Impact of structured multiprofessional rounds on clinical outcomes in a resource-limited intensive care unit: A
Hiago Sousa Bastos1, Paula De Carvalho Bacelar1, Déborah Lydia Oliveira Da Silva1
1Intensive Care Unit, Hospital Municipal Djalma Marques (HMDM), São Luís, Brazil.
Abstract:
Effective communication among intensive care professionals is essential for patient safety and outcome optimization. Multiprofessional rounds supported by checklists have demonstrated the potential to improve the quality of care, particularly in high-income settings. However, evidence remains limited for low- and middle-income countries (LMICs). We conducted a retrospective observational cohort study of 652 adult patients admitted to the ICU of a tertiary public hospital in Brazil between January 2021 and December 2022. Clinical outcomes were compared for 1 year before and 1 year after the implementation of structured daily multiprofessional rounds, which were guided by a standardized checklist. Clinical severity (SAPS 3), standardized mortality ratio (SMR), invasive mechanical ventilation (IMV), and device use were analyzed using univariate tests and Pearson correlations. Despite a significant increase in illness severity postintervention (SAPS 3: 39.4 vs 60.6; P = .005), the postintervention group showed a substantial reduction in SMR (3.7 to 0.8; P = .001) and IMV duration (10 to 7 days; P = .003). Device usage increased proportionally with the patient acuity. A moderate positive correlation was observed between the SAPS 3 and central venous catheter (CVC) use (R = 0.662; P = .019). The implementation of structured multiprofessional rounds with checklists in a resource-limited public ICU was associated with improved clinical outcomes. Although these findings are promising, future studies with multivariate and prospective designs are required to establish causal relationships.
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