We're all truly pulling in the exact same direction

1. Patient Care Gains from Bedside IDRs:

Decreasing Unnecessary Care:

• “Pharmacy input does save a lot of medication errors and unnecessary meds.” (Attending 4)

• “We eliminate unnecessary care more often… it makes care more efficient from a utilization and communication standpoint.” (Attending 2)

Screening for Risks and Errors:

• “It was brought to a case manager’s attention right away instead of later on. It brings up barriers and problems that we can triage much earlier.” (Resident 10)

• “Bedside IDR is like a screening tool on where we’re deficient in understanding between providers.” (Resident 27)

Creating a Shared Mental Model of Care:

• “One of the main advantages of multidisciplinary rounds… you don’t have people calling you all day saying, ‘What’s the plan?’” (Resident 38)

• “Bedside IDR allows all team members at one time to explain their problems, concerns, their goals… messages can be crossed.” (Resident 81)

2. Increased Physician Empathy and Understanding:

Increased Understanding of Patient Needs:

• “It makes you consider patients’ priorities more.” (Resident 53)

• “Bedside IDR makes you memorize the patient’s needs better because you’re physically seeing them and hearing them ask about it.” (Resident 10)

Increased Empathy and Understanding of Team Members:

• “You learn perspective of what different teams are worried about, what they’re thinking about.” (Resident 49)

3. Perceptions of Patients’ Experience of Bedside Rounds:

Positive Patient Experiences:

• “Bedside IDR definitely benefits the patient. They feel involved.” (Resident 10)

• “It makes patients happy… it makes them trust that we’re all working on their behalf.” (Attending 8)

Negative Patient Experiences:

• "As a patient, it could be overwhelming to have twelve people in your room at once.” (Resident 18)

4. Challenges Engaging Key Stakeholders:

Engagement and Preparation of Interprofessional Team Members:

• “One pharmacist brings really helpful things to the table; another pharmacist… that’s not helpful.” (Attending 2)

• “When we have new people that are learning how to do IDR, sometimes it does feel like a waste of time when it’s not done well.” (Attending 8)

Engagement of Resident and Attending Physicians:

• “We can buy in to something like this being better for patients if we have time… I don’t know if it’ll ever get as efficient as table rounds.” (Resident 36)

• “Everyone’s concern is that it’s way less efficient… it turns out to be the opposite, far more efficient.” (Attending 1)

5. Navigating Unstandardized Communication in a Standardized Setting:

Concern for Team’s Time:

• “It’s difficult to balance how much you talk to the patient about their concerns during bedside IDR versus later on… I don’t know how to fix it.” (Resident 4)

• “Sometimes IDR makes you self‐conscious about whether to bring something up… it’s a balance and you have to know when it’s appropriate and when it’s not.” (Resident 28)

Patient Centeredness:

• “I’ve always struggled with cutting patients off… if they have any significant questions, you have to say, ‘sorry, we’ll come back and address that later.’” (Resident 50)

• “We don’t really explain [bedside IDR] to people… they just see a group of people who are all doctors that they really want to ask a bunch of questions to.” (Resident 60)