Medicolegal Issues

Hospitalist/Nurse Collaboration Drives Multidisciplinary Rounding


 

Aultidisciplinary patient rounding system implemented on a non-teaching hospitalist unit at the Ohio State University Medical Center (OSUMC) has been well received by unit staff, according to an HM11 abstract presentation. Key to its success, says lead author and OSUMC hospitalist Eric Schumacher, DO, MBA, was to involve nursing staff from the start and to work closely with the unit’s nurse manager and charge nurse.

“Once we got their buy-in, we proposed what we wanted to do and asked for their suggestions,” Dr. Schumacher says.

Hospitalists partner with the nurse leaders to establish a morning bedside rounding process on the unit, using a “Physician Nurse Rounding Sheet” for each hospitalist. The sheet is prepared daily by the charge nurse and unit clerks, listing the hospitalist’s patients, assigned nurses, and phone numbers. A short debriefing is performed outside the patient’s room before each encounter, and a daily feedback sheet is given to the patient and family with a picture of the hospitalist, a list of all care-team members, and such information as goals for the day, pending tests and consultations, and anticipated discharge date.

“Part of the challenge is to create a process that is efficient for both doctors and nurses, given multiple nurses caring for multiple patients,” Dr. Schumacher says.

Charge nurses or nursing managers provide backup when the bedside nurse is not available for bedside rounding. “Right now we’re rounding with hospitalists and nurses only, but a long-term goal is to expand it to include the social worker and other ancillary professionals,” he says.

Preliminary data on the project show the feasibility of multidisciplinary rounding, with elevated Press Ganey patient satisfaction scores on the unit in the first two months after rounding began. In the third month, compliance with rounding went down, and so did satisfaction scores, but with a renewed commitment the following month, scores went back up again. Subjective reports from hospitalists also suggest fewer interruptions during the day from nursing pages, Dr. Schumacher says.

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