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Interdisciplinary Rounds: The Key to Communication, Collaboration, and Agreement on Plan of Care
1Sandra Marlene Terra, DHS, MS, BSN, is CEO and owner of the Terra Firm, Inc, a consulting firm dedicated to improving clinical processes and promoting the role of the case manager. Dr. Terra has over 30 years experience in clinical optimization and case management processes.
Purpose/Objectives:
In the era of Pay for Performance, multiple auditing entities, and shorter length of stays, Interdisciplinary Rounds are the future of hospital care. This article seeks to take a broad look at this tool in its current and historical perspective and examine how it can provide a stable foundation for improved physician-nurse communication, agreement on the plan of care, successful care transitions, and improvements in quality metrics, and reduced length of stay. These rounds reflect the changing attitudes of nurses and physicians toward a more collaborative cooperation, and teamwork, in the delivery of patient care. When supported by strong, visible leadership, they can transform not only direct patient care, but the perception of that care by the patient, families, and caregivers.
Primary Practice Setting:
Acute care hospitals.
Findings And Conclusions:
Properly executed, Interdisciplinary Rounds improve communication among the health care team and provide a basis for agreement upon the plan of care.
Implications For Case Management:
Case management is a logical and frequent choice for a leadership role in Interdisciplinary Rounds. Creating a sustainable culture that drives improved clinical care delivery and reduces readmissions and length of stay requires efforts to ensure clear, concise care transitions. With hospitalist programs and nursing care shifts spanning 12 hr, and several days' off between work days, case management continues to be one of the few constant members of the health care team-often with more knowledge of the episode of care than even the current attending physician. Embracing rounds is a change for the better.
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