A case study of healthcare providers’ goals during interprofessional rounds

Abstract

Daily interprofessional rounds enhance collaboration among healthcare providers and improve hospital performance measures. However, it is unclear how healthcare providers' goals influence the processes and outcomes of interprofessional rounds. The purpose of this case study was to explore the goals of healthcare providers attending interprofessional rounds in an internal medicine ward. The second purpose was to explore the challenges encountered by healthcare providers while pursuing these goals. Three focus groups were held with healthcare providers of diverse professional backgrounds. Focus group field notes and transcripts were analysed using thematic analysis. The data indicated that there was no consensus among healthcare providers regarding the goals of interprofessional rounds. Discharge planning and patient care delivery were perceived as competing priorities during rounds, which limited the participation of healthcare providers. Nevertheless, study participants identified goals of rounds that were relevant to most care providers: developing shared perspectives of patients through direct communication, promoting collaborative decision making, coordinating care, and strengthening interprofessional relationships. Challenges in achieving the goals of interprofessional rounds included inconsistent attendance, exchange of irrelevant information, variable participation by healthcare providers, and inconsistent leadership. The findings of this study underscore the importance of shared goals in the context of interprofessional rounding.

Interventions to Improve Interprofessional Bedside Rounds in a Paediatric Critical Care Unit

“…Results from study demonstrate that a participatory design approach can be taken to redesign rounds which is a complex process that involves multiple stakeholders with varying and sometimes conflicting viewpoints (Prystajecky et al, 2017). Critical to the success of the participatory design approach, was a thorough understanding of user needs, which was enabled by the collection of interview and survey data.…”

“…Rounds are the most important opportunity for interprofessional communication but are also complex. Several challenges impede effective communication during rounds such as frequent interruptions (Khairat et al, 2019), misrepresentations of data (Artis, Dyer, Mohan, & Gold, 2017) and misalignment in HCPs goals and objectives for attending rounds (Prystajecky, Lee, Abonyi, Perry, & Ward, 2017). While several CCU rounding best practices have been identified (Lane et al, 2013) to address barriers such as these, implementations of best practices have produced mixed results.…”

Bedside nurses’ roles in discharge collaboration in general internal medicine: Disconnected, disempowered and devalued?

“…These rounds involved two physicians and a nurse or other care provider discussing the case at the patient's bedside, potentially allowing for patient involvement; however, other healthcare professionals were not involved. Further, and regular, explicit attention to the purpose and outcomes of interprofessional rounds and how they fit into larger organizational improvement efforts is needed (Liu et al., ; O'Leary, Johnson, & Auerbach, ; Prystajecky, Lee, Abonyi, Perry, & Ward, ).…”

“…however, other healthcare professionals were not involved. Further, and regular, explicit attention to the purpose and outcomes of interprofessional rounds and how they fit into larger organizational improvement efforts is needed (Liu et al, 2014;O'Leary, Johnson, & Auerbach, 2016;Prystajecky, Lee, Abonyi, Perry, & Ward, 2017).…”

Communication about patients during ward rounds and verbal handovers: A gender perspective

“…This categorization and communicative construction of patients has been previously analyzed primarily from a patient/healthcare worker perspective. With respect to ward rounds, previous research has mainly focused either on the relationships that exist in the interprofessional teams based on the professions of the different team-members (Bradfield, 2010;Prystajecky, Lee, Abonyi, Perry, & Ward, 2017;Reeves et al, 2009;Walton & Steinert, 2010), their cultural background (Andersson, 2009), or the teams' communication with the patients (Liénard et al, 2010;Subramony, Schwartz, & Hametz, 2012). When the research focus is on communication about the patient from an interprofessional perspective, it is primarily strictly medical factors that are dealt with and communication is viewed from an efficiency perspective (Blough & Walrath, 2007;Burns, 2011;Desai, Caldwell, & Herring, 2011;O'Leary et al, 2010).…”