Interdisciplinary Rounds is a patient care improvement strategy that brings members of the care coordination team (case management and social work), members of the medical team (physicians and consultants), members of the therapy team (physical therapists and occupational therapists), and members of the nursing team (nurse manager, primary care nurses, nursing assistants) to a round table discussion regarding patient care and discharge planning.
Traditionally, primary care nurses and nursing assistants were not included in this meeting. It was usually a nurse manager or charge nurse that would attend the meeting as a representative of the entire nursing team. The problem with this is that each individual nurse was not involved in the care planning process, and vital information was being missed. In more recent years, all members of the nursing team are being invited to attend, thus creating a more cohesive gathering of insight that helps everyone understand what needs to be done for the patient to be safely discharged from the hospital.
This “care plan meeting” serves as a brief overview of a the patient’s status, and allows for each member of the interdisciplinary team to present on the patient, identifying any actual or potential barriers to a safe discharge from the hospital. In traditional format, the case manager presents each patient, and then the physician who is caring for the patient will provide an estimated discharge date, pending tests or procedures, and will offer any additional information that helps case management and/or social work arrange for special discharge services such as home care equipment or transfer to another healthcare facility.
After the physician presents, then the nurse caring for that patient has an opportunity to provide updates regarding the patient’s status, advocate for additional needs based off of their assessment and interactions with the patient, and to ask any clarifying questions about patient care. This component of the meeting has proven to be so essential in the discharge planning process because it offers the interdisciplinary team an early alert to any potential barriers that may stand in the way of a timely discharge. Not only does this significantly aide the physician in moving forward with the plan of care for the patient, but it also lets case management and social work know exactly where their focus should go for the day.
In my experience, this streamlining of interdisciplinary knowledge in the early morning of each shift greatly improves patient care outcomes, raises patient satisfaction scores, empowers all healthcare team members with the insight they need to move forward in planning care for the patient, and significantly improves collegiality and professionalism among the healthcare providers involved.
You Want Positive Culture Change? You MUST be an Advocate!
This is one of the most beautifully orchestrated examples of positive culture change that I have witnessed in my 5 years of nursing, and I am a major advocate for the implementation of interdisciplinary rounding. If your facility does not host this very helpful meeting, then I suggest you become an advocate as well – you will be so happy you did!