As a nurse, you realize that the "patient/physician" partnership needs so much more than top-quality healthcare. In order to improve patient engagement and patient outcomes, all members of a patient's healthcare team must work together.
Without relevant contact, this kind of successful and productive conjunction will simply not occur. In fact, interdisciplinary collaboration is so successful that multidisciplinary rounds are now being implemented by a rising number of hospitals and other healthcare settings (sometimes referred to as MDR). Factual studies show that multidisciplinary rounds give both the patients and the clinical staff many advantages. Soon, you'll get a chance to learn about these benefits.
Of course, even though you can readily discover the advantages for your patients of multidisciplinary rounds, this knowledge is not always okay to ensure the rounds go efficiently. Nursing shifts get extremely busy and it can be hectic and exhausting to take time away from your other tasks to round up with the squad.
How do health facilities improve multidisciplinary rounds to ensure that they remain an effective and time-efficient way to improve patient care? Time to round up what the results of reality mean.
A critical look at Multidisciplinary Rounds for Patients
Usually, multidisciplinary patient rounds cut through a variety of individuals that embody associated disciplines involved in the care of a patient. Although the rounding process can and does differ widely between facilities (and even within facilities in some instances, depending on the care unit or floor), team members present at rounds can include:
The attending doctor, hospitalist, resident, and other primary medical team members (e.g., surgeon)
Other support personnel, including clergy, licensed medical translators, advocates for patients, and pet therapists
Clinical students (e.g., nursing students, physical therapy students) may also be asked to engage in learning about the environment and situation. In addition, patients and their loved ones who can provide an acceptable amount of input for coordinating and continuing care can also be welcomed.
There are also extremely variable frequencies and durations of rounds. Teams can formally round up their patients for up to an hour or more, a few days a week or even once a day. The rounds themselves may be kept at the patient's bedside, in the unit, in a conference room, or anywhere that can be privately analyzed for confidential health information.
Any team member may spearhead multidisciplinary rounds, but they are usually run by the attending physician, resident, or nurse. Team members typically have an opportunity during these rounds to update the rest of the team on how the patient is doing within their associated scope of treatment. Discussion issues can include the outcomes of recent or pending medical procedures (including imaging tests and laboratory work), treatment plan goals, discharge schedules, discharge barriers, and objectives.
Are Multidisciplinary Rounds essential? A Sneak Peek!
Of course, it definitely seems like a smart idea to get the entire team together for formal contact. But, are rounds successful in reality?
Overall, okay! At least, according to the literature that is available. Virtually everyone involved stands to benefit from improving coordination between clinical team members.
Multidisciplinary rounds in hospital settings have been shown primarily to:
1. Work on Patient Care Quality
A 2003 study published in the Archives of Internal Medicine showed that when pharmacists were active in inpatient rounds, the incidence of preventable adverse drug effects fell by almost 80 percent!
2. Patient Results Boost
A decreased incidence of anything from central line-associated bloodstream infections to dropping events is shown by different studies.
3. Enhance the satisfaction of members of the Clinical Team
By increasing autonomy, work enjoyment, and team interaction/communication, for instance,
4. Cut healthcare expenses
5. Cut Duration of Stay of a Patient
6. Allowing the presence of patients and/or their family members
Having family members at the level they want in the decision-making process will make them feel more informed, improve their education and awareness of their treatment, and give them an opportunity to ask clarifying questions.
When the rounds are genuinely "multidisciplinary," these advantages have been clearly found to exist, indicating that every team member has the ability to participate. Ultimately, the need for facilities to make a drastic change from the more conventional physician-centered model seems to be demonstrated by current research.
Four Strategies for more efficient multidisciplinary rounds
So, there is strong evidence to suggest that patient outcomes are enhanced by multidisciplinary rounds. But not all rounds were produced equal, as you might know. It appears that certain multidisciplinary rounds run smoothly and seamlessly. Others can tend to be disorganized, repetitive, or inefficient.
How can rounds be mastered while also improving patient treatment and respecting the time and efficiency of team members? These four tips may be of assistance:
1. Start at a fixed, agreed-upon time and location
Although there is really no "one-size-fits-all" solution to rounding, it is usually considered best practice to have a planned and anticipated start time. This keeps things up-to-date and guarantees that all required team members are present as they will know when they are needed.
2. Establish Team Input
Establish an order for when, if necessary, each team member speaks or has the opportunity to talk. This streamlines rounds dramatically and reduces the likelihood of tangential conversation and contact lapses. In the experience of the author of this report, for instance, team members speak in the following order during intensive care unit rounds: attending doctor, nurse, respiratory therapist, occupational or physical therapist, pharmacist, nutritionist, quality assurance, and case management. Note that during rounds, the chief viewpoint is relatively "big picture." Whether a patient, family member or other team member has specific questions that involve a more in-depth discussion, after, not during, rounds, these questions should be answered.
3. Maintain Profesionalism
Pay attention, don't interrupt, ask questions to clarify as necessary, mute your cell phone, and don't have side conversations with other team members, especially while another person is talking. Put those active listening skills to use. If the patient is present, ensure that he or she is treated with respect and can engage greatly to the best of their capacity, mute the TV, ensure that they are appropriately dressed or covered with linen, speak to them rather than about them, and do something else that is necessary to make them feel relaxed and ready to join in.
4. Prioritize Goals
During rounds, the ultimate questions that should be answered include: 1) Why is the patient here? 2) Why is he still here with the patient? 3) Before the patient can be discharged, what needs to happen? And 4) Where is the patient going to go, and are there any challenges to getting them there? Each member of the team is accountable for knowing their particular position and goals and should be prepared to provide the minimum effective amount of data to support the overall objectives of the teams.
Multidisciplinary patient rounds are no doubt the most critical aspect of high-quality healthcare. As a nurse, since you spend so much time with the patient and his or her family members, your job is also important. Know that you are a key member of the interdisciplinary team and that your feedback will make an efficient difference in the treatment plan and overall results of a patient.
You are a regular part of the facility's patient care rounds? Share these tips with your team so that these cost-effective and value-based approaches will get the best out of you, your fellow staff members, and your patients.