Improving Teamwork and Patient Outcomes with Daily SIBR Multimethod Evaluation
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Overview
In a study conducted at a large tertiary care hospital in regional Australia, the implementation of daily Structured Interdisciplinary Bedside Rounds (SIBR) in an Acute Medical Unit (AMU) improved teamwork, communication, and patient outcomes.
Objectives
To assess the impact of daily Structured Interdisciplinary Bedside Rounds (SIBR) combined with a ward restructure on teamwork, communication, and patient outcomes in an Acute Medical Unit (AMU).
Methods
The study used a convergent parallel multimethod approach involving 32 clinicians and inpatients aged 15 years and above. Data were collected over two years: one year prior to and one year post-intervention. Measures included:
Qualitative: Semi-structured interviews with clinicians.
Quantitative: Length of stay (LOS), cost of care, and monthly clinical response calls.
Results
Teamwork and Communication
Cost of care: 29% reduction in adjusted cost of stay (p=0.012)
Teamwork and Communication
Clinicians reported improved teamwork, communication, and understanding within and between clinical professions and patients.
Greater organization and structure in the AMU were noted, though some nurses felt a loss of ownership and collegiality.
Patient Outcomes
No significant change in LOS between intervention and control wards (P=0.31).
Significant reduction in clinical response calls in the AMU from a mean of 63.1 to 31.5 per month (P=0.004).
Significant interaction for cost of stay ($1,200 USD), with a decrease in the AMU and an increase in control wards (P=0.012).
Conclusion
The implementation of SIBR in an AMU significantly improved teamwork and communication among clinicians, leading to better patient outcomes, such as reduced clinical response calls. Multimethod evaluations are essential to understand the contextual factors contributing to successful interventions.
