Impact of Structured Interdisciplinary Rounds on Teamwork on a Hospitalist Unit

BACKGROUND: Collaboration and teamwork are essential to deliver high quality patient care. Though teamwork is often suboptimal in the inpatient setting, Structured Inter-Disciplinary Rounds (SIDR) has improved nurses' ratings of collaboration and teamwork on a medical teaching unit. OBJECTIVE: We sought to assess the impact of SIDR on nurses' ratings of collaboration and teamwork on a medical unit staffed by hospitalists. METHODS: We conducted a controlled trial involving intervention and control inpatient general medical units staffed by hospitalists. On the intervention unit, nurses and physicians participated in SIDR daily using a standardized communication tool. Unit nurses rated the quality of communication and collaboration with hospitalists using a 5-point ordinal scale. Teamwork and safety climate was also assessed using a previously validated instrument. We used multivariable regression analyses to determine the impact of SIDR 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. More 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). The teamwork and safety climate was rated significantly higher by nurses 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 improved nurses' ratings of collaboration and teamwork with hospitalists. No impact on LOS and cost was seen. Journal of Hospital Medicine 2011;6:88-93. (C) 2011 Society of Hospital Medicine.