not decrease LOS in a telemetry ward. Whereas a potential benefit of IRs in other settings cannot be ruled out, this study emphasizes the importance of rigorous testing of strategies to enhance the quality or reduce the costs of inpatient care.

Cited by 40 publications

References 8 publications

Improving Teamwork: Impact of Structured Interdisciplinary Rounds on a Medical Teaching Unit

Improving Teamwork: Impact of Structured Interdisciplinary Rounds on a Medical Teaching Unit

Improving teamwork: Impact of structured interdisciplinary rounds on a hospitalist unit

Assessment of teamwork during structured interdisciplinary rounds on medical units

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