Patterns of nurse-physician communication and agreement on the plan of care

O’Leary, Kevin J.; Thompson, Julian; Landler, Matthew P.; Kulkarni, Nita Shrikant; Haviley, Corinne; Hahn, Karen; Jeon, Jiyeon; Wayne, Diane B.; Baker, David W; Williams, Mark

doi:10.1136/qshc.2008.030221

Cited by 75 publications

(59 citation statements)

References 20 publications

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“…The first section was based on previously published surveys assessing teamwork attitudes among providers. 6,7 Nurses rated the quality of communication and collaboration they had experienced with hospitalists using a 5-point ordinal scale (1 ¼ very low, 2 ¼ low, 3 ¼ adequate, 4 ¼ high, 5 ¼ very high). The second section assessed teamwork and safety climate using the teamwork and safety domains of the Safety Attitudes Questionnaire (SAQ), 19 which is based on previous research in aviation and medicine and has been validated in clinical settings.…”

Section: Provider Surveymentioning

confidence: 99%

“…[1][2][3][4][5] Yet, research documents that nurses and physicians in the hospital do not communicate consistently and frequently disagree on their patients' plans of care. 6,7 Nurses and physicians have discrepant views on the quality of collaboration according to research conducted in operating rooms (ORs), intensive care units (ICUs), and general medical units. [8][9][10] Although physicians typically rate the quality of collaboration highly, nurses perceive the degree of collaboration with physicians differently and rate the quality of it as relatively poor.…”

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confidence: 99%

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Improving teamwork: Impact of structured interdisciplinary rounds on a hospitalist unit

O’Leary

Haviley

Slade

et al. 2011

Journal of Hospital Medicine

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BACKGROUND:Effective collaboration and teamwork is essential in providing safe and effective care. Research reveals deficiencies in teamwork on medical units involving hospitalists.OBJECTIVE:The aim of this study was to assess the impact of an intervention, Structured Inter‐Disciplinary Rounds (SIDR), on nurses' ratings of collaboration and teamwork.METHODS:The study was a controlled trial involving an intervention and control hospitalist unit. The intervention, SIDR, combined a structured format for communication with a forum for regular interdisciplinary meetings. We asked nurses to rate the quality of communication and collaboration with hospitalists using a 5‐point ordinal scale. We also assessed teamwork and safety climate using a validated instrument. Multivariable regression analyses were used to assess the impact on length of stay (LOS) and cost using both a concurrent and historic control.RESULTS:A total of 49 of 58 (84%) nurses completed surveys. A larger percentage of nurses rated the quality of communication and collaboration with hospitalists as high or very high on the intervention unit compared to the control unit (80% vs. 54%; P = 0.05). Nurses also rated the teamwork and safety climate significantly higher on the intervention unit (P = 0.008 and P = 0.03 for teamwork and safety climate, respectively). Multivariable analyses demonstrated no difference in the adjusted LOS and an inconsistent effect on cost.CONCLUSIONS:SIDR had a positive effect on nurses' ratings of collaboration and teamwork on a hospitalist unit, yet no impact on LOS and cost. Further study is required to assess the impact of SIDR on patient safety measures. Journal of Hospital Medicine 2010. © 2010 Society of Hospital Medicine.

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Section: Provider Surveymentioning

confidence: 99%

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Improving teamwork: Impact of structured interdisciplinary rounds on a hospitalist unit

O’Leary

Haviley

Slade

et al. 2011

Journal of Hospital Medicine

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“…45 Over-reliance on medical records was reported in a study that investigated handover and communication between doctors and nurses. 46 This study found that often there was inadequate communication, and, as a result, there were disagreements on issues such as planned medication changes (42%), planned tests (26%) and necessary procedures (11%).…”

Section: Inadequate Documentation and Over-reliance On Documentationmentioning

confidence: 99%

Clinical handover within the emergency care pathway and the potential risks of clinical handover failure (ECHO): primary research

Sujan

Spurgeon

Inada-Kim

et al. 2014

Health Services and Delivery Research

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Copyright and reuse:The Warwick Research Archive Portal (WRAP) makes this work by researchers of the University of Warwick available open access under the following conditions. Copyright © and all moral rights to the version of the paper presented here belong to the individual author(s) and/or other copyright owners. To the extent reasonable and practicable the material made available in WRAP has been checked for eligibility before being made available. Copies of full items can be used for personal research or study, educational, or not-forprofit purposes without prior permission or charge. Provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/). PublisherEditorial contact: nihredit@southampton.ac.ukThe full HS&DR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hsdr. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Services and Delivery Research journalReports are published in Health Services and Delivery Research (HS&DR) if (1) they have resulted from work for the HS&DR programme or programmes which preceded the HS&DR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. HS&DR programmeThe Health Services and Delivery Research (HS&DR) programme, part of the National Institute for Health Research (NIHR), was established to fund a broad range of research. It combines the strengths and contributions of two previous NIHR research programmes: the Health Services Research (HSR) programme and the Service Delivery and Organisation (SDO) programme, which were merged in January 2012.The HS&DR programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services including costs and outcomes, as well as research on implementation. The programme will enhance the strategic focus on research that matters to the NHS and is keen to support ambitious evaluative research to improve health services.For more information about the HS&DR programme please visit the website: www.netscc.ac.uk/hsdr/ This reportThe research reported in this issue of the journal was funded by the HS&DR programme or one of its proceeding programmes as project number 10/1007/26. The contractual start date was in April 2011. The final report began editorial review in January 2013 and was accepted for publication in May 2013. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HS&DR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, th...

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“…Research studies show that nurses and physicians on patient care units do not communicate consistently and frequently do not agree on key aspects of their patients' plans of care. 7,8 Interdisciplinary rounds (IDR), also known as multidisciplinary rounds, provide a means to assemble hospital care team members and improve collaboration. [9][10][11][12][13] Prior research on the use of IDR has demonstrated improved ratings of collaboration, 11,12 but inconsistent effects on length of stay and cost.…”

Section: Discussionmentioning

confidence: 99%

Assessment of teamwork during structured interdisciplinary rounds on medical units

O’Leary

Boudreau

Creden

et al. 2012

Journal of Hospital Medicine

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BACKGROUND:Interdisciplinary rounds (IDR) provide a means to assemble hospital team members and improve collaboration. Little is known about teamwork during IDR.OBJECTIVE:To evaluate and characterize teamwork during IDR.DESIGN:Cross‐sectional observational study.SETTING:Six medical units which had implemented structured interdisciplinary rounds (SIDR).MEASUREMENTS:We adapted the Observational Teamwork Assessment for Surgery (OTAS) tool, a behaviorally anchored rating scale shown to be reliable and valid in surgical settings. OTAS provides scores ranging from 0 to 6 (0 = problematic behavior; 6 = exemplary behavior) across 5 domains (communication, coordination, cooperation/backup behavior, leadership, and monitoring/situational awareness) and for prespecified subteams. Two researchers conducted direct observations using the adapted OTAS tool.RESULTS:We conducted 7–8 independent observations for each unit (total = 44) and 20 joint observations. Inter‐rater reliability was excellent at the unit level (Spearman's rho = 0.75), and good across domains (rho = 0.53–0.68) and subteams (rho = 0.53–0.76) with the exception of the physician subteam, for which it was poor (rho = 0.35). Though teamwork scores were generally high, we found differences across units, with a median (interquartile range [IQR]) 4.5 (3.9–4.9) for the lowest and 5.4 (5.3–5.5) for the highest performing unit (P < 0.01). Domain scores differed, with leadership receiving the lowest (median [IQR] = 5.0 [4.6–5.3]), and cooperation/backup behavior and monitoring/situational awareness receiving highest scores (median [IQR] = 5.4 [5.0–5.5] and 5.4 [5.0–5.7]). Differences across subteams were of borderline significance (P = 0.05).CONCLUSIONS:The adapted OTAS instrument demonstrated acceptable reliability for assessing teamwork during SIDR across units, domains, and most subteams. Variation in performance suggests a need to improve consistency of teamwork and emphasizes the importance of leadership. Journal of Hospital Medicine 2012. © 2012 Society of Hospital Medicine

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Patterns of nurse-physician communication and agreement on the plan of care

Abstract: Nurses and physicians did not reliably communicate with one another and were often not in agreement on the plan of care for hospitalised medical patients.

Cited by 75 publications

References 20 publications

Improving teamwork: Impact of structured interdisciplinary rounds on a hospitalist unit

Improving teamwork: Impact of structured interdisciplinary rounds on a hospitalist unit

Clinical handover within the emergency care pathway and the potential risks of clinical handover failure (ECHO): primary research

Assessment of teamwork during structured interdisciplinary rounds on medical units

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