Case Study

How four organizations structured interdisciplinary rounds

15 Minute Read

Overview

The challenge

Interdisciplinary rounds are often poorly attended, inefficient, and lack clear role definition. As a result, they often fail to achieve the intended goal of ensuring clinicians make critical patient care decisions in close coordination. By implementing a highly structured format, leaders can improve the efficiency and effectiveness of interdisciplinary rounds.

The organizations

Orange Health Service is a 220-bed hospital in Orange, New South Wales, Australia. Fraser Health Authority is an integrated health care service in British Columbia, Canada. Northwestern Memorial Hospital is a 897-bed teaching hospital in Chicago, Illinois. The Johns Hopkins Hospital is a 1,162-bed teaching hospital in Baltimore, Maryland.

The approach

The three models in place at the above mentioned organizations all took a highly structured approach to interdisciplinary rounds. With a well-defined structure in terms of timing, attendance, and agenda, these three models make real-time care progression amongst members of the care team possible.

The results

These are highly effective models of enabling busy care team members to collaborate across disciplines while advancing daily patient care. The models detailed offer improvements across a number of efficiency and quality indicators, including duration of rounds, bed occupancy, and length of stay.

 

Solution

Rounding model depends on priorities, desired outcomes

There are several different ways to organize interdisciplinary rounding practices depending on an organization’s priorities and what leaders hope to achieve with the rounds. Clinical leaders should determine their desired model based on their needs and patient population.

Structured interdisciplinary bedside rounds (SIBR®) stand out as a ‘gold standard’ approach to rounding. Especially as organizations place increasing importance on patient and family engagement during care team rounds. If a focus on complex patient management is of priority, stratified rounding offers an effective way to manage throughput for this patient population. Finally, highly structured interdisciplinary care conferences favor a choreographed reporting format to ensure round efficiency and clinician attendance.

 

The three models

  • Model

    Structured interdisciplinary bedside rounds (SIBR®)

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  • Model

    Stratified rounding

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  • Model

    Highly structured interdisciplinary care conferences

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