Teamwork Key to Effective Interdisciplinary Rounds


A new study in the Journal of Hospital Medicine is among the first to assess and characterize the effectiveness of teamwork in interdisciplinary rounds (IDR). The upshot: Varied performance on rounds suggests a need to improve the consistency of teamwork.

The report, "Assessment of Teamwork During Structured Interdisciplinary Rounds on Medical Units," adapted the Observational Teamwork Assessment for Surgery (OTAS) behavioral rating scale tool to evaluate and characterize teamwork of hospitalists. Mark Williams, MD, FACP, MHM, professor and chief of the division of hospital medicine at Northwestern University’s Feinberg School of Medicine in Chicago, says the review shows that mere implementation of IDR is not enough. Physician leaders must occasionally check how the rounds operate to ensure against such roadblocks as a team member who dominates discussions, or the formation of hierarchal relationships that not everyone is comfortable participating in, he says.

"You can't just say, 'Oh, we're practicing teamwork, we have structured interdisciplinary rounds,'" says Dr. Williams, who credits the research to lead author Kevin O'Leary, MD, MS, also of Feinberg. "You need to ensure that it’s occurring."

The paper fills a gap in research, the authors write, as much of the prior work on IDR has focused on patient outcomes, cost, and length of stay. But Dr. Williams says he doesn't expect community hospital medicine groups to conduct similar research because of their busy schedules. Still, he hopes group leaders and administrators consider the research an impetus to periodically check those rounds.

"Even in an institution [like Northwestern] that has strong buy-in to this [teamwork], you need to go back and check," Dr. Williams adds. "We saw variation in performance and we realized we needed to do some retraining."

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