Paper
Tuesday, November 6, 2007
584
The Relationship between Multidisciplinary Rounds and Patient and Provider Outcomes
Joan P. Roche, PhD, RN, School of Nursing, University of Massachusetts Amherst, Amherst, MA, USA and Tara M. Tehan, RN, MSN, MBA, Respiratory Care Unit, Baysate Medical Center, Springfield, MA, USA.
| Learning Objective #1: Describe the process of implementing nurse coordinated multidisciplinary rounds on an intermediate care inpatient unit. |
| Learning Objective #2: Discuss the patient and provider outomes associated with nurse coordinated multidisciplinary rounds. |
Purpose. Increasing multidisciplinary collaboration can create a safer hospital for patients and a better environment for the healthcare workers. The Institute of Medicine proposed several changes to transform the hospital work environment and to protect patient safety, including structured opportunities for physicians and nurses to collaborate in an interdisciplinary model. The purpose of this study is to compare patient and provider outcomes before and after the initiation of weekly nurse-coordinated multidisciplinary rounds in a large medical center.
Theoretical Framework. This study is based on Donabedian's framework of Structure Process Outcomes. The researchers recognized that there were informal but inconsistent collaboration processes in place on this intermediate nursing unit. They hypothesized that a structure to facilitate consistent, regularly scheduled multidisciplinary dialogue processes on each patient would be associated with improved patient and provider outcomes.
Methods. This is a pre and post test design. The staff nurses collaborated with Nurse Manager, University Faculty and CNS to initiate and coordinate weekly multidisciplinary rounds, run by the charge nurse. Stakeholder support was invited and pulmonary physicians, respiratory therapists, case managers, pulmonary nurses, social workers, chaplains, dieticians, PTs and OTs agreed to participate. Provider outcomes are perceptions of and satisfaction with collaboration (Baggs, 1994). Patient outcomes are length of stay , patient complaints and multidisciplinary consults. These measures are being compared prior to the rounds and at six months using the appropriate statistical tests. The study was approved by the IRB.
Results. The multidisciplinary round process was developed over a three month planning period. Initial data was collected. There has been strong participation of all of the disciplines in these meetings. Post test data is currently being measured and findings and discussion of the results will be reported in the presentation.
Conclusions and Implications The conclusions and implications will be presented at the conference.